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MSK > Physiology of pain > Flashcards

Physiology of pain Flashcards

1
Q

What is the definition of pain?

A

An unpleasant sensory and emotional experience, associated with actual tissue damage or described in terms of such damage

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2
Q

What are the 4 processes in the physiology of pain?

A

Transduction
Transmission
Modulation
Perception

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3
Q

What is transduction?

A

Translation of noxious stimulus into electrical activity at the peripheral nocicpeto

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4
Q

What is transmission?

A

Propagation of pain signal as nerve impulses through the nervous system

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5
Q

What is modulation?

A

Modification of pain transmission in the nervous system e.g. by inhibitory neurotransmitters like endogenous opioids

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6
Q

What is perception?

A

Conscious experience of pain. Causes physiological and behavioural responses

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7
Q

What is a nociceptor?

A

Specific primary sensory afferent neurones normally activated by intense noxious stimuli (e.g. mechanical, thermal or chemical)
First order neurones that relay info to second order neurones in CNS via chemical synaptic transmission

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8
Q

What neurotransmittors are involved in the nociceptive pathway?

A

Glutumate and pepties (substance P and neurokinin A)

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9
Q

Where is the cell body in the nociceptive pathway found?

A

Dorsal root ganglion

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10
Q

Where will you find second order neurones?

A

In the anterolateral system

They terminate in the thalamus

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11
Q

What is the spinothalamic tract?

A

Involved in pain perception (location, intensity)

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12
Q

What is the spinoreticular tract?

A

Involved in autonomic responses to pain, arousal, emotional respones and fear of pain

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13
Q

Where will the pain impulse go after the thalamus?

A

Sensory information is relayed (3rd order) to the primary sensory cortex

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14
Q

What kind of stimulus can activate a noiceptive receptor?

A

Mechanical
Thermal
Chemical

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15
Q

What are the different types of nocicpetors?

A

A-delta

C-fibres

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16
Q

What is an A-delta fibre?

A

Mechanical/ thermal nociceptors that are thinly myelinated.
Respond to noxious mechanical and thermal stimulus
Mediate first/ fast pain

17
Q

What is a C-fibre?

A

Nociceptors that are unmyelinated
Collectively respond to all noxious stimulus
Polymodal
Mediate second/ slow pain

18
Q

What type of pain with A-delta fibres produce?

A

Lancinating
Stabbing
Prickling

19
Q

What type of pain will C-fibres produce?

A

Burning
Throbbing
Cramping
Aching

20
Q

How can pain be classified?

A

Mechanisms (nociceptive, inflammatory, pathological)
Time course (acute, chronic, breakthrough)
Severity (mild, moderate, severe)
Source of origin (somatic or visceral)

21
Q

What is nocicpetive pain?

A

Normal response to injury by noxious stimulus
Only provoked by an intense stimulus
Adaptive pain

22
Q

What is inflammaory pain?

A

Activation of the immune system by tissue injury or infection
Variety of mediators released at the site of inflammation by leucocytes, vascular endothelium and tissue resident mast cells
Adaptive - promotrs repiar until healing occurs

23
Q

What is hyperalgesia?

A

Heightened pain sensitivity to noxious stimuli

24
Q

What is allodynia?

A

Pain sensitvity to innocuous stimulus

25
Q

What causes neuropathic pain?

A

Damage to neural tissue

26
Q

What are examples of neuropathic pain?

A 
Compression neuropathies
Peripheral neuropathies
Central pain
Postherpetic neuralgia 
Trigeminal neuralgia
Phantom limb
27
Q

What type of pain will neuropathic pain cause?

A

Burning
Shooting
Numbness
Pins and needles

28
Q

What is dysfunctional pain?

A

No identifiable damage or inflammation

29
Q

What are some examples of dysfunctional pain?

A 
Fibromyalgia
Irritable bowel syndrome
Tension headache
Temprormandibular joint disease 
Interstitial cysititis
30
Q

What type of drugs can be used to treat dysfunctional pain?

A

Antidepressants

Anti-epileptics

31
Q

What are the 2 different types of pathological pain?

A

Neuropathic

Dysfunctional

32
Q

What is referred pain?

A

Pain developed in one part of the body felt in another structure far from the place of development

33
Q

Why does referred pain occur?

A

Convergene of nociceptive visceral and skin afferents upon the same spinothalamic neurones at the same spinal level

34
Q

Where can cardiac pain refer to?

A

Left arm and jaw

35
Q

Where can gall bladder and liver pain refer to?

A

Right shoulder

36
Q

Where can stomach/ pancreatic pain refer to?

A

Epigastric area

37
Q

Where can appendix pain refer to?

A

Umbilical area

MSK (34 decks)

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