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56 Cards in this Set
- Front
- Back
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Definition of Pain
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An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
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Where is the sensation of pain perceived?
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In the sensory cortex of the brain.
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True/False: Physiological Pain is also referred to as "good pain" because it informs you about the noxious external stimuli.
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True
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Two types of pain that fall under the category of physiological pain are ____ and ____ pain.
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Fast and slow
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Fast pain is carried by ____ fibers.
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A delta
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Slow pain is carried by ____ fibers.
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C
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Nociceptors in teeth include the ____ and ____ fibers.
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A delta; C
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Name the 2 types of receptors types in A delta fibers:
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Mechanoreceptors
Thermoreceptors |
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Name a type of receptor contained within C fibers:
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Chemoreceptors
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What are the 3 categories of pain?
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1. Physiological
2. Clinical 3. Persistent |
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Fast pain fibers transmit what 2 sensations?
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1. very sharp pain
2. well-localized |
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A delta fibers are large in diameter. They are myelinated.
a.Both true b.First false, second true c.First true, second false d.Both false |
b.
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Match the signal with the receptor
Cold P2X2 Heat ASIC ATP VR1 H+ TRP |
Cold: TRP
Heat: VR1 ATP: P2X2 H+: ASIC |
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What is the difference between physiological and clinical pain?
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Clinical pain is accompanied by inflammation.
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What are nociceptors?
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A specific subset of peripheral sensory organs which respond to noxious stimuli
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Define the Gate Control Theory of Pain.
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There is a gate-keeper in the spinal cord or brainstem that modulates the flow of nociceptive information from the periphery to the higher centers in the CNS
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Epicritic Pain
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Pain that can be tactically localized; associated with fast pain A Delta fibers
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Protopathic Pain
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Primitive pain sensing mechanism with very poor localization
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A beta fibers for tactile & mechanical sensation respond to a high/low threshold stimuli?
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low
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A delta and C fibers respond to high/low threshold stimuli?
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high
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A delta fibers are:
a. polymodal b. monosynaptic |
monosynaptic
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C fibers are polymodal/monosynaptic?
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polymodal
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Referred Pain
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Occurs when both nociceptors and visceral receptors synapse with the same types of second order neurons
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Second order neuron (Projection neuron)
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A neuron in the spinal cord that sends afferent information to higher centers (cortex) in the brain; it decides whether stimulation will go up to the brain or not
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Myofascial pain
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Occurs due to receptors from many different areas converging on the same neuron in the brainstem
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Which receptor has a glutamate as a natural agonist, is excitatory (permeable to Na & K, but not Ca), and opens it's channels for only 10 ms?
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AMPA Receptor - receives info from A delta & C fibers
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What are ascending CNS pathways composed of?
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The Spinothalamic Tract (below neck) and Trigeminothalamic tract (head & neck) send signals to the Thalamus, which relays to the reticular & limbic system and cerebral cortex
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What are the descending CNS pathways composed of?
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Signals occurring in the cerebral cortex and other centers of the brain can send signals to the brainstem and spinal cord
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Inhibition of Descending CNS Pathway
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Inhibitory neuron from CNS allows influx of Ca; activates the inhibiting interneuron (which thereby inhibits the PN) & inhibits the nociceptor neuron (Fear: pain threshold decreased)
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Facilitation of Descending CNS Pathway
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Facilitatory neuron from CNS allows influx of Na & K; acts on both excitatory neurons and the nociceptive neuron, triggering Anxiety (Pain threshold is reduced)
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Enkephalins are found where?
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Spinal dorsal horn
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Dynorphins are found where?
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Hypothalamus, PAG, and dorsal horn
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Beta-endorphins are found where?
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Hypothalamus - may be involved in stress-induced analgesia
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True/False: Glycine is most important to inhibition of pain
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True
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True/False: Both Primary and Secondary Hyperalgesia are responses to inflammation
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True
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Hyperalgesia
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An increased response to a normally painful stimulus
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Allodynia
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A painful response to a normally innocuous stimulus
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What is Primary Hyperalgesia (Peripheral Sensitization)?
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Occurs on the nociceptor itself around the injured site; the nociceptors on that site have increased their sensitivity to stimuli
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TTx-S (Tetrotoxin Sensitive) Na Channels
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TTx toxin and local anesthetic blocks these Na channels
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TTx-R (Tetrotoxin Resistant) Na Channels
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Not sensitive to local anesthetics or toxins; more sensitive to pain; these channels proliferate in injured site -> pain threshold is lowered & more SP is released by nociceptors
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Secondary Hyperalgesia (Central Sensitization)
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Refers to the area within the CNS that has become sensitized; starts from the projection neuron onto the brain (this is NOT caused by increased sensitivity of the nociceptors, but rather to CNS & Spinal Cord)
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NMDA Receptor
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Natural agonist is glutamate; blocked by Mg; depolarization opens channel by removing block for up to 100 ms
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What occurs during summation of inputs in NMDA receptors?
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By the time the nociceptors receive a 2nd stimulus, the NMDA receptors have not finished activation from the 1st stimulus yet, so the effects of both stiumuli is summated
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Relay the chain of events occurring on an NMDA receptor in Secondary Hyperalgesia
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Inc. in SP (nociceptor) -> Inc. in IP3 (PN) -> Inc. in Ca (PN) -> Inc. in active NMDA receptors -> Inc. in Na (PN) -> Dec in Threshold -> depolarization & Inc sensitivity
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What does ASIC stand for?
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Acid Sensing Ion Channel; permeable to both Na & Ca; increase in IC conc. of each leads to depolarization
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What does VR1 stand for?
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Vanilloid Receptor; heat sensitive receptor; permeable to Ca; increase in IC Ca conc. leads to depolarization
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What does P2X2 stand for?
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Purinergic receptor; permeable to Ca; increase in IC Ca conc. leads to depolarization
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Facial Nerve (CN7) through ____ _____ to ________ and _____ salivary glands.
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chorda tympani; submaxillary and sublingual
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Glossopharyngeal (CN9) through ____ _____ to ______ gland.
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otic ganglion; parotid
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Muscarinic M1 receptors predominate in:
a. the heart b. exocrine secretory cells c. smooth muscle of gut & bronchi d. postganglionic nerves e. B and D. |
e
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Muscarinic M2 receptors predominate in:
a. the heart b. exocrine secretory cells c. smooth muscle of gut & bronchi d. postganglionic nerves e. B and D. |
a
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Muscarinic M3 receptors predominate in:
a. the heart b. exocrine secretory cells c. smooth muscle of gut & bronchi d. postganglionic nerves e. B and D. |
c
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Adrenergic Alpha 1 receptors:
a. Constrict arteries and sphincter of bladder b. Increase secretion of salivary and sweat glands c. Decrease nasal secretion d. Contract radial muscles of eye (mydriasis) e. All of the above |
e
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All are true of Adrenergic Alpha 2 receptors EXCEPT:
a. Constrict veins b. Relax GI tract c. Stimulate pancreas to release insulin d. Stimulate pancreas to secreate glucagon |
d
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Beta 1 receptors affect:
a. contraction and heart rate b. renin release by kidneys c. vasodilation of skeletal muscle d. Dilation of bronchi e. Contraction of ciliary muscles of eye f. a and b |
f
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Beta 2 receptors affect:
a. contraction and heart rate b. renin release by kidneys c. vasodilation of skeletal muscle d. Dilation of bronchi e. Contraction of ciliary muscles of eye f. d and e |
f
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