Week 9 ch 49

Question 1

Fast pain examples

Answer 1

sharp, prickling, acute, electric feeling

Question 2

Slow pain examples

Answer 2

burning, aching, throbbing, nauseous, chronic

Question 3

3 types of nociceptors

Answer 3

1. mechanical
2. thermal
3. chemical

Question 4

Fast pain nociceptors:

Answer 4

Mechanical, thermal

Question 5

Slow pain nociceptors:

Answer 5

Mechanical, thermal, chemical

Question 6

Chemicals that do NOT cause AP (examples and what they do)

Answer 6

1. prostaglandins
2. substance P

enhance sensitivity but do not excite (do not cause action potential)

Question 7

Pain receptors and adaptation

Answer 7

do not adapt, excitation becomes progressively greater

Question 8

Tissue damage does what

Answer 8

activates nociceptors

Question 9

Pain correlates with

Answer 9

rate at which damage to the tissue is occuring

Question 10

Tissue ischemia and pain correltaion

Answer 10

greater rate of metabolism, more rapidly pain appears

i.e. blood pressure cuff on still arm or exercising forearem

Question 11

Pain and metabolism correlation

Answer 11

more metabolic tissue = more pain from ischemia

i.e. muscle spasm: muscle spasm causes compression of blood vessels and causes ischemia, muscle spasm is a high rate of metabolism in that muscle

Question 12

Fast pain pathway fibers:

Answer 12

A delta

Question 13

Slow pain pathway fibers;

Answer 13

C

Question 14

Fast sharp pain signals are elicited by

Answer 14

mechanical or thermal pain

Question 15

Sudden painful stimulus gives pain sensation on what fibers?

Answer 15

A delta AND C
(“double” pain sensation)

i.e glucose prick = sharp, then dull throbbing pain

Question 16

Pain fibers terminate on

Answer 16

relay nuerons in DORSAL HORNS

Question 17

Fast pain signals take the ___ pathway

Answer 17

neospinothalmic tract

Question 18

Slow pain fibers take the ____ pathway

Answer 18

Paleospinothalmic tract

Question 19

Fast pain fibers terminate in

Answer 19

lamina I of the dorsal horns

Question 20

2nd order neurons in the fast pain pathway terminate in

Answer 20

1. brain stem
2. ventrobasal complex (in thalamus)

Question 21

What neurotransmitter is at type A delta pain nerve fiber endings?

Answer 21

glutamate

Question 22

Type C fibers are transmitted via thw

Answer 22

paleospinothalmic pathway

Question 23

Type C pain fibers terminate in

Answer 23

spinal cord laminae II and III (substantia gelatinosa)

Question 24

Type C pain fibers cause release of

Answer 24

substance P

Question 25

Slow, chronic paleospinothalmic pathway terminates in

Answer 25

brainstem

Question 26

Pain still felt without cerebral cortex =

Answer 26

lower brain centers cause conscious perception of pain

Question 27

Cordotomy

Answer 27

surgical interruption of thoracic region of spinal cord

Question 28

Built in analgesia system

Answer 28

1. neurons send signals to lower pons and medulla 2. second order neurons transmit to inhibitory complex in dorsal horns 3.Nervous system secretes opiate-like substances

Question 29

Neurtotransmitters in pain suppression/built in analgesia system: (examples and role)

Answer 29

1. enkephalin 2. serotonin role: pre and post synaptic inhibition of type C and A delta pain fibers

Question 30

opiate-like substances secreted by nervous system at end of pain supression pathway:

Answer 30

endorphins enkephalin byproducts dynorphin

Question 31

What depresses transmission of pain signals?

Answer 31

Tactile stimulation of large type A beta sensory fibers i.e. rubbing a painful spot i.e. pressing/pinching an area before a stick

Question 32

Mechanism of referred pain

Answer 32

Visceral pain fibers synapse on teh same second-order neurons that receive pain signals from the skin

Question 33

Examples of diffuse stimulation of pain nerve endings(4):

Answer 33

1. ischemia 2. chemical stimuli 3. Spasm 4. Overdistention

Question 34

Insenstive viscera (2):

Answer 34

1. parenchyma of the liver 2. alveoli of the lungs

Question 35

Parietal pain (definintion and cause)

Answer 35

Friction form membranes rubbing together often from inflammation

Question 36

Parietal pain areas

Answer 36

Peritoneiuum, leura, pericardium

Question 37

Visceral pain is localized

Answer 37

poorly, localized to dermatomal segment from where visceral organ originated

Question 38

Hyperalgesia

Answer 38

hypersensitivity to pain

Question 39

Primary hyperalgesia

Answer 39

excessive sensitivty of receptors

Question 40

Secondary hyperalgesia

Answer 40

additional neurons firing to move neuron towards AP (facilitation of transmission)

Question 41

Herpes zoster is an infection of

Answer 41

dorsal root ganglion

Question 42

Herpes zoster pain in

Answer 42

dermatomal segment affected

Question 43

Pan in herpes zoster thought to be from

Answer 43

infection of pain neuronal cells

Question 44

Tic douloureux is

Answer 44

trigenimal neuraglia

Question 45

Tic Doulreux presentation

Answer 45

Sudden severe pain on one side of face - set off by very sensitive trigger areas (mechanoreceptive) requires surgical treatment

Question 46

Brown-sequard syndrome

Answer 46

Spinal cord transected on one side weaknessor paralysis on same side of transection loss of pain, heat, and cold sensation on oposite side of body

Question 47

Intracranial Headache MOA (3)

Answer 47

1. tugging of venous sinuses around brain -->damage tentorium --> stretching of dura 2. traumatizing stimulus to blood vessels of meninges

Question 48

pain receptors in cerebral vault above tentorium cause

Answer 48

front half of head pain

Question 49

pain receptors located below tentorium cause

Answer 49

occipital head pain

Question 50

Headache types of intracranial origin:

Answer 50

1. meningitis inflammation 2. low CSF fluid pressure 3. MIgraine 4. alcohol headaches

Question 51

Migraine MOA

Answer 51

vasospasm of arteries of head = ischemia to meninges

Question 52

Extracranial headache types:

Answer 52

1. Muscle spasm 2. Nasal 3. Eye disorders

Question 53

Muscle spasm HA MOA

Answer 53

Emotion tension causes muscles of head to become spastic

Question 54

Nasal HA MOA

Answer 54

infection or irritative process (HA behind eyes)

Question 55

Eye disorder HA MOA (2)

Answer 55

excessive contraction of eye ciliary muscles trying to focus eyes Excessive irradiation (sun or welder)

Question 56

Types of thermal receptors (4)

Answer 56

1. Cold - pain 2. Cold - receptors 3. Warmth receptors 5. Heat - pain

Question 57

Cold receptor nerve is

Answer 57

Type A delta (myelinated)

Question 58

thermal sensations travel

Answer 58

up anterolateral pathway

Question 59

Thermal sensation - how?

Answer 59

gradation determined by degree of stimulation of different type of nerve endings

Question 60

Thermal sensation adaptation

Answer 60

cold receptors are fast to adapt but never completely

Question 61

Temp signals terminate in

Answer 61

laminae I, II, III of dorsal horn--->brain stem and thalamus