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Disease, Diagnostics and Therapeutics > Sensory System and Pain > Flashcards

Sensory System and Pain Flashcards

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1
Q

How do anticonvulsant drugs effect GABA

A

agonists to chloride conductance, blocking GABA reuptake or inhibiting its metabolism by GABA transaminase

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2
Q

Why is the ear drum larger than the oval window

A

to allow the wave frequency to be transferred through the fluid of the cochlea

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3
Q

describe the A delta fibres

A

fast
large myelinated
up to 10m/sec
sharp stabbing pain

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4
Q

True or false: Low plasma drug = low Vd = drug not widely distributed

A

False

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5
Q

What happens when glutamate binds to a mGlu receptor

A

Gαq

PLC –> IP3 + DAG –> Ca2+ via IP3 R on ER–> Ca2+ + DAG –> PKC

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6
Q

State the 3 ionotropic glutamate receptors

A

NMDA
AMPA
Kainate

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7
Q

What are the two types of spontaneous pain

A

continuous and paroxysmal (intermittent) pain

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8
Q

What does ketamine antagonise to cause effects

A

NMDA- , which prevents excitatory stimuli inducing a state of euphoria/sleep

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9
Q

What do thermoreceptors sense

A

Temperature

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10
Q

Explain the steps of photoreception

A

Light activating photoreceptors –> conformational change –> decreased glutamate release

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11
Q

What does the organ of corti contain

A

hair cells and the auditory nerve

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12
Q

What is GABA converted to for breakdown

A

succinate

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13
Q

Describe non-depolarising neuromuscular blockers

A

Curare Derivatives
No Na influx, muscle is relaxed
Prevents ACh binding to receptors
Inhibits respiratory muscle such as the diaphragm

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14
Q

Give effects of opioids

A

analgesia, constipation, sedation, respiratory depression, and mood alteration

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15
Q

What are anticonvulsant drugs

A

a diverse group of drugs used in the treatment of seizures such as epilepsy. They suppress excessive rapid firing of neurons during seizures and prevent the spread through the brain.

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16
Q

What does Gi inhibit

A

adenylate cyclase

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17
Q

What is the role of glycine

A

potentiate NMDA signalling

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18
Q

What do photoreceptors sense

A

vision

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19
Q

What is the calculation for the volume of distribution

A

(amount of drug in body (dose))/(plasma concentration (extrapolated))

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20
Q

Does the ear canal or cochlea have cells with cilia

A

cochlea

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21
Q

When light hits the excitatory portion of the receptive field, what happens

A

the photoreceptor becomes hyperpolarised, and the process of photoreception occurs

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22
Q

What are the three layers of the retina

A
  • epithelial cells
  • photoreceptors
  • bipolar/ganglion/amacrine cells
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23
Q

Describe the withdrawal reflex

A
  • Pain signal travels along the Ad fibre, to the dorsal root ganglion
  • travels across an interneuron to the anterior horn cell
  • travels along a motor neuron to move e..g the hand
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24
Q

Define Peripheral sensitisation

A

sensory neuron expression of α-adrenoreceptors, so more stress means more pain, and overexpression of V-G Na+, which increases AP production and increases stimuli above the original injury.

