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Block 5 ellen > Pain and nociception L9 > Flashcards

Pain and nociception L9 Flashcards

(63 cards)

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1
Q

Pain=

A

unpleasant sensory and emotional experience associated with actual or potential damage (subjective response)

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2
Q

Nociception=

A

The neural processes of detecting, encoding and processing noxious stimuli
(physiological response)

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3
Q

pain based on origin can be; (2)

A

Somatic

Visceral

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4
Q

Visceral pain=

A

organs of thorax and abdominal cavity

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5
Q

Somatic pain=

A

superficial or/

deep

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6
Q

Superficial pain=

A

sharp brief pain (pinching)

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7
Q

Based on duration pain can be either

A

chronic or/

acute

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8
Q

Chronic pain= (3)

A

persists
ill defined onset
poorly treatable

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9
Q

Acute pain= (3)

A

resolves when injury heels
adequately treatable
recent well defined onset

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10
Q

nociception involves

A

PNS and CNS

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11
Q

nociceptors=

A

sensors found in most body tissues that respond to noxious stimuli

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12
Q

Nociception is separate to

A

somatosensory

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13
Q

Where has no nociceptors

A

the brain

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14
Q

What two things are nociceptors characterised by

A

axon properties

receptor channels

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15
Q

What is special about the end of nociceptors

A

unspecialised (free) nerve endings

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16
Q

Types of nociceptors

A 
thermal 
mechanical 
Chemical 
Polymodal 
Sleeping/ silent
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17
Q

What are polymodal nociceptors

A

include thermal, mechanical, chemical stimuli

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18
Q

What are sleeping/ silent nociceptors

A

inflammation, only once injury has occurred

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19
Q

What fibres are large diameter, rapidly conducting

A

A alpha and A beta

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20
Q

What receptors are associated with A alpha and B beta

A

Low threshold mechanoreceptors

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21
Q

Small diameter, slow conducting afferents=

A

A delta and C fibres

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22
Q

What are A delta associated with

A

nociceptors and thermo-receptors

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23
Q

What are C fibres associated with

A

polymodal nociceptors

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24
Q

What is first pain (4)

A

Sharp or prickling
fast A delta fibres
Mechanical or thermal nociceptors
rapid and short

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25
what is second pain (4)
dull, aching, burning Slow C fibres slow onset and long duration Polymodal nociceptors
26
what neurotransmitters are associated with nociception
glutamate and substance P
27
What do gene mutations in Na+ channels (specific to nociceptors) lead to
congenital analgesia
28
What is cogenital analgesia
insensitivity to pain (internally and externally)
29
Which is the nociceptive pathway
spinothalamic pathway
30
where do sensory inputs from the spinothalamic pathway decussate
2 levels up on the spinal cord (ascend on opposite side)
31
In the spinothalamic pathway where does the information travel from the medulla
to the thalamus----> then to the somatosensory cortex
32
What causes our emotional response to pain
side pathways to the hypothalamus and limbic system
33
What causes our alertness from pain
reticular formation
34
Where does the DCML pathway decussate
in the medulla
35
What does the DCML pathway carry signals off
Touch, vibration proprioception
36
Where does pain from the face and head enter the pons
cranial nerves 5,7,9 and 10
37
What is the tract for face pain called
spinal trigeminal tract
38
What fibres is tooth pulp innervated by
c and A delta fibres
39
What causes referred pain
convergance of nociceptor inputs from viscera and skin
40
Where is heart pain referred
chest and left arm
41
Where is early appendicitis referred to
abdominal wall
42
What is a phantom limb
sensation that a missing limb is still attached to the body and moving appropriately
43
what is phantom limb pain
chronic pain in phantom limb
44
Treatment for phantom limb pain
mirror therapy | stump stimulation
45
what is gate theory
co-activation of A alpha/ beta (not nociceptors) suppresses activation of C fibres (nociception)
46
Where is perception of pain modulated
higher brain centres
47
What can suppress pain
strong emotions, stress, stoic determination
48
Dissociation=
central modulation of pain
49
Hyperalgesia=
increased pain sensitivity (reduced threshold) | Caused by C afferents ---> stimulus that normally evokes pain
50
allodynia=
touched evoked pain | caused by Beta afferents (stimulus that does NOT normally evoke pain. )
51
What can induce hyperalgesia
the sensitisation of peripheral nociceptors; by tissue damage/ inflammation releasing substance P, histamine ect
52
primary hyperalgesia
occurs at the site of tissue damage
53
secondary hyperalgesia
occurs around the site of tissue damage
54
What is fibromyalgia
medical disorder characterised by chronic widespread pain and allodynia
55
symptoms of fibromyalgia
fatigue difficulty sleeping muscle stiffness IBS
56
Treatment for fibromyalgia
analgesics antidepressants exercise counselling
57
back pain
is the number one cause of disability in Britain
58
Pharmacological pain treatment overview
opioids NSAID Local anaesthetics Psychotropic drugs
59
What do Opioids produce
analgesia (pain relief)
60
where do opioids bind
to opioid receptors in the brain
61
Three types of opioid receptors
Mu Delta Kappa
62
6 clinical analgesics
``` Morphine Diamorphine (heroin) Codeine Fentanyl Pethidine Tramadol ```
63
When not have to morphine
acute respiratory depression

Block 5 ellen (17 decks)

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