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46 Cards in this Set
- Front
- Back
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Opiods will target...
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The cortex and spinal cord
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SSRIs will target...
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Thalamus and spinal cord
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Anticonvulsants will target...
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Cortex and thalamus
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Where do NSAIDs target?
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Neuron receptors
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Explain how preganglion sympathetics can cause pain.
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Damaged preganglionic sympathetics can synapse in the DRG and cause pain with stimulation.
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Where are nociceptor cell bodies?
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In the DRG or CN ganglia
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Explain the difference between the stimulation of low and high threshold nociceptors.
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Low: non-painful, intense sensation
High: pain |
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Which pain fibers conduct first and second pain?
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First is fast fibers- A-delta
Second is slow fibers- C |
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Which pain fibers are not myelinated?
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C fibers
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Which pain fibers conducts slow and long lasting pain?
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C fibers
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What types of stimuli can stimulate nociceptors?
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Mechanical
Chemical Thermal |
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What kind of receptor is the capsaicin receptor?
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nonselective cation channel
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What stimuli can open the Capsaicin receptor?
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heat
low pH Capsaicin |
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Where does nociceptive neurons from the head and body synapse in cord?
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In the dorsal horn
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What neurons form the anterolateral tract?
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Axons from the secondary nociceptive neurons
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Where does the anterolateral tract go?
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From the dorsal horn to the thalamus on the contralateral side
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What kind of fibers carry TVP? How fast are they?
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A-beta fibers
Fastest of the afferent fibers |
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Put the afferent TVP, pain, and temperature fibers in order from fastest to slowest.
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A-beta
A-alpha A-delta C |
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What pathway forms the dorsal column?
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TVPs to the medulla (Pathway A)
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What are the (2) TVP pathways?
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Dorsal column
Trigeminal (face) |
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Where will the dorsal column TVPs synapse?
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in the medulla, Gracile and Cuneate nuclei
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When would the TVP from the dorsal column decussate?
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When they reach the Gracile and Cuneate nucleus
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What is the distinction in the Gracile and Cuneate nucleus?
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Gracile: Lower limbs
Cuneate: Upper body |
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What forms the medial lemniscus?
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Crossing over of the internal arcuate tract.
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Where in the medial lemniscus does the lower limb and upper limb align in the mid-medulla? Pons? Midbrain?
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Medulla:
Lower limbs: most ventral Upper limbs: central Pons Lower limb: lateral Upper limb: central Midbrain Lower limb: lateral Upper limb: central |
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Where does the medial lemniscus go?
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Thalamus: Ventral posterolateral nucleus
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The tracts from the Gracile and Cuneate are the ... which will synapse in the ...
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Internal arcuate tract will synapse in the Ventral posterior nucleus of the thalamus
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What part of the cortex will somatic sensory end up?
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Postcentral gyrus, Primary sensory cortex
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Describe the pathway from the trigeminal ganglion to the sensory cortex.
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From the trigeminal ganglion the tract will synapse in the principle nucleus of the trigeminal complex (mid-pons), then enter the medial lemniscus.
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Where does sensory fibers from the trigeminal synapse in the thalamus?
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Ventral posterior medial nucleus of the thalamus
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Describe the blood supply to the sensory cortex.
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Trunk and legs: Anterior cerebral
Arms and face: Middle cerebral |
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How will a one side lesion effect TVP and P/T?
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Ipsilateral TVP reduction
Contralateral P/T reduction |
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What travels on the spinothalamic (anterolateral) tract?
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P/T
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Where does the spinothalamic (anteriolateral) tract synapse?
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Ventral posterior lateral nucleus of the thalamus
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Where does P/T from the face travel on?
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Trigeminal
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Where does P/T from the trigeminal cross over?
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Axons descend from mid-pons to middle medulla and caudal medulla and crosses over to form the trigeminothalamic tract
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In which regions of the brain will P/T from the face be on both sides of the brainstem?
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Mid-pons to middle medulla
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The anterolateral and trigeminothalamic branch into two pathways. What are they?
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Sensory-discriminative
Affective-motivational |
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What are the highest centers for the affective-motivational pathway?
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Anterior cingulate cortex
insular cortex |
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How can visceral pains such as those caused by cancer be treated?
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surgical removal of the pathway
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What afferent affective motivational pathways are key in inhibition of pain sensation?
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Amygdala
Hypothalamus Midbrain periaqueductal gray Medullary reticular formation |
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The periaqueductal gray projects will ultimately reach ...
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The dorsal horn
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In the descending pathways that inhibit nociception, what NTs are important?
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serotonin and enkephalins
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How does stimulation of TVP inhibit nociception?
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Stimulates an interneuron which inhibits the anterolateral pathway
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How do opioids work?
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target receptors in the periaqueductal gray and in the spinal cord to reduce pain
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What is the suggested mechanism of a placebo treatment?
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Release of endorphins which bind to opioid receptors
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