Physiology - Pain

Front 1

pain results from noxious stimulation of a particular area

Back 1

somatic pain

Front 2

an abnormality in the neural components innervating an area and does not require the presence of a noxious stimulus

Back 2

neurogenous pain

Front 3

human pain experience is divided into 4 distinct processes

Back 3

transduction, transmission, modulation and perception

Front 4

the detection and subsequent transmission of a noxious event

Back 4

nociception

Front 5

nociceptors have what types of nerve ending of primary afferent nerve fibers

Back 5

free nerve endings

Front 6

does acute pain or chronic pain responds to nonsteroidal anti-inflammatory drugs (NSAIDs) and narcotic analgesics

Back 6

acute pain

Front 7

T/F acute pain is almost always caused by an identifiable tissue injury and serves a protective function by warning the body of imminent danger.

Back 7

T

Front 8

function of prostaglandins and it's derived from

Back 8

sensitize free nerve ending to other inflammatory mediators by lowering the pain threshold.

arachidonic acid -> prostaglandins (by cyclooxygenase)

Front 9

peripheral mediators of nociception (7)

Back 9

bradykinin, serotonin (5-HT), Acetylcholine, potassium, prostaglandins, substance P, calcitonin gene related peptide

Front 10

Aspirin and NSAIDS (ibuprofen)

Back 10

analgesic and anti-inflammatory effect. They block the cyclooxygenase enzyme system, inhibiting the synthesis of prostaglandins.

Front 11

substance P and calcitonin gene-related peptide (CGRP)

Back 11

exacerbates the inflammatory process by causing vasodilation and edema

Front 12

capsaicin

Back 12

deplete substance P

Front 13

2 classes of nerve fibers that transmit pain signals to CNS via primary afferent nerve fibers

Back 13

myelinated A delta fibers
unmyelinated C fibers

Front 14

myelinated A fibers

Back 14

transmit the fast component of pain

Front 15

unmyelinated C fibers

Back 15

conduct the slow component of pain

Front 16

function of lidocaine (Xylocaine) and bupivacaine (Marcaine)

Back 16

block the generation and propagation of AP by inhibiting the influx of Na+ necessary for depolarization of nerve cell membranes and creation of AP

Front 17

detection and transmission of pain in the orofacial region is conveyed to the CNS primarily by

Back 17

CN V and upper cervical nerves

Front 18

Are there any synapses between sensory fibers within the peripheral nervous system?

Back 18

no

Front 19

primary afferent neurons' cell bodies lie where?

Back 19

dorsal root ganglion, just outside the spinal cord.

Front 20

In the orofacial region, the cell bodies of the primary trigeminal afferent neurons are located?

Back 20

gasserian (trigeminal gangion

Front 21

trigeminal brain-stem complex, where primary trigeminal affferent neurons synapse with connecting neuron (second order) are divided into 2 categories

Back 21

main trigeminal sensory nucleus
trigeminal spinal tract nucleus

Front 22

trigeminal spinal tract nucleus is subdivided into

Back 22

subnucleus oralis
subnucleus interpolaris
subnucleus caudalis

Front 23

the main brain-stem replay site of orofacial nociceptive information is

Back 23

subnucleus caudalis (aka medullary dorsal horn)

Front 24

Second-order neurons arising in the trigeminal nucleus caudalis and dorsal horn of the spinal cord can be classified into ... (3)

Back 24

nociceptive-specific (NS)
wide dynamic range (WDR)
low-threshold mechanoreceptor (LTM)

Front 25

NS neurons respond to ___ stimuli, receive input from ____ fibers and ___ fibers

Back 25

receive noxious stimuli

eceive input from small-diameter A fibers and C fibers

Front 26

WDR neurons respond to ___ stimuli and ___ stimuli, receive input from ___ (3 kinds of fibers)

Back 26

respond to noxious and non-noxious stimuli

receive inputs from large- and small-diameter A fibers and C fiber

Front 27

LTM respond to ____ and receive input from ___ fiber

Back 27

respond to light touch

receive inputs from large-diameter A fibers

Front 28

upper cervical nerves (C1-C3) converge with trigeminal afferent neurons at ____ complex and is the basis for referral pain

Back 28

trigeminocervical complex

Front 29

primary afferent neurons release ___ in the synaptic cleft btw second-order neurons, within medullary and spinal dorsal horns.

Back 29

Substance P

Front 30

pain carried by primary afferent neurons stimulate

Back 30

second-order neuron (transmit info to CNS) for modulation

efferent sympathetic and motor reflex loops within the dorsal horn (localized vasoconstriction and skeletal muscle spasm, further intensifies pain).

Front 31

function of enkephalins, it's released by ___neurons

Back 31

block the release of substance P
released by interneurons in the spinal and medullary dorsal horns.

Front 32

analog of enkephalins

Back 32

morphine, codeine (Tylenol 3), hydrocodone (in Vicodin), oxycodone (in Percodan)

Front 33

non-drug control of pain

Back 33

acupuncture and transcutaneous electrical nerve stimulation (TENS)

Front 34

serotonin (5-HT), norepinephrine in the CNS are released by, function?

Back 34

They are released from descending analgesic fibers, they serve to trigger release of enkephalin from interneurons

Front 35

beta endorphin is released by ___ and functions

Back 35

released by pituitary under pain or stress into the blood stream, b-endorphin interact with opiate receptors all over the body

Front 36

endogenous opioid

Back 36

enkephalins, b-endorphin, dynorphin

Front 37

deafferentation pain

Back 37

pain caused by partial or total loss of sensory nerve supply to a particular body

Front 38

2 mechanisms that pain pain

Back 38

sympathetically maintained pain (SMP)

sympathetically independent pain

Front 39

example of peripheral mechanism of pain is ___ and describe it

Back 39

neuroma: when primary afferent nerve fibers are cut distal to the nerve-cell body. When the healing process occur, the axonal sprouts cannot find each and become tangled. This produces increased spontaneous nociceptive activity and are hypersensitive to touch.

Front 40

central pain pathway is altered in what way and produce what kind of result?

Back 40

the primary afferent nerve dibers are cut central to the nerve cell body, second-order neurons can become hyperactive, producing spontaneous pain that requires no peripheral stimulation.

Front 41

SMP symptoms can be relieved by ___ blocker

Back 41

alpha adrenergic receptor blocker (phentolamine)

Front 42

trycyclic antidepressant drug is used to manage SMP, they block the reuptake of ___ and ____ into descending analgesic nerve terminals

Back 42

serotonin and NE