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Neurology Clinical > Pain > Flashcards

Flashcards in Pain Deck (27)
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1
Q

What are the pain fibers and are they myelinated or not?

A

A delta fibers - myelinated

C fibers - non myelinated

2
Q

What pain receptors cause fast and slow pain?

A

Fast pain A delta fibers

Slow pain C fibers

3
Q

What horn does the pain fibers enter and synapse?

A

Enter and synapse in the dorsal horn

Synapse at point of entry

4
Q

What is the name of the ascending tract of the pain receptors and what horn is it found in?

A

Ventrolateral horn

Spinothalamic tract

5
Q

What layers of grey matter does the pain fibers synapse in?

A

Rexed 2 and 5

6
Q

What is the sensory relay station?

A

Thalamus

7
Q

Where is responsible for pain perception ?

A

Somatosensory cortex

8
Q

What is the periaqueductal grey?

A

The primary control Centre for the descending pain modulation

9
Q

Where does the ascending tract for nociceptors synapse?

Second synapse

A

Ventromedial nucleii of thalamus

10
Q

What is hyperalgesia?

A

Having an increased response to painful stimuli

11
Q

What is allodynia?

A

Having a painful response to non painful stimuli such as light touch

12
Q

What is spontaneous pain?

A

Spontaneous activity in nerve fibers, feeling pain without any stimulus

13
Q

What condition is associated with spontaneous pain?

A

Fibromyalgia

14
Q

What condition is associated with chronic acute pain?

A

Oesteoarthritis

15
Q

What’s the difference between acute and chronic pain?

A

Acute < 1 month and occurs in response to tissue damage (pain stops when tissue is healed)

Chronic >3-6 months and occurs in the absence of tissue damage

16
Q

What is central sensitization?

A

The response of the second order neurons in the CNS to normal input both noxious and non-noxious

17
Q

What are the 3 main components of central sensitization?

A

Wind up
Classical
Long term potentiation

18
Q

What component of central sensitization involves

  1. opening up of new synapses?
  2. activated synapses?
A
1 = classical
2 = windup (and long term potential potentiation)
19
Q

In which component of central sensitization involves homosynaptic activity and heterosynaptic activity?

A
Homosynaptic = wind up 
Heterosynaptic = classical
20
Q

What is neuropathic pain?

A

Pain initiated or caused by a primary lesion or dysfunction in the somatosensory nervous system

21
Q

What type of treatment is given for pain which acts on the periphery?

A

NSAIDS
Rest
Ice
Local anesthetics I.e. Na channel blockers

22
Q

What type of treatment is given for pain which acts on the transmission of pain stimuli?

A

Nerve blocks
Drugs I.e. opioids, anticonvulsants
Surgery I.e. DREZ, cordotomy

23
Q

What type of treatments are given for pain which work our the perception of pain?

A
CBT
Mirror box therapy 
Graded motor therapy 
Education
Relaxation
Distraction
24
Q

What type of treatment is given for pain which acts not he descending modulation of pain fibers?

A

Placebos
Drugs I.e. opioids, antidepressants
Surgery I.e. spinal cord stimulation

25
Q

What is gate control theory?

A

Activation of A beta fibers (non-noxious) which stimulates the release of interneurones which inhibit nociceptive firing (A delta and C fibers)

26
Q

What are the stages of transmission which can be modulated for pain therapy/treatment?

A

Transduction (acting at the periphery)
Transmission
Perception
Descending

27
Q

What types of neurons receive nociceptive input?

A

Nociceptive specific neurons

Low threshold mechanoreceptors