Term
The International Association for the Study of Pain (IASP) defines pain as:
|
|
Definition
| “Unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage, or both.” |
|
|
Term
A. Pain is a natural response to _____ tissue injury
B. The experience of pain depends on both______ stimulus and________ . |
|
Definition
A. soft
B. sensory & perception |
|
|
Term
The perception of pain can be influenced by _____________ that modulates sensation of pain.
|
|
Definition
| endogenous analgesic system |
|
|
Term
Name the 4 Classifications of pain
|
|
Definition
1) duration: Acute & chronic
2) location: Somatic & Visceral
3) Neuropathic pain
4) Referred pain
|
|
|
Term
A. ______ pain is the main complaint of the most people in the world.
B. This pain lasts less than (#) months.
|
|
Definition
A. Acute pain
B. 6 months |
|
|
Term
Acute pain's 4 characteristics |
|
Definition
shooting in nature
It is associated with anxiety
trauma or surgery
is self limited |
|
|
Term
This pain may be associated with increased sympathetic activities such as tachycardia, tachypnea, increased blood pressure, pupillary dilation, decreased gut motility and decreased salivation.
|
|
Definition
|
|
Term
A. This is a useless pain or pain without a function
B. This pain lasts over (#) months |
|
Definition
A. Chronic Pain
B. 6 months |
|
|
Term
True or False:
There is no evidence of ongoing damage to the tissues in chronic pain. |
|
Definition
|
|
Term
Sometimes this pain has an identifiable cause such as degenerative disc disease, spinal stenosis or spondylolisthesis.
BUT, sometimes, there is no identifiable cause. |
|
Definition
|
|
Term
Name the pain:
no autonomic response.
produces psychological, physiological, familial and emotional stresses.
loss of appetite, sleep disturbances and depression
|
|
Definition
|
|
Term
| Nervous tissue may be sending pain signals even though there is no ongoing tissue damage. |
|
Definition
|
|
Term
Name the type of pain:
sharp and localized
Example is injury from a paper cut |
|
Definition
|
|
Term
| Q. ________________arises from cutaneous structures such as skin and subcutaneous tissue |
|
Definition
A. Superficial somatic pain |
|
|
Term
| Q. ______________arises from deeper structures such as periosteum, muscles, tendons, joints and blood vessels. |
|
Definition
|
|
Term
* This pain is more diffuse,
radiation is possible,
*Example is sprained ankle inversion ankle injuries
|
|
Definition
|
|
Term
| Name the 2 types of visceral pain receptors |
|
Definition
1) High threshold receptors
2) Intensity coding receptors
|
|
|
Term
| Q. _____________receptors - respond to noxious stimuli - example is intense contraction of an organ causing intense pain |
|
Definition
High threshold visceral pain receptors |
|
|
Term
Q. ____(A)______ receptors lower threshold for stimulation - respond to continuous ______ and _________ causing dull aching type of pain for longer duration.
|
|
Definition
A. Intensity coding visceral pain receptors
B hypoxia & inflammation |
|
|
Term
Q. What causes the diffuse quality in visceral pain? |
|
Definition
| When nerve fibers enter in the spinal cord, they synapse in more than one spinal cord segments. So the visceral pain is experienced as dull and diffuse pain. |
|
|
Term
| Which type of pain has sympathetic and parasympathetic nerves that carry the action potential generated in receptors. |
|
Definition
|
|
Term
| Q. What causes "referred pain" that is perceived in a different site than the site of origin? |
|
Definition
| A. due to overlapping of the visceral pain & somatic pain fibers in the dorsal horn of spinal cord. |
|
|
Term
Q. The pain receptors are known as _____________ and they are _____ nerve endings.
|
|
Definition
A. nociceptors ..... free nerve |
|
|
Term
The structural triad of
capillary, nociceptor, and mast cell represents a _____________, which is sensitive to tissue damage. |
