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Flashcards in Pain lecture 2 Deck (52):
1

What are pain tranducers known as?

-Nociceptors

2

What are the different types of nociceptors?

-Mechanical
-Thermal
-Polymodal
-Chemical

3

What are mechanical subtypes of nociceptors?


-Force
-Trauma

4

What are the receptor types for nociceptors?

-Transient receptor potential
-Prostaglandin/purino and pyrimidine receptors

5

What are the chemical subtype of nociceptors?

-H+ ions

6

What are the thermal subtypes of nociceptors?

-Cold
-Heat

7

What receptor type is found in thermal nociceptors?

-TRP

8

What are polymodal subtypes of nociceptors?

-Mechanical
-Thermal
-Chemical

9

What does Capsaicin activate?

-Polymodal nociceptors TRPV1

10

What is the transmitter for Capsaicin?

-Substance P

11

What is the positive feedback that causes secondary activation of nociceptor nerves?

-Chemical messengers released from activated nociceptor nerve endings act locally to release messengers that further activate the nociceptors

12

Action potentials propagate toward the cell body in the ______ and then enters the ______?

-Dorsal root ganglion
-Spinal cord

13

What is sensitization?

-Increased sensitivity and response to stimuli in and near the injured area caused by chemical messengers that make the nociceptors more excitable

14

What is Hyperalgesia?

-Increased perception of pain in response to painful stimuli

15

What is Allodynia?

-Pain evoked by normally nonpainful stimuli

16

What are the major candidates for sensitization?

-Substance P from nerve endings
-Prostaglandins from damaged cells

17

Prostaglandin receptor stimulation results in activation of what?

-Specific Na+ channels

18

What do you the activation of specific Na+ channels by PG receptor stimulations do?

-Makes the nociceptive nerve endings more excitable

19

Do we have selective COX-1 inhibitors?

-No

20

What is COX-1?

-Is constitutive (always present) in many tissues

21

What does COX-1 do?

-GI cytoprotection
-Platelet aggregation
-Renal electrolyte homeostasis
-Renal blood flow maintenance

22

What are COX -1 inhibited by?

-NSAIDS

23

What are some adverse effects of classic NSAIDS?

-Bleeding
-stomach irritation
-GI side effects

24

What does COX-2 do?

-Pain (inducible)
-Fever (inducible)
-Inflammation (inducible)
-Cardiovascular protection (constitutive)

25

What is COX-2 inhibited by?

-NSAIDS
-Selective COX-2 inhibitors (Celebrex)

26

What stimulated COX-2?

-Hormones
-Growth Factors
-Inflammatory mediators

27

What do NSAIDS inhibit?

-Synthesis of prostaglandins that are involved in sensitizing the nociceptor nerve ending

28

How are nociceptors in the viscera normally activated?

-Mechanical stimulation such and distention or contractions (visceral pain can be referred to outside areas)

29

Do you take NSAIDS for visceral or somatic pain?

-Somatic

30

Which pain pathways are small, myelinated, and fast conducting?

-A -delta

31

What are A-delta fibers associated with?

-Mechanical and thermal nociceptors

32

Are A-beta fibers pain associated?

-No they are proprioception fibers

33

What pain fibers are small, unmyelinated, and slow conducting?

-C axons

34

What are C- axons associated with?

-Polymodal nociceptors

35

What are plexus of nerves in the tooth called?

-Sub-odontoblastic plexus
-Plexus of Raschkow

36

Which fiber gives you sharp pain?

-A-delta

37

Which fiber gives you dull diffuse pain?

-Dull diffuse

38

Nociceptive fibers synapse with "projection" neurons in what area?

-Dorsal horn

39

What are important pain neurotransmitters in modulation?

-Glutamate
-Substance P

40

T/F Projection neurons send axons across midline

True

41

Where do the ascending pathways ascend contralaterally?

-Spinothalamic tract
-Thalamus
-Somatosensory relay

42

Where does the trigeminal nucleus input to?

-Thalamus

43

Where is nociceptive input heavily modulated at?

-=Dorsal horn with both facilitatory and inhibitory influences

44

What is Central sensitization?

-Dorsal horn projection neurons also become sensitized and hyper-responsive to nociceptive input.

45

T/F Prostaglandins can sensitize at the nociceptive level and at the spinal cord level (central sensitization)

True

46

T/F The dorsal horn is a major site of action for analgesic drugs

True

47

What is a second mechanism for the anti-nociceptive action of NSAIDS for central analgesia?

-Inhibits the synthesis of prostaglandins in the dorsal horn that participate in central sensitization

48

T/F The dorsal horn is a major site of action of opioids

True

49

Sometimes strong touch stimulation can inhibit what?

-Nociception

50

T/F A Beta and A delta fibers never converge together

False
-They do converge

51

Visceral afferent nociceptors ________ on the same pain projection neurons as the afferents from the somatic structures in which the pain is perceived?

-Converge

52

What is a type of referred pain that can be thought of a possible dental problem?

-Sinusitis feels like tooth pain sometimes

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