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10 Cards in this Set
- Front
- Back
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What is the difference between somatic and visceral pain?
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Visceral pain is usually more dull, POORLY LOCALIZED.
Diaphragm pain localizes to shoulder. |
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What are the 4 steps in pain?
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Transduction from nerve endings (nociceptors)
Transmission of signal Processing of pain in the cortex Descending modulation (via norepinephrine and serotonin) |
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What is a C fiber?
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small diameter, unmyelinated, dull aching pain. Upregulated by bradykinin, histamine (inflammatory cytokines). FOUND IN LAMINAE II
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What is an A-delta fiber?
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Small diameter, fast conduction, MYELINATED. Sharp, immediate pain.
FOUND IN LAMINAE I, V |
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What is the gate control theory of pain?
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A-beta fibers carry vibration, position information.
Incoming pain stimuli can be gated by other incoming stimuli. Incoming A-beta fibers of peripheral nerve can alter sensitivity of post-synaptic cells to painful stimuli from C and A-delta fibers. |
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What are the important ascending tracts for pain?
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DC, spinothalamic, spinoreticular, spinomesencephalic
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What two molecules modulate pain sensation downward?
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Serotonin (raphe nucleus in medulla) and norepinephrine (locus ceruleus in pons)
STIMULATION OF THESE TWO AREAS CAUSES ANALGESIA. |
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What receptors are located on nociceptors?
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Nociceptors are the nerve endings of A-delta and C fibers)
GABA (inhibitory), bradykinin, prostaglandins (excitatory) |
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What is c-fos?
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It is a gene that is expressed preferentially during pain stimulation.
When patients are given analgesia, these individuals do not express c-fos. Local anasthesia, same thing. HOWEVER, general anesthesia, normal c-fos expression. Nerve block = ABOLISH c-fos FOUND IN LAMINAE I, V (A-delta) and II (c) |
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Difference between men and women in pain?
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Men have higher pain threshold. Men respond to analgesics at mu receptor. Woman respond at kappa receptor.
Difference in receptor response is a reason why women need more morphine to get to same pain score than men. |