|
Definition
A. functional nociceptive unit |
|
|
Term
Q. a stimuli of such intensity that they cause pain or close to causing tissue damage.
Examples - pressure from a sharp object, strong electrical current, heat and cold above or normal skin temperature
|
|
Definition
|
|
Term
Q. Response to pressure on skin or violent muscle contraction
i) A delta mechanical receptors
ii) A delta thermal receptors
iii) C polymodal receptors
|
|
Definition
A. i - A delta mechanical receptors |
|
|
Term
Q. Response to chemical stimuli such as trauma, ischemia, inflammation, continuous low intensity mechanical and thermal stimuli
i) A delta mechanical receptors
ii) A delta thermal receptors
iii) C polymodal receptors |
|
Definition
A. iii) C polymodal receptors
|
|
|
Term
Q. Response to extreme of heat and cold
i) A delta mechanical receptors
ii) A delta thermal receptors
iii) C polymodal receptors |
|
Definition
A. ii) A delta thermal receptors |
|
|
Term
Q. True or False
The action potential generated in the nociceptors, is transmitted either through unmyelinated A or myelinated C fibers. |
|
Definition
A. False:
The larger A , which are myelinated fibers,
The C fibers are smaller unmyelinated nerve fibers |
|
|
Term
peripheral (a) nerve have greater conduction velocities, transmitting impulse at a rate of (b). Pain conducted by this is called (c) and typically is elicited by (d) stimuli because it is connected with (e) receptors.
|
|
Definition
a) A fibers
b) 10 to 30m/second
c) fast pain
d) mechanical or thermal
e) A delta mechanical and A delta thermal |
|
|
Term
(a) nerve fibers; they transmit impulse at a rate of (b). This pain is described as slow pain.
(c x3) elicit it because it is connected
with c polymodal fibers |
|
Definition
A) small C fibers
B) 0.5 to 2.5m/second
C) Chemical stimuli or
persistent mechanical or thermal stimuli |
|
|
Term
[image]
These are known as
first generation neurons.
These fibers enter spinal cord through dorsal horn. |
|
Definition
[image]
A. Peripheral Nerve fibers |
|
|
Term
[image]
True or False: The pain fibers enter the spinal cord through dorsal horn. |
|
Definition
[image]
False: Dorsal Roots |
|
|
Term
Q. After entering into the spinal cord, pain afferent travels one or two segments up and down.
This is known as ___________.
|
|
Definition
|
|
Term
Q. The spinal nerve fibers project to particular laminae in the spinal ______________.
|
|
Definition
|
|
Term
In the spinal cord, ______cross the opposite side and ascend upwards as neospinothalamic tract and enters into thalamus.
i) A delta fibers
ii) C fibers
iii) A & C fibers |
|
Definition
|
|
Term
The C fibers synapse on interneurones-->
Then they cross opposite side and ascend upwards as (a) tract and gives branches to (b) and reach to thalamus. |
|
Definition
a) paleospinothalamic
b)reticular activating & limbic systems |
|
|
Term
Matching:
a. Paleospinothalamic tract & entering thalamus:
b. Peripheral nerves:
c. from thalamus and cerebral cortex:
1st generation neurons
2nd generation neurons
3rd generation neurons |
|
Definition
1st generation: begin w/ peripheral nerves
2nd generation: con't paleospinothalamic tract & entering thalamus
3rd generation: leave from thalamusto cerebral cortex |
|
|
Term
Which generation of pain fiber?
* They enter the spinal cord through dorsal roots
* Lissauer’s tract
* A delta fibers cross |
|
Definition
A. 2nd generation pain fibers |
|
|
Term
Q. The thalamus acts as
1.__________________
2.__________________ |
|
Definition
A. 1. relay station for sensations
2. the start point for the 3rd gen. neurons that end in the sensory humonculus in sensory cortex
|
|
|
Term
When tissue is injured; nociceptor stimulation...(Put in proper order)
a. stimulation of membrane bound phospholipase A2
b. production of prostaglandins, thromboxanes, and leukotroenes.
