Flashcards in Pain Management Final Exam Deck (77)
Where does morphine cause analgesia which rexed?
Rexed 2 associated with the substantia gelatinousa
Which neurotransmitter is responsible for hyperalgesia?
What are two types of Nociceptive pain?
What are types of Non-nociceptive?
What is Somatic pain?
pain that has an identifiable locus as a result of tissue damage causing the release of chemicals from injured cells that mediate pain. well localized, sharp in nature, generally hurts at the point of stimulus.
i.e. sharp, well localized, hurts in area of stimulus
What is Visceral pain?
diffuse and can be referred to another area. It is often associated with distention of an organ capsule or the obstruction of a hollow viscus. Also, it is often accompanied with autonomic reflexes such as N/V/D.
i.e. dull, cramping, squeezing, vague in nature
What is Neuropathic pain?
caused by damage to peripheral or central neural structures resulting in ABNORMAL processing of painful stimuli.
i.e. burning, tingling, shock-like
What is Idiopathic or Psychogenic pain?
associated with chronic pain states and is used to describe pain that has no apparent cause. Neither nociceptive or non-nociceptive mechanisms can be identified as a cause for pain and psychological symptoms are commonly present.Still real pain.
What is transduction?
the transformation of a noxious stimulus(chemical, mechanical or thermal) into an action potential.
Describe A-delta nerve fibers.
Large, myelinated, primary afferent neurons conduct action potentials at velocities between 6 and 30 m/sec and elicit sharp pain (mechanical and chemical?thermal?)
Describe C nerve fibers.
Nonmyelinated C fibers Smaller, conduct at velocities between 0.5 and 2 m/sec, aka polymodal fibers because they respond to mechanical, thermal, and chemical injuries, slow pain, chronic pain, dull, burning, throbbing, aching
Chemical mediators and neurotransmitters stimulate peripheral nociceptors causing an influx of ___ ions to enter the nerve fiber membranes. This is called ___. There is a subsequent efflux of ___ ions from the nerve fiber membrane which is called ___. An action potential is the result and a pain impulse is generated.
What are the primary afferent neurons?
-A delta fibers
Primary afferent neurons have cell bodies in the.....?
dorsal root ganglia of the spinal cord, ascend or descend several spinal segments in the Tract of Lassoer
In the Spinothalamic(anterolateral) system what are the two types of second-order neurons?
What is the function of the nociceptive neurons of the Spinothalamic system?
receive input solely from primary afferent A delta and C fibers
What is the function of the WDR neurons of the Spinothalamic system?
receive input from both nociceptive and non-nociceptive primary afferents. WDR neurons are activated by a variety of stimulants(innocuous and noxious).
What is the Spinothalamic (anterolateral) system?
a sensory pathway from the skin to the thalamus.
Primary afferent nuerons(a delta and C fibers) have cell bodies in the dorsal root ganglia of the spinal cord
after leaving the tract of Lissauer, the axons of the primary afferents enter the gray matter of the dorsal horn where they synapse with second-order neurons and terminate primarily in LR I, II, V
first order neurons terminate primarily in
LR I, II, V
Where are third order neuron?
in thalamus to cortex where perception takes place
Where does pain modulation take place?
descending efferent pathways
what is considered the body's analgesic system/pain control system
the descending efferent modulatory pathways from the brain
descending axons from the cerebral cortex, hypothalamus, thalamus, periaquaductal gray, nucleus raphe magnus, and locus corealus via the _____ ______ synapse with and suppress pain transmission to the ____ and the ___ ___ ____ ____.
-spinal cord dorsal horn
What is the efferent pathway?
descending dorsolateral funiculus- body's analgesic system
What is Central Sterilization?
inadequately controlled acute pain that recruits Beta fibers, constantly barraged with nociceptive input, threshold decreases d/t spasticity of upper brain centers, then turns into plasticity-- the reconfiguring of upper brain centers to painful stimulus
Substance P receptors?
Neurokinin 1 and 2
NMDA, AMPA, kainate
another name for tract