Pain Flashcards
(20 cards)
Projections of CN V in the pons
Parabrachial Nucleus
Projections of CN V in the Midbrain
periaquaductal grey matter
Projections of CN V in the Thalamus
VM Nucleus,
MedioDorsal Nucleus
Projections of CN V in the forebrain
globus pallidus- MOTIVATIONAL
amygdala, – EMOTIONAL
Ventral medial Hypothalmus - DANGER RESPONSE
Projections of CN V in the Cortex
S1 – MOTIVATIONAL
Insula - MOTIVATIONAL
Cingulate – EMOTIONAL, MOTIVATIONAL
Locus Ceruleus
Nor Epi generation
What order of cord feedback to pain occurs? ( 4 levels))
- Parabrachial N, Medullary reticular, Locus Ceruleus, Raphe
- Periaquaductal gray
- Amygdala and Hypothalmus
- Somatosensory cortex
How do pain reflexes work?
Raphe nuclei (serotonin) and Locus ceruleus (noradrenalin) Feedback opioids immediately to spinal cord
What are the four types of pain disorders?
nociceptive (cutaneous and visceral)
• inflammatory
• dysfunctional
• neuropathic
Which pain fiber types are mylinated? Which are not?
A-Delta = mylenated and fast C = unmylenated and slow
referred pain
Viceral pain that criss crosses with nocioceptive pain
Inflammatory pain works how?
Mast cells, macrophages, and neutrophils release factors that amplify pain peripherally
allodynia definition
normally nonpainful stimuli become painful
Hyperalgesia
exaggerated pain
Dysfunctional Pain
Fibromyalgia (central amplification)
Rare genetic disorders/channelopathys lead to peripheral amplification
Neuropathic Pain
Maladaptive plasticity
allodynia mechanism
wide dynamic range neurons in the dorsal horns connect C and Abeta fibers
Central sensitization
changes in gene expression that amplify pain signals
Phantom limb pain
maladaptive reorganization
Neuropathic pain tx (5)
Antidepressants – stop NorEpi and seratonin
Anticonvulsants (Na channel) – block extra APs
Anticonvulasnts (Ca Channel) – block extra APs
Opiods - enhance endogenous analgesics
Cannabinoids - reduces pain in amygdala
Topical - Chile peppers overwhelm nerves
