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BSO6 Neuro > Workshop 8 > Flashcards

Workshop 8 Flashcards

(64 cards)

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1
Q

Pain Def

A

An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage

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2
Q

Peripheral Sensation

A

abnormally increased input to the spinal cord

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3
Q

Nociceptors

A

peripheral sensory neurons that detect potenially damaging stimuli

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4
Q

External nociceptors

A

found in tissues, skin, corneas, mucosae

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5
Q

Internal Nocicpetors

A

various organs, mm, joints, viscera

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6
Q

C-Polymodal=C fibres

A

most numerous type
Unmyelinated, slow conducting 2m/second
prolonged burning, aching

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7
Q

Ao Nociceptors

A

thinly myelinated, rapidly conduction 20m/secomd
brief, sharp, stabbing

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8
Q

Somatic Nociceptive Pain characteristics

A

Intermittent
Sharper on Movement, duller at rest
Local to injury
Proportionate to the injury
Proportionate to aggravating and relieving factors

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9
Q

Nociceptors:

A

smallest unmyelinated or lightly myelinated primary afferent nerve fibres

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10
Q

Spatial Summation

A

signals coming from multiple simultaneous input

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11
Q

Temporal Summation

A

summation comes from repeated input

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12
Q

Visceral Nociceptive Pain

A

often diffuse
poorly localised

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13
Q

Visceral Nociceptive Pain- Spatial Summation?

A

large area is stimulated, pain theresold is lowered

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14
Q

Neuropathic Pain def

A

lesion caused by a lesion of the somatosensory Nervous System

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15
Q

Causes of Neuropathic Pain

A

trauma, infection, ischaemia, neoplasia, chemical/drug induced

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16
Q

Central Neuropathic Pain

A

caused lesion or disease of the central somatosensory nervous system

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17
Q

Peripheral Neuropathic Pain

A

caused by a lesion or disease of the peripheral somatosensory nervous system

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18
Q

Neuropathic Pain characteristics

A

constant, intense
Associated positive or negative sensory symptoms
Associated autonomic findings
often aggravated by emotional, stress or sleep related triggers
Very difficult to manage
Responds poorly to typical analgesics
Responds better to neural modulators

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19
Q

Stages in Pain Perception

A

1: Transduction: noxious stimuli are converted into electrophysiological activity
2: Conduction: action potential travels to the dorsal horns of the spinal cord
3: Transmission: info is relayed via spinal cord, to brainstem & thalamus
4: Modulation:
Involves both excitatory and inhibitory mechanisms
5: Perception: Cortex finally registers the modulated sensation of pain
6: Supraspinal Responses: Connections b/w the thalamus and higher cortical centres control perception and integrate the affective responses to pain

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20
Q

Transduction

A

Conversion of Noxious Stimuli into the action potential

Nociceptor Stimulation creates an ion reflux via gated channels

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21
Q

Stages of Transmission

A

Central processes of the nociceptors enter the spinal cord via dorsal roots where they synapse with 2nd oorder neurons in the dorsal horn

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22
Q

Major Pathway involved in the Transmission process

A

Spinothalamic Tract, originated in Rexed laminae 1 and 5-7

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23
Q

Role of Lamina 1 cells

A

Project to the posterior part of the ventromedial nucleus of the thalamus and mediate the autonomic/unpleasant emotional perception of pain

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24
Q

What direction do STT axons cross?

