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22 Cards in this Set

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1. Differentiate between somatic and visceral pain.

Somatic pain can arise from the skin or deeper structures such as muscle and bone. It is usually conducted by sensory nerves.


Visceral pain is conducted via sympathetic fibers and originates from abdominal or thoracic organs.

2. List three chemical sources of pain.

Prostaglandins


Histamine


Bradykinin

3. What is suggested by the term, ": pain threshold"?

This term refers to the level of sufficient stimulation that is required to activate the nerve ending.

4. Starting from the stimulus, list the steps that exist in the neural pain pathway.

1. Stimulus


2. Nociceptor


3. Peripheral nerve (afferent)


4. Synapse


5. Spinal decussation


6. Lateral spinothalamic tract (pain)


7. Reticular formation (pons and medulla) create awareness


8. Thalamus (sensory relay center)


9. Somatosensory cortex (located in parietal lobe) pain location


10.Hypothalamus (stress response)


11. Limbic system (emotional reaction)




(SNPS-SS-RTSHL)

5. Differentiate between A delta fibers and C fibers.

These are both afferent fibers that conduct pain.


A delta fibers are myelinated and transmit impulses very quickly.


C fibers are unmyelinated, and transmit impulses slowly.


A delta fibers are responsible for acute and sharp pains.


C fibers actuate a dull, aching or burning pain.

6. What are the the two types of neural tracts found in the spinothalamic bundle?

1. Neospinothalamic tract


2. Paleospinothalamic tract


Neospinothalamic tract- transmits fast impulses for acute and sharp pain.


Paleospinothalamic tract-transmit slower pain that tend to be more dull.

7. What is the function of the RAS as it receives a painful stimulus?

In the brain, as the pons and medulla receive the pain stimulus, they influence the brain's awareness of the incoming stimuli.

8. what is meant by the " gate control theory of pain"?

It is believed that there are certain systems or controls (gate controls) are built into the normal pain neural pathways that can regulate or modify the entry of painful stimuli into the spinal cord and brain.


These gates can be open, thus allowing pain impulses to pass from the peripheral nerves to the spinothalamic tract and ascend to the brain. If the gstes are closed, the pain impulses are much modified.

9. Why would gate closure occur?

This may happen in response to other sensory stimuli along other competing nerve pathways that may lessen the pain sensations, or inhibit it from higher brain centers.


The application of ice on an injury may elicit a stronger response in neural pathways that transmit the sensation of cold.

10. What is TENS?

This is trancutaneous electrical nerve stimulation. This intervention is meant for therapeutic purposes. it increases sensory stimulation at a site, thus blocking pain transmission.

11. What are opioid interneurons?

These units are part of a wide sytem of analgesia. They may block or modify pain impulses by releasing a number of opiate like substances, called opioids, secreted by interneurons. They are pharmacologically similar to the drug morphine, which is in fact derived from opium or endogenous morphine.

12. list three types of endorphins.

1. Enkephalins


2. Dynorphins


3. Beta lipotropins

13. Enkephalins can block the release of substance P at the synapse. True/False

True. This can prevent transmission of the pain stimulus into the spinal cord.


serotonin may as well increase the release of enkephalins.

14. Why might some people with clinical depression whether real or imagined,report feelings of chronic pain?

Findings suggest that they may have diminished levels of serotonin.

15. What is Substance P?

Substance P a peptide composed of 11 amino acids, present in nerve cells scattered throughout the body and in special endocrine cells in the gut; it increases the contractions of gastrointestinal smooth muscle and causes vasodilatation; it is one of the most potent vasoactive substances known, and it seems to be a sensory neurotransmitter involving pain, touch, and temperature.

16. Define referred pain.

Occasionally, the source of pain may be localized to another area of the body. The pain is sensed in an area of the body that is actually distant from the source.


The pain in left side of the neck or shoulder or down the left arm are noted referred pain stimuli of a possible heart attack.

17. Define Phantom pain.

This is pain perceived by an individual in a limb that has amputated. The brain may still perceive the limb as still being present.


Its cause is not well understood. It is believed that nerves near or proximal to the amputated limb may encourage the brain to continually send pain signals to an area that is no longer there.

18. Though several drugs for the treatment of migraine are available, ergotamine can be useful if given immediately after the headache begins. True/False

True.

19. What are some drugs of choice for severe migraine?

Drugs of choice are the triptans. They may act on some 5-hydroxytriptamine receptors to block the vasodilation and release of vasoactive peptides in the brain.

20. List some other drugs that act on 5HT receptors to block vasodilation.

Maxalt


Axert


Zomig


Relpax

21. Why might Elevil, an older tricyclic antidepressant be occasionally used for migraine prevention?

It can raise Serotonin and norepinephrine levels.

22. Define causalgia.

It is a form of neuralgia that involves sensations of severe burning that can be triggered by, nontraumatic stimuli such as a light touch, sound or cold.