c. release of Arachidonic acid |
|
Definition
1. stimulation of membrane bound phospholipase A2-->
2. which releases Arachidonic acid -->
3. Arachidonic acid causes production of prostaglandins, thromboxanes, and leukotroenes.
|
|
|
Term
Q. During tisse damage, which cells releases histamine and chemotactic agents?
Q. What do these agents attract? |
|
Definition
A. Mast cells
A. neutrophils & eosinophils |
|
|
Term
| Q. What causes the release of arachindonic acid from the cell membrane? |
|
Definition
| A. physical, chemical or immunological agents injure the tissue causing Phospholipase A2 to cause the release of arachindonic acid from membrane phospholipids |
|
|
Term
| Q. Arachidonic acid causes production of which chemical mediators in the initial phase of the pain response? |
|
Definition
A. prostaglandins, thromboxanes, and leukotroenes |
|
|
Term
Q. How does histamine release cause pain? |
|
Definition
A. it causes dilation of the capillaries and increase capillary permeability. This causes accum. of edema fluid and produces mechanical pressure that activates sensory neurones. |
|
|
Term
True or False:
Ion channels in nociceptors are sodium channels. |
|
Definition
|
|
Term
| Q. The nociceptor channels open and _________ions flow into the nociceptor ______ terminal, producing action potential. This occurs in the ______________ phase of the pain response. |
|
Definition
A. sodium and calcium
B. peripheral
C. activation of receptors |
|
|
Term
| Q. The conversion of a thermal, mechanical or chemical stimuli into electrical activity is known as___________ .This occurs in the ______________ phase of the pain response. |
|
Definition
A. transduction
B. activation |
|
|
Term
| Q. The passage of action potential from the peripheral receptor to central nervous system is known as _______. This occurs in the ______________ phase of the pain reponse. |
|
Definition
A. conduction
B. transmission in the peripheral nerve |
|
|
Term
Q. Where is the action potential generated in nociceptors, when it is transmitted either through A or C fibers.
a. Transmission in spinal cord
b. Transmission in higher centers
c. Transmission in peripheral nerve
|
|
Definition
| c. transmitted either through A or C fibers in peripheral nerve. |
|
|
Term
The larger A fibers transmit pain at a __________rate; while the smaller C fibers transmit pain at a _______rate. |
|
Definition
A. faster rate (10 to 30m/second)
B. slower rate ( 0.5 to 2.5m/second) |
|
|
Term
Q. During transmission of "pain" in peripheral nerves, action potential reaches to the ____________. |
|
Definition
A. pre-synaptic neurones in spinal cord (CNS) |
|
|
Term
Q. The action potential transmitted from one neuron to another neuron by release of neurotransmitters is known as_____________.
Q. This occurs where? |
|
Definition
A. transmission
B. Spinal Cord (CNS) |
|
|
Term
Q. During "pain"...When the action potential reaches to the pre-synaptic neurons in the dorsal horn of spinal cord, it releases glutamic acid from pre-synaptic neurons. Which fibers participate in this? |
|
Definition
|
|
Term
Q. During "pain",
C fibers - when the action potential reaches to the pre-synaptic neurons in the dorsal horn of spinal cord, it releases what neurotransmitter?
a. substance P
b. glutamate
c. histamine |
|
Definition
A. C fibers--> Substance P |
|
|
Term
Q. In the CNS, glutamate and their NMDA receptors are associated with:
a. fast C fibers
b. fast A fibers
c. slow C fibers
d. slow A fibers |
|
Definition
|
|
Term
| Q. When slow C fibers are repetitively stimulated at a rate of one per second, each stimulus produces a progressively increasing response (wide dynamic neurons). This amplification of transmitted signal is called _____________________. |
|
Definition
|
|
Term
True or False:
Release of neurotransmitters, dopamine, seratonin and substance P, cause sensitization of the central nervous system. |
|
Definition
| A. False - glutamate and substance P are the pain transmission neurotransmitters in the CNS |
|
|
Term
| Q. When A delta fibers carry action potentials in transmitting "pain" it is done thru: __________ tract --> reaches to______ and then to________ . |
|
Definition
A. neospinothalamic--->thalamus--->
cerebral cortex |
|
|
Term
Q. Perception and interpretation of pain - gives precision, discrimination and meaning to the pain... is done thru this area of the brain...
|
|
Definition
|
|
Term
Q. When _______fibers carry action potential - transmits through paleospinothalamic tract - reaches to RAS and limbic system
|
|
Definition
|
|
Term
| Q. C fibers - carry action potential - transmits through _______tract - reaches to ________ and _______. |
|
Definition
A. paleospinothalamic-->RAS & limbic system |
|
|
Term
A. Pain is experienced as sharp, bright and stabbing
B. Associated with emotional aspect of pain
C. Perceived as dull, diffuse, aching and unpleasant pain
Which above is C fiber and/or A delta? |
|
Definition
A. Pain is experienced as sharp, bright and stabbing - A delta
B. Associated with emotional aspect of pain - C fiber
C. Perceived as dull, diffuse, aching and unpleasant pain - C fiber
|
|
|
Term
A. transmits through paleospinothalamic tract -
B. transmits through neospinothalamic tract -
C. reaches to RAS and limbic system
D. reaches to thalamus and then to cerebral cortex.
Which fiber? A delta or C fiber
in transmitting pain. |
|
Definition
A. transmits through paleospinothalamic tract - reaches to RAS and limbic system
-->slow C fibers
B. transmits through neospinothalamic tract -
reaches to thalamus and then to cerebral cortex -----> Fast A delta fibers
|
|
|
Term
Q. True or False:
The endogenous analgesia system modulates the pain in the peripheral nervous system.