A

Locally and ascend Contra-lateral

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25
Modulation
Descending axons from the brainstem synapse in the dorsal horn and modulate nociceptive transmission
26
Non-Noxious Stimuli?
can inhibit ascending pain signals such as touch/pressure carried by Alphabeta fibres
27
TENS?
Transcutaneous Electrical Nerve Stimulation, touch a pressure due to Alphabeta fibres, analgesia achieved by rubbing an affected
28
Perception involves
Primary/Secondary Somatosensory Cortices
29
Anterior Cingulate Cortex
implicated in several complex cognitive functions, such as empathy, impulse control, emotion, decision-making
30
Insular Cortex
responsible for sensory processing, decision-making and motor cortex
31
Modulation of Pain/Perception
Nociceptive info is transmitted to brain via spinothalamic Ascending info can activate info can activate descending pathways from the mid-brain periaqueductal grey area Exert an inhibitory control over dorsal horn neurons
32
Descending Pain Mechanisms:
brainstem plays a crucial role in the modulation of pain processing at the spinal cord levels Pathway orginaitng in the cortex and thalamus are relayed via the medulla and adjacent areas to the dorsal horn of the spinal cord
33
Brainstem receive afferent input from the
superficial dorsal horn PAG Nucleus Tractus Solitarius Parabrachial Nucleus
34
Neurotransmitters Descending Pathways
Serotonin, Noradrenaline and endogenous opiods
35
Gate Control Theory
Open gate: pain is transmitted Central Control trigger is inactive allowing the gate remain open Activity of the A-delta & C fibres produces stimulation that opens the gate in the spinal cord
36
Proximally Mediated Gate Closure
Central control trigger is active, sending messages from the brain to close the gate in the spinal cord eg. Distraction, relaxation causes the gate to close, decreasing the perception
37
Peripherally mediated gate closure
Activity in the Alpha Beta Fibres produces inhibition closing the gate in the spinal cord eg. Stimulation of touch sensors (alpha-beta fibres) in the skin by rubbbing
38
Peripheral Sensitisation defin
increased responsivenss and reduced thresold of PNS nocicpetive neurons to the stimulation of their receptvie fields
39
Due to the Peripheral Senstation
injury of the mast cell,s macrophages, neutrophils release a mixture of pro-inflammatory substances
40
injury of the mast cells macrophages, neutrophils release a mixture of pro-inflammatory substances results in
increased efficacy of tranducting ion channels reduced firing th of voltage-gated channels an exaggereted responses following activation of these channels Exaggerated responses following activation of these channels activation and sensation of peripheral nociceptors occurs
41
Brain Plasticity/ Central Sensitiation def
Central sensitation decrisbes the changes that occur in the brain in response repeatednerve stimulation
42
Repeated Nerve Stimulation causes
neurotransmitter levels and the brain electrical signals change as neurons develop a memory
43
increased responsiveness of nocicpetors in the CNS to either normal or sub-threshold afferent input resuts in
Hypersensitivity to stimuli (HYPERALGESIA) Responsiveness to non-noxious stimuli (ALLODYNIA) Increased output to nociception Expanded receptive field: ie increased pain respone evoke by stimuli outside the area (2nd Hyperalgesia)
44
Allodynia
Pain due to stimulus that doesn't normally provoke pain
45
Hyperalgsia
Perception of a painful stimulus as more painful than normal caused by peripheral/central senstiation
46
Hyperalgsia
Perception of a painful stimulus as more painful than normal caused by peripheral/central senstiation
47
Hyperparthia
painful syndrome characteries by an abnormal painful reaction to a stimulus espically a repetitive stimulus as well as reduced thershold
48
Dysasesthia::
Unpleasant abnormlal sensations
49
Central Sensitiaton
increases responsivenss to nociceptive neurons in theCNS to their normal or sub-thershold afferent input
50
Peripheral Sensitisation
Increased responsivenss and reduced threshold of nociceptive PNS neurons to the stimulation of their receptive field
51
Analgesic Strategies that target following aspects of pain include
Transduction-inhibtion of nocicpetor activation Conduction/Transmission- inhibition of nocicpetor activation Modulation-inhibition of CNS neurons Perception: inhbitons of CNS neurons
52
Analgesic Drugs
Anti-Inflam(Non-Sterodial anti-inflammaotry drugs, Corticosteroids) Opioids Paracetamol Antiepileptics Antidepressants
53
NSAIDS what are they
inhbiit prostaglandin synthesis by inhibiiting cycclooxygenase(COX) key enzyme in inflammatory cascade
54
NSAID Actions
anti-inflammatory analgesic (treatment of mild-moderate) anti-pyretic anti-platelet aggregation duration of action 6-8hr
55
Opioids definitions
agonists of central and peripheral receptors which are located on the cell membranes of neurons
56
where opioid receptor cell membrane located in the Cns and PNS
CNS: Brain and Spinal Cord PNS: mytenteric plexus and submucos plexus in the wall of the gut Peripheral Sensory and Autnomic nevers
57
Glucocorticoids def
synthesised in the adrenal cortex manufactured as a pharmaceutical.
58
Glucocorticoids effects
immediate vasodilation
59
Glucocorticoids function
reduce pain by inhibiting prostaglandin synthesis which turn in reduces inflammation useful in arthritis Reduce spontaneous discharge in injured nerves hence thier use in the treatment of neuropathic pain
60
Where are Glucocorticoids receptors
neuron membranes on the CNS/PNS
61
Most Commonly prescribed corticosteroid for pain
Dexaemthasone
62
Gluocorticoid reduced pain by
down-regulation the expression of pro-inflammatory proteins, prostaglandins Up-regulating the expression of anti0inflmmatory proteins
63
Paracetamol works on mainly?
CNS
64
Mainly on the CNS it induces?
COX inhibition which reduces prostaglandin synthesis Activation of descending sertonergic, opioid, nitric oxide and cannabinoid pathways

BSO6 Neuro (9 decks)

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