Unit 2_Pain

Question 1

What is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage?

Answer 1

Pain

Question 2

Pain is always a _________ ________that is influenced to varying degrees by biological, psychological, and social factors.

Answer 2

personal experience

Question 3

Pain and ________ are different phenomena. Pain cannot be inferred solely from activity in sensory neurons.

Answer 3

nociception

Question 4

Through their life experiences, individuals learn what?

Answer 4

the concept of pain

Question 5

A person’s report of an experience as pain should be what?

Answer 5

respected

Question 6

Although pain usually serves an adaptive role, it may have _______ ________ on function and social and psychological well-being.

Answer 6

adverse effects

Question 7

What is only one of several behaviors to express pain?

Answer 7

Verbal description

Question 8

What type of pain fibers presents as fast pain = pinprick, extreme cold temp?

Answer 8

Type A Delta

Question 9

What type of pain fibers presents as slow pain, “dull” “burning”, hot temp?

Answer 9

Type C

Question 10

What type of pain fibers react to mechanical (squishing your finger, extreme temperatures) stimuli (–> Na+ influx into cell –> action potential) –> A Delta fibers?

Answer 10

Nociceptors

Question 11

What results in pain releases chemicals (e.g., H+, K+, histamine) –> C fibers?

Answer 11

Tissue damage

Question 12

What type of are Merkel’s discs, peritrichial, and most important free nerve endings –> A Delta + C fibers?

Answer 12

crude touch + superficial pressures

Question 13

What makes the difference in transduction speed?

Answer 13

Myelination

Question 14

We experience adaptation from acute (sharp, short-lasting) to _______ pain (longer lasting, vanishes when the injury has healed).

Answer 14

persistent

Question 15

Pain can be attributed to any what (example spicy food)?

Answer 15

sensation

Question 16

What pathway does pain travel in?

Answer 16

ALS

Question 17

Pain from the body will relay through what?

Answer 17

the ventral posteriolateral thalamic nuclei

Question 18

Pain from the face will relay through what?

Answer 18

the ventral posteriomedial thalamic nuclei

Question 19

Pain from the face enters what structure and immediately crosses?

Answer 19

The medulla

Question 20

In the cortex, pain will be perceived on what side?

Answer 20

Contralateral

Question 21

What initiate pain responses (autonomic and endogenous)?

Answer 21

Pain from the spinoreticular and spinomesencephalic pathways

Question 22

Approximately what percentage of afferent C fibers synapse in the reticular formation, which alerts almost the entire cerebral cortex?

Answer 22

85%

Question 23

What carries information from the spinal cord to the parabrachial nucleus of the dorsolateral pons?

Answer 23

spinoparabrachial tract

Question 24

What do the spinoparabrachial tract neurons target, including the insular and anterior cingulate cortex, which process emotional features of the pain experience?

Answer 24

limbic forebrain regions

Question 25

What is an inflammatory response to tissue damage?

Answer 25

NOCICEPTIVE STIMULI

Question 26

What are released by damaged tissues augment the response of nociceptive fibers (chemically)?

Answer 26

Substances

Question 27

What cause the release of peptides and neurotransmitters that further inflammatory responses?

Answer 27

Nociceptors

Question 28

What is sensation in areas associated with tissue damage are perceived as more painful than if tissue was not damaged?

Answer 28

Hyperalgesia

Question 29

What is sensation that is not painful is perceived as painful due to peripheral sensitization?

Answer 29

Allodynia

Question 30

What in the dorsal root ganglia send their axons via the dorsal roots to terminate in the dorsal horn of the spinal cord? Afferents branch and course for several segments up and down the spinal cord in Lissauer’s tract*, giving rise to collateral branches that terminate in the dorsal horn. Second-order neurons in the dorsal horn send their axons (black) across the midline to ascend to higher levels in the anterolateral column of the spinal cord.

