1Aa. S3/b3 Neuro Pain

Front 1

What does allodynia mean?

Back 1

1.Other pain
2. Painful response to a non painful stimulus

Front 2

What are some of the adaptive aspects of pain?

Back 2

1. sensation outlasts the stimuli. 2. protective
3. Don't want to repeat

Front 4

Name 3 types of pain?

Back 4

1. Acute
2. Chronic
3. Cancer related

Front 5

Describe actue pain?

Back 5

Perception outlasts the stimulus

Front 6

Describe cancer related pain?

Back 6

Caused by a tumor taking up space or destroying bone

Front 7

Describe chronic non-malignant pain?

Back 7

1. Pain persisting beyond the point of tissue damage
2. back pain, migraines or arthritis

Front 8

Describe transmission of acute pain, what fibers and feelings, and tissues?

Back 8

1. Very rapid along myelinated Adelta fibers .....A for acute
2. Easily localized sharp, prickling sensations
3. Not felt by deep tissues

Front 9

Describe slow pain transmission, what fibers, feelings, tissues and areas its found?

Back 9

1. Slower transmittance across unmyelinated C fibers .... C for chronic
2. Chronic, throbbing, burning, aching
3. Over a generalized area in the skin and deep tissue

Front 10

What is nociception?

Back 10

Painperception

Front 11

What is a nociceptor?

Back 11

A pain receptor

Front 12

What is superficial somatic pain?

Back 12

Pain from the skin

Front 13

What is deep somatic pain

Back 13

Pain from the deep tissue/SKM

Front 14

What is visceral pain?

Back 14

Pain from the visceral receptors

Front 15

Name 7 NTs of pain transmission?2 axon reflux... five damaged tissue

Back 15

1. Substance P and CGRP
2. Bradykinins
3. Histamine
4. Prostaglandins
5. Serotonin
6. K

Front 16

What are the pain supressors of the body and where do they come from?

Back 16

The enkephalins and endorphins from the peri-aqueductal gray

Front 17

Through what pathway do we percieve pain? What two types of tracts and fibers go along with this?

Back 17

1.The STT.
2. The NeoSTT is fast for the A fibers
3. The PaleoSTT is slow for the C fibers

Front 18

What types of axons are the A and C fibers?

Back 18

The faster fibers are in 3rd place, A type 3 axons
The slower fibers come in later, C type 4 axons

Front 19

When you damage tissue what happens with regards to pain in the 1st order neurons?

Back 19

1. A cut releases; Pglandins, Bkinins, serotonin and K
2. Stimulates the free nerve ending to illicit pain
3. Also stimulates a positive feedback loop called the axon reflux
4. Continues pain and inflammation

Front 20

Describe the 4 steps of the axon reflux of pain?

Back 20

1. After the initial pain stimulation
2. The feed back sends Sub P and CGRP onto a mast cell
3. Histamine and serotonin are released back onto the free nerve ending = Pain
4. Sub P and histamine also VasoD

Front 21

What is CGRP?

Back 21

1. Calcitonin gene releasing peptide
2. It is part of the axon reflux

Front 22

How do mast scells relate to pain?

Back 22

They release serotonin and histamine

Front 23

What do the bradykinins do?

Back 23

They degranulate the mast cells

Front 24

What types of bradykinin receptors are there?

Back 24

B1 and B2

Front 25

What are the B1 bradykinin receptors and what do they do?

Back 25

1. B1 protein made after injury 2.Upsthe cytosolic Ca
3. Chronic and acute inflammatory responses.

Front 26

How are histamine and pain/itching related?

Back 26

Low levels = itching
High levels = pain

Front 27

What is the peri aqueductal grey or central grey matter?

Back 27

1. A part of the midbrain that releases endorphins in response to pain

Front 28

Describe the periaqueductal grey pathway?

Back 28

1. 2nd order pain neurons travel here
2. PAG releases endorphins onto the Raphe Nucleus
3. The rpahe nucleus releases 5HT to modulate and supress pain in the spinal cord

Front 29

Describe the gate control theory and pain?

Back 29

1. Small umyelinated C fibers keep the gate open while large myelinated A fibers close the gate

Front 30

How do internueurons act on the STT?

Back 30

They inhibit second order STT normally, unless disinhibited by C fibers

Front 31

How does touch relate to the gate control theory?

Back 31

Touch is a large myelinated fiber that turns the gate off and inhibits pain

Front 32

What nerve connects the EAM and the throat?

Back 32

Vagus

Front 33

What are the two different types of pain in the cerebral cortex?

Back 33

S1 and S2

Front 34

Describe S1 Pain in the brain and when it is needed?

Back 34

1. Primary somatosensory in the 1,2,3 gyrus
2. This is for pain localization
3. In Rambo only this pain is activated

Front 35

Describe S2 Pain in the brain and when it is needed?

Back 35

1. It is pain in the cingulate gyrus and insula
2. Gives the emotional aspect of pain
3. The pussy gyrus

Front 36

What is strange about how chronic pain on one side of the body affects the thalamus?

Back 36

1. If it is on one side then it should only affect the contrlateral side of the thalamus
2. It eventually lights up both sides of the thalamus

Front 37

What is mechanical pain?

Back 37

1. Pain from joints, discs, vertebrae and soft tissues

Front 38

What is neuropathic pain?

Back 38

1. Pain from damaged/compressed nerves

Front 39

How can compression neuropathy manifest itself, besides pain?