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25
describe the C fibres
slow small unmyelinated 1.2m/sec aching burning pain
26
``` How is the activity of NMDA receptors controlled? A. voltage-gated B. ligand-gated C. enzyme antagonist D. all of the above ```
D NMDA receptors are both voltage-gated and ligand-gated: they will only open the ion channels if the membrane is depolarized and the neurotransmitters glutamate and glycine are attached. When the membrane is not depolarized the activity of the NMDA receptors is blocked as Mg2+ acts as an enzyme antagonist.
27
How does neostigmine work
inhibits AchE activity, so Ach is not broken down in the synaptic cleft and continues to activation the nicotinic ACHR, for Na+ to cause depolarisation and contraction.
28
what are the two types of pain conduction
fast response - A delta fibres slow response - C fibres
29
What is the purpose of GABAa channels
Causes hyperpolarisation which reduces excitability
30
what is the pain pathway
injury --> peripheral nerve (afferent neurone, excitatory (glutamate and ATP release)) --> spinal cord - receptor binding, AMPA (fast), NMPA (slower, release block of prolonged depolarisation) --> thalamus --> cortex
31
What is glycine
Glycine is an inhibitory neurotransmitter
32
What is the retina
a thin layer of tissue, lining the back of the eye. It receives the light that the lens has focused and converts it to neural signals, sending these to the brain for visual recognition.
33
What type of channels are GABAa
Ligand gated chloride channels
34
what is a precursor of glutamate
glutamine
35
What happens when glutamate binds to a NMDA receptor
When glutamate and glycine bind to the NMDA receptors the conformation of the protein changes and Ca2+ permeable ion channels open.
36
Symptoms of phantom pain
* Continuous or paroxysmal pain * Often effects part of the limb furthest from the body * Shooting, stabbing, burning, throbbing pain * May be triggered by pressure on remaining part of the limb, or emotional stress
37
What types of non-medication may be helpful for phantom pain
* Acupuncture * Massage of the residual limb * Use of a shrinker * Repositioning of the residual limb by propping on a pillow or cushion * Mirror box therapy * Biofeedback * TENS (transcutaneous electrical nerve stimulation) * Virtual reality therapy * Imagery
38
What do nociceptors sense
extremes of pain and temperature
39
Which fibres are the fast pain conductance
A delta fibres
40
what is the predominant precursor of GABA
glucose
41
What is the receptive field
Areas of the retina which change membrane potential in the presence of light. Every cell of the retina has one.
42
Describe depolarising neuromuscular blockers
Succinylcholine Blockade for a few minutes Metabolised by plasma cholinesterase Causes persistent refractory depolarisation
43
What can alter sensitivity (broadly), and give examples
inflammatory mediators such as K+, H+, histamine, ATP, prostaglandins, bradykinin, substance P, 5-HT.
44
What types of medication may be helpful for phantom pain
* Non-steroidal anti-inflammatory drugs (NSAIDs) * Opioids (narcotic pain medications) * Antidepressants * Anticonvulsants * Beta-blockers * Muscle relaxants.
45
Is GABA an inhibitory or excitatory neurotransmitter
inhibitory
46
True or False: Low plasma drug = high vd = drug widely distributed in other tissues
True
47
what can the volume of distribution be affected by
* Drug size * Drug lipophilicity (pKa/pH) * Plasma protein binding * Body composition * Patient age/gender
48
State the metabotropic glutamate receptor
mGLu
49
By blocking the sodium/calcium channels, how do anticonvulsant drugs help?
they reduce the release of glutamate as by stabilising the channels in an inactive state, they prevent the repetitive firing of the axons
50
How does botox work
cleaves SNARE proteins to stop Ach vesicles fusing to the terminal bouton. This prevents exocytosis, and ‘freezes’ the muscle
51
What is phantom pain
as ongoing painful sensations which seem to be coming from a body part which is no longer there
52
Is glutamate essential or non-essential
non-essential
53
What do chemoreceptors sense
olfaction, taste, arterial PO2,
54
what are photoreceptor cells
light-sensitive cells responsible for detecting the intensity and colour of light.
55
What do mechanoreceptors sense
touch, audition, vestibulation
56
Which fibres are the slow pain conductance
C fibres
57
Is glutamate an inhibitory or excitatory neurotransmitter
excitatory
58
Which nerves do sensory receptors send signals along? and where to?
afferent nerves to the CNS
59
What is a neuromuscular blocker
A molecule which acts at a neuromuscular junction to prevent normal action of ACh.
60
Are glutamate receptors ionotropic or metabotropic
Both/either
61
Define anesthesia
a state of temporary induced loss of sensation/awareness
62
True or false: The brain shows activity when the person feels phantom pain, even if neurologically, it is no longer connected
True
63
What is the calculation for clearance
([drug]in urine x urine flow rate)/([drug]in plasma)
64
What do glutamate receptors synapse with
sensory neurons in the spinal cord
65
how do opioids works
By inhibiting the descending pathway from the cortex and midbrain, they prevent pain signals from happening
66
``` What neurological functions are not thought to be influenced by glutamate activity? A. memory formation B. learning C. arousal D. movement ```
C is correct. Glutamate is a very common excitatory neurotransmitter that is involved in memory formation, learning, and movement. Arousal is thought to be influenced by the excitatory neurotransmitter norepinephrine.
67
Anaesthetics are agonists of which type of receptor
GABAa agonists
68
What factors affect renal clearance
* Renal blood flow/kidney function * Drug lipophilicity * Plasma protein binding
69
What is the pKa
the pH at which 50% of the molecules exist in the tertiary form and 50% exist in the quaternary form
70
What is the pKa value for all anaesthetics
>7.4
71
What does Go do
decrease the neuronal excitability, having an inhibitory effect. This opens K+ channels and causes membrane hyperpolarisation meaning they are less likely to fire action potentials
72
What is the ionisation constant
(pKa) for an anaesthetic predicts the proportion of molecules which exist in each of the states
73
What is the volume of distribution
The volumes in which total amount of drug would need to be dissolved to match plasma concentration.
74
True or false: AchE can hydrolyse suxamethonium
False
75
What is the precursor to glycine
Serine
76
True or false: More than one photoreceptor can become hyperpolarised for each bipolar cell.
true
77
What is the most abundant g protein in the CNS
Go
78
What type of channels are GABAb
Gi/GO
79
What is neuropathic pain
Caused by damage or disease of the somatosensory nervous system, rather than stimulation of pain receptors
80
Which GCPR signalling pathway do opioids use
Gi/Go signalling pathway.
81
Is the ear canal or cochlea fluid filled
cochlea
82
what prevents the opening of the NMDA receptor ion channels when the membrane is not depolarized
a voltage-dependent Mg2+ block
83
``` How many classes of glutamate receptor subunits are found in NMDA receptors? A. two B. five C. ten D. one ```
A is correct. While each NMDA receptor is made up of five subunits, these subunits fall into two classes of glutamate receptor subunit family.
84
What is the purpose of GABAb channels
Inhibits VOCCs & opens K+ channels | =reduces excitability
85
If there is a decrease in GiGo inhibitory VOCCs/K release, does this increase or decrease excitation?
Increase
86
If there is less glutamate, and a decrease in NMDA and AMPA receptors, is there more or less excitation?
Less

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