Answer 30

Primary afferents in the anterolateral tract

Question 31

What type of fibers terminate in Rexed’s laminae I and II of the dorsal horn, while A Beta fibers terminate in laminae I and V? The axons of second-order neurons in laminae I and V cross the midline and ascend to higher centers.

Answer 31

Type C fiber

Question 32

What accounts for the fact that activation of low-threshold primary afferent fibers can attenuate pain? The two classes of sensory fibers also terminate on the inhibitory interneurons; the C fibers indirectly inhibit the interneurons, thus increasing the activity of the projection neurons (thereby “opening the gate”), whereas the Aβ fibers excite the interneurons, thus suppressing the output of the projection neurons (and “closing the gate”).

Answer 32

Gate Control Theory - Central Modulation

Question 33

What kind of pathway arises in the nucleus raphe magnus and projects to the dorsal horn of the spinal cord as part of the ENDOGENOUS OPIODS EFFERENT PATHS?

Answer 33

A serotonergic pathway

Question 34

What system arises in the locus coeruleus and other nuclei in the pons and medulla as part of the ENDOGENOUS OPIODS EFFERENT PATHS?

Answer 34

A noradrenergic system

Question 35

In the spinal cord, what descending pathways inhibit nociceptive projection neurons through direct connections as well as through interneurons in the superficial layers of the dorsal horn? These sites express endogenous opioids and are the targets for drugs like natural or synthetic opioids (e.g., morphine).

Answer 35

A serotonergic pathway A noradrenergic system

Question 36

Both the serotonergic nucleus raphe magnus and noradrenergic nuclei receive input from neurons in what region?

Answer 36

in the periaqueductal gray region

Question 37

What decrease the duration of the postsynaptic potential, probably by reducing Ca2+ influx, and thus decrease the release of transmitter from the primary sensory terminals? In addition, opiates hyperpolarize the dorsal horn neurons by activating a K+ conductance and thus decrease the amplitude of the postsynaptic potential in the dorsal horn neuron.

Answer 37

Opiates

Question 38

What forebrain areas, including the anterior cingulate cortex (ACC), other frontal cortical areas, the hypothalamus (H) and central nucleus of the amygdala project to the midbrain periaqueductal grey (PAG), which can be thought of as a main output pathway of the limbic system?

Answer 38

Limbic

Question 39

The separate components that convey, modulate, and control pain do not act in what?

Answer 39

Isolation

Question 40

Interconnections happen between what of the cortex and areas that control emotions and the somatosensory system?

Answer 40

regions

Question 41

What in the hypothalamus activate the autonomic nervous system that controls the body’s responses to pain, such as grimacing, tearing, or sweating?

Answer 41

Neurons

Question 42

What can be an abnormal response to a lesion or an intervention and is a condition in which pain is experienced every day for three months or longer and lasts beyond the expected period of healing. It is referred to as chronic pain?

Answer 42

Severe, long-lasting pain (this does not include the normal persistent pain response that disappears when an injury has healed)

Question 43

What show altered neural activity of many areas in the pain matrix, e.g., the insula cortex (Ins), prefrontal cortex (PFC), anterior cingulate cortex (ACC), and amygdala (Amg) in patients with chronic pain?

Answer 43

Imaging studies with magnetic resonance tomography (MRI)

Question 44

What are 2 aspects to the pain experience?

Answer 44

The spinothalamic tract The affective (emotions) and motivational aspects of second pain

Question 45

What conveys signals that mediate the sensory discrimination of first pain?

Answer 45

The spinothalamic tract

Question 46

What are mediated by complex pathways that reach integrative centers in the limbic forebrain?

Answer 46

The affective (emotions) and motivational aspects of second pain

Question 47

What is a positive physical or psychological change that occurs after taking medication without an active ingredient?

Answer 47

The placebo effect

Question 48

What is a negative physical or psychological change that occurs after taking medication without or without and active ingredient?

Answer 48

The nocebo effect