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49 Cards in this Set
- Front
- Back
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are not usually nocioreceptors but can be recruited if C Fibers are damaged
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A beta
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afferent fibers but can have an efferent component to begin inflammatory and sensitization process
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C
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Thermal ranges of pain
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>43
<8 |
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Substances released from nerve endings during hyperalgesia
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substance P
calcitonin |
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4 inflammatory factors that are released by capillaries
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Neutrophils
Leukocytes bradykinin nerve growth factor |
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Spinal Cord Receptors that Modulate release of Substance P
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5HT – serotonin receptors
GABA μ2 α2 |
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Pathway for temperature, touch, pain specific localization, somatic
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spinothalamic
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Pathway for Reflex withdrawal, increased arousal and muscle activity, initiates BP changes
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spinoreticular
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Pathway of large, fast, override channels
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spinomesencephalic
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Pathway of addiction, motivation, fear, memory, behavior, autonomic reaction
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spinolimbic
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Pathway of chronic pain
ipsilateral |
spinocervical
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Ipsilateral pain pathway
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spinocervical
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Areas that are the root for all supra spinal modulation
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PAG
Raphe nucleus |
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Most effective way to inhibit pain is in the
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spinothalamic tract
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endogenous agents that act pre-synaptically to modulate the pain response (ie they decrease Calcium conductance)
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serotonin 5-HT
NorAdrenergic Enkephalin |
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Non pain stimulus is now exciting pain
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Allydonia
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What does pain do to the immune system
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depresses the reticuloendothelial system
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What is the only way to completely block the SNS response to pain
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local anesthetic block
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6 sources of pain that NSAIDS are particularly good at treating
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Post Traumatic Injury
Inflammatory Pain: Osteoarthritis Patients Dysmenorrhea: Obstetric Patients – D&C Renal Colic: Opiods ↑ sphincter tone – nonsteroidal do not! Billiary Obstruction pts with caffeine withdrawal |
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What are the three endogenous opioid prohormones
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POMC
Proenkephalin Prodynorphin |
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Where is POMC syntesized
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Major site of synthesis is the pituitary, but synthesis also occurs in the pancreas and placenta
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Endogenous opioid of the brain, SC, and periphery that prefers to bind at K
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dynorphin
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Endogenous opioid of the brain, SC, and periphery especially the adrenal medulla that prefers to bind at mu and delta
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Enkephalin
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Pre-cursor for beta-endorphins
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POMC
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Drug used in L&D because it binds to Kappa receptors with minimal resp. depression
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(butorphanol) Stadol
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2 CV unstable opioids
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demerol
morphine |
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Primary receptor sites of all IV opioids
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mu
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Area of the brain responsible for mood, euphoria, tranquility, and rewarding properties; responsible for addictive properties of the drug
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Nucleus accumbens
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Mu receptor response that is not blunted with tolerance
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miosis
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What receptors does glutamate bind to
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NMDA
AMPA |
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What receptors does sub P bind to
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Neurokinin 1+2
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Sharp localized pain transmitted over type A delta fibers that alerts the subject that an injury has occurred
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epicritic pain
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Type of pain transmitted over type C fibers that is annoying and urges the subject to rest the injured area
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protopathic pain
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Mu receptors in the higher brain are usually post-synaptic and respond by
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increasing potassium conductance
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Two receptor types that are primarily located in the spinal cord and the periphery
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Delta
Kappa |
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What is the MOA of Mu receptors
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Increases potassium conductance.
decreases calcium conductance |
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What is the MOA of Delta receptors
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Increases potassium conductance.
Increases calcium conductance |
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Two receptors that depress pain AND respiratory fxn
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Mu 2
Delta |
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Two receptors that provide analgesia and miosis
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Mu 1
Kappa |
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Receptor that causes euphoria, hypothermia, and bradycardia
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Mu 1
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Opioid antagonists
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naloxone
naltrexone |
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Opioid agonist antagonist
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buprenorphine buprenex
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Opioid partial agonist
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nalbuphine Nubain
butorphanol Stadol |
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Where are mu receptors dense in the brain
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amygdala
reticular formation periaqueductal grey areas |
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Where do primary pain conduction fibers synapse in the dorsal root horn
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1, 2, 5, 10
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What CNs does pain travel over
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5,7,9,10
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Pelvic visceral pain pathway
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postsynaptic dorsal column pathway
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Locations that don't have pain receptors
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Liver
Lung Brain Visceral pleura |
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Nerve innervation of the pupil from the PSNS that causes miosis
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Ed-wesphal; occulomotor nerve
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