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Dent 6600 - Physiology > Peripheral mechanisms of pain > Flashcards

Peripheral mechanisms of pain Flashcards

(62 cards)

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1
Q

“normal” pain is mediated by

A

A-delta & C fibers

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2
Q

pathological pain “hyperalgesia” is mediated by

A

peripheral and central sensitization

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3
Q

which fiber type makes up majority of cutaneous nociceptors?

A

C fibers (87%)

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4
Q

this nociceptor type is unmyelinated and very small

A

C fibers

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5
Q

this nociceptor type contains a limited neuropeptide content

A

A-delta fibers

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6
Q

nociceptive specific to noxious mechanical stimuli with limited response to thermal and heat

A

A-delta fibers

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7
Q

nociceptive specific to mechanical, chemical, thermal stimuli

A

C-fibers

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8
Q

nociceptor for “first pain” - fast, sharp, well localized

A

A-delta fibers

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9
Q

nociceptor for “second pain” - dull, burning, poorly localized

A

C fibers

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10
Q

this type of pain receptor can be found on odontoblasts and therefore has a possible role in tooth pain

A

TRP receptor

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11
Q

Trigeminal nerve branches with prominent chemesthesis

A

nasal - ethmoid
oral - nasopalatine
posterior palatine
lingual nerve

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12
Q

chemesthesis is mediated by:

A

TRP receptors

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13
Q

tooth pain fibers

A

A-delta & C fibers

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14
Q

dentinal tubules have what kinds of fibers?

A

A-delta fibers

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15
Q

Pulp chamber has what kind of fibers?

A

C fibers

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16
Q

A-delta fibers of dentinal tubules

A

extend a little into dentin tubules
contain CGRP
mechanical & thermal sensitivity
sharp pain

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17
Q

C-fibers of pulp chamber

A

dull, throbbing apin
contain Substance P
thermal sensitivity
chemosensitivity to inflammatory mediators

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18
Q

fiber type responds to algesic stimuli such as Bradykinin (BK)

A

pulp chamber C-fibers

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19
Q

A-delta fibers respond to which types of chemical stimuli?

A

NH4Cl and NaCl

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20
Q

C-fibers respond to which types of chemical stimuli?

A

Bradykinin (BK) and Histamine

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21
Q

Fibers respond mainly to inflammatory mediators

A

Pulpal C-fibers

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22
Q

theories of sharp pain

A
  1. neuron theory
  2. hydrodynamic theory
  3. odontoblast theory
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23
Q

smear layer for pain transduction

A

necessary to avoid pain when high pressure applied to dentinal tubules
used in root canal walls

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24
Q

EDTA does what?

A

dissolve smear layer = pain

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25
odontoblast TRP thermoreceptors
TRPV1, 2, 3 TRPM8 TRPA1
26
odontoblast TRP mechanoreceptors
TRPV4 TRPM3 TRPP1, 2
27
purinergic signaling
part of odontoblast transducer theory | extracellular signaling mediated by purine nucleotides (adenosine, ATP)
28
Steps in odontoblast signaling
1. depolarization by TRP receptors 2. initiation of AP 3. release of ATP via membrane channels 4. afferent nerve response via P2X3 channels
29
P2X3
a type of nerve fiber found in pulp | present in both myelinated and unmyelinated pulpal nerve fibers
30
P2X3 receptors
nociceptive afferent nerve fiber
31
odontoblasts have what kinds of channels?
voltage gated Na+ channels
32
variety of TRP receptors can be found where?
odontoblasts | dentinal tubule innervating fibers
33
hyperalgesia
greater responsiveness to stimuli, allodynia | pain is prolonged and spontaneous
34
allodynia
response to non-painful stimuli produces pain
35
CGRP leads to
vasodilation and swelling | mechanical stimulus to C-fiber
36
Substance P leads to
mast cell > release histamine > stimulate C fiber
37
events after thermal or mechanical injury:
C-fiber releases substance P or CGRP > SP releases mast cells > histamine release > C fiber stimulated > CGRP leads to swelling > mechanical stimulus to C fiber
38
sensitize C-fibers rather than direct excitation
prostaglandins cytokines protons released from inflamed tissue that stim. vanilloid receptors
39
cytokines that sensitize C-fibers
interleukins, TNF
40
role of NGF in peripheral sensitization
induces local receptor trafficking retrograde transport of signaling endosomes to promote gene expression bind to high affinity TrkA receptor forming complex that sensitizes nociceptor
41
T/F? Prostaglandins directly depolarize neuron
false
42
TTX
fish substance that blocks sodium channels
43
A-fiber sodium channels are TTX _____ and potassium channels are ________
TTX sensitive ; Bradykinin
44
C-fiber sodium channels are TTX _______ and potassium channels are __________
TTX resistant ; Bradykinin and SK
45
prostaglandins block what channel
SK
46
Vanilloid receptor (TRPV1 or V1) lower threshold by:
- inflammatory mediators (BK and protons) - Ca++ activated phosphorylation of VR1 receptor - increase in # of receptors
47
neurogenic inflammation
substance P > histamine release | CGRP > swelling, vasodilation
48
direct stimulation of nociceptors
histamine (mast cells) bradykinin (blood clotting) 5HT (platelets)
49
sensitization of nociceptors
prostaglandins (affect K+ channels) proton release from inflamed tissue (TRPV1 vanilloid) NGF (increases receptor trafficking)
50
mechanisms of hyperalgesia - allodynia
TRPV1 sensitization = lower temperature threshold | Prostaglandin sensitization= lower mechanical threshold
51
inflammatory mediators do what to peripheral stimulus
augment (add to) = greater response to painful stimuli, makes it prolonged and spontaneous
52
causalgia
burning pain
53
sympathetic nerve dystrophy
temperature induced pain
54
NGF secreted by
Schwann cells
55
promotes sprouting and regulates gene expression
NGF
56
NGF transported to
ganglion cell body
57
Schwann cells produce _______ for regenerating axons
laminin
58
ectopic discharge
1. spontaneous activity 2. prolonged response to known stimulus 3. initiation of response from atypical site (ganglion) 4. injury > increase in # Na+ channels response to catecholamines - activity evoked locally, not by normal receptor ending
59
ephaptic transmission is the mechanism for:
allodynia (pain response to nonpainful stimulus) | referred pain
60
sprouting
increased fiber density | induced by NGF
61
contain CGRP
dentinal tubule fibers
62
contain Substance P
pulpal fibers

Dent 6600 - Physiology (3 decks)

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