|
|
Definition
|
|
Term
True or False:
The most important effect of the endogenous modulatory system is to decrease the pain sensations coming from outside of the body, so the pain signals coming inside of the body are perceived properly.
|
|
Definition
False: The most important effect of this modulatory system is to decrease the pain sensations coming from inside of the body, so the pain signals coming outside of the body are perceived properly.
|
|
|
Term
| Q. Which 3 areas of the brain send signals to the PAG (Peiaqueductal gray) area for endogenous pain modulation? |
|
Definition
A.
amygdala, hypothalamus and cerebral cortex |
|
|
Term
Q. This area is located in midbrain and contains lots of opioid receptors and is known as endogenous analgesia center.
|
|
Definition
A. Peiaqueductal gray area or PAG |
|
|
Term
| Signals from the amygdala, hypothalamus and cerebral cortex --> PAG in midbrain -> Medulla + pons -> dorsal horn of spinal cord -> release of ______________(3 transmitters)-> combines with opioid receptors -> modulation of pain |
|
Definition
A. enkeplalins, endorphins and dynorphins |
|
|
Term
| Signals from the amygdala, hypothalamus and cerebral cortex --> PAG in midbrain -> Medulla + pons -> ___________-> release of enkeplalins, endorphins and dynorphins -> combines with opioid receptors -> modulation of pain |
|
Definition
A. dorsal horn of spinal cord |
|
|
Term
| Which two areas of the CNS contain many opioid receptors? |
|
Definition
| A. PAG in midbrain and the dorsal horn of the spinal cord |
|
|
Term
Q. The dorsal horn of the spinal cord gets its endogenous pain modulating signals from where? |
|
Definition
A. the pons and the medulla
(while those signals come from the PAG) |
|
|
Term
Q. The origin of where the pain modulation comes from is from the:
a. peripheral A delta fibers
b. pons and medulla
c. hypothalamus
d. amygdala and cerebral cortex |
|
Definition
| A.amygdala, hypothalamus and cerebral cortex |
|
|
Term
| Lack of serotonin and noradrenergic receptors -> Loss of endogenous analgesia system -> multiple pain syndrome; causes this disease state. |
|
Definition
|
|
Term
This pain theory: Pain receptors share endings or pathways with other sensory modalities -
a. Specificity theory
b. Gate control theory
c. Pattern theory
d. Neuromatrix theory |
|
Definition
|
|
Term
Different pattern of activity of the same neurons can be used to signal painful or non painful stimuli
a. Specificity theory
b. Gate control theory
c. Pattern theory
d. Neuromatrix theory |
|
Definition
|
|
Term
Light touch causes low frequency firing of receptors which is perceived as a light touch. Intense pressure causes high frequency firing of same receptor which is perceived as a pain.
a. Specificity theory
b. Gate control theory
c. Pattern theory
d. Neuromatrix theory |
|
Definition
|
|
Term
Phantom limb pain - integration of multiple sources of input, into a widely distributed neuronal network cause brain to misinterprete the stimuli as pain.
a. Specificity theory
b. Gate control theory
c. Pattern theory
d. Neuromatrix theory |
|
Definition
|
|
Term
Q. Internuncial neurons are activated by large diameter, faster propagating fibers that carry tactile information.This transmission blocks impulses from small diameter pain fibers:
a. Specificity theory
b. Gate control theory
c. Pattern theory
d. Neuromatrix theory |
|
Definition
|
|
Term
Pain intensity is temporarily reduced by activation of tactile stimulus:
a. Specificity theory
b. Gate control theory
c. Pattern theory
d. Neuromatrix theory |
|
Definition
|
|
Term
"Pain is a separate sensory modality
Evoked by activity of specific receptors - transmits information to brain centers "
a. Specificity theory
b. Gate control theory
c. Pattern theory
d. Neuromatrix theor |
|
Definition
|
|