Back 39

1. As parasthesia
2. commonly as carpal tunnel

Front 40

What is spondolysis and causes?

Back 40

1. Vertebral defects
2. Degenerative arthritis of the spinal vertebrae

Front 41

What are three compression problems in the back?

Back 41

Herniated disks, osteoarthritis, and spinal stenosis

Front 42

Describe cauda equina syndrome(CES) causes and 4 P's symptoms?

Back 42

1. Compression neuropathy of the caude equina
2. Acute symptoms occur below that point
3. Paralysis, parasthesia saddle, pissing, poor penis

Front 43

What is LMN atrophy and how does it relate to carpal tunnel?

Back 43

1. Remeber that when a nerve is paralyzed those muscles will degenerate
2. Compression neuropathies cause this too
3. A carpal tunnel man will have his thenar muscle severely atrophied

Front 44

Describe sciatica, what nerves and dermatomes = what toes?

Back 44

1. Of course the sciatic nerve is compressed
2. Supplies the L4/L5 dermatome
3. Pain/ numbness/ weakness felt in the first four toes

Front 45

Where is referred pain from and why does it happen?

Back 45

1. Visceral pain is often severe but poorly localized
2. The pain is usually referred out to the dermatomes because the brain thinks the pain is somatic on the surface

Front 46

Where would the diaphragm pain be referred to?

Back 46

C3-C4

Front 47

Where would heart pain be referred to?

Back 47

T1-T8

Front 48

Where would Appendix pain be referred to?

Back 48

T10

Front 49

Where would Testes/prostate/ovaries/uterus pain be referred to?

Back 49

T10-T12

Front 50

What is the nipple dermatome?

Back 50

T4

Front 51

What is the Bellybutton dermatome?

Back 51

T10

Front 52

What is hyperalgesia?

Back 52

Increased pain senstivity

Front 53

What are the terrible three's of chronic pain?

Back 53

Suffering, sleeplessness, and sadness

Front 54

What are the three major classes of analgesics?

Back 54

1. Paracetemol and NSAIDs
2. Opiates
3. COX-2 inhibitors

Front 55

What does Aspirin do overall(3) and intracellularly(3)?

Back 55

1. Anti inflammatory, anti-pyretic, anti-clotting
2. Blocks production of prostaglandins, leukotrienes, and thromboxanes

Front 56

What are side affects of aspirin?

Back 56

1. GI irritation, bleeding and ulcers
2. Reyes syndrome

Front 57

What can reyes syndrome cause?

Back 57

1. In people below 18
2. Occurs in children with a viral condition
3. can cause Fatty Liver and Encephalopathy

Front 58

Name some Ibuprofens?

Back 58

Advil and motrin

Front 59

What is naproxen and contraindication?

Back 59

1.AKA Aleve
2. An NSAID, possible GI problems
3. Do not want to take with MAO-I

Front 60

What is Acetomenophin, class and problems?

Back 60

1. Tylenol
2. Not an NSAID
3. Could cause hepatic toxicity

Front 61

What are NSAIDs and how do they work and get used?

Back 61

1. Drugs that inhibit COX-1 and COX-2
2. Block arachadonic acid formation means no Pglandins
3. Primary line of pain relief

Front 62

How do corticosteroids affect bone and the immune system? How come stress does the same things?

Back 62

1.They weaken bone and the immune system
2. because cortisol is another steroid that is sequestered during the stress response

Front 63

How do antidepressants interact with pain?

Back 63

The emotional response of pain from the S2 portion is subjective. If you change the mood then you can change the pain

Front 64

What do opiates do to pain?

Back 64

They cause sedation and pain relief.

Front 65

How are osteoclasts and corticosteroids related?

Back 65

IL-6 and IL-1 are not formed. Osteoblasts do not form unless osteoblasts release growth factors

Front 66

How do you administer pain medication?

Back 66

Round the clock to maintain effective levels

Front 67

What are 3 chronic headaches?

Back 67

1. Migraines
2. Cluster
3. Tension

Front 68

What are sinus headaches?

Back 68

1. Problems with the TM joint
2. Dialation of the temporal artery

Front 69

What are primary headaches?

Back 69

Tension is the most common, migraines too

Front 70

What are secondary headaches?

Back 70

They are due to a tumor or other cause

Front 71

What are two types of migraines?

Back 71

1. Classic migraines = aura
2. Common = no aura(80%)

Front 72

What are 3 symptoms of an aura?

Back 72

1. Sound and light senstivity
2. Vision changes
3. Lightheadedness
4. Happening for 30-60 minutes before the headache

Front 73

What is a coital migraine? What is it like?

Back 73

1. A headache that occurs with orgasm
2. It can be the worst headache of their life like the subarachnoid hemmorhage

Front 74

What is temporal arteritis?(2)

Back 74

1. Inflammation of the medium and large vessels in older white women
2. They have a loss of vision, tender scalp, with painful chewing

Front 75

What are cluster headaches? What do they do to help?

Back 75

1.They occur at the same time every day. Patients have ptosis, running nose and red eye.
2. Walking around helps these guys

Front 76

Why does corticosteroids weaken bones?

Back 76

It inhibits collagen formation, because it is an anti-inflammatory

Front 77

What is arachadonitis?

Back 77

Inflammation of the arachnoid

Front 78

What is glosspharyngeal neuralgia?

Back 78

A problem in the nerves in the throat. Causes severe pain while eating or drinking.

Front 79

What is complex regional pain?

Back 79

Used to be known as RSD. Hypersensitivity to pain.