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585-5
Pain
| Term | Definition |
|---|---|
| pain is a percept | Learned association between stimulus and consequence Bringing to conscious awareness the sensation of tissue damage |
| 1. acute pain 2. persistent pain 3. chronic pain | 1. Sharp, immediate. Detection of tissue damage 2. Healing, nociceptive (activate nociceptors to alert about damage), neuropathic (how NS interprets pain) 3. Not related to damage, maladaptive |
| alpha-delta afferents | Myelinated fibers, relatively small diameter compared to alpha beta Nociceptors, any noxious stimulus to body (thermal & mechanical) Synapses onto 2 neurons in spinal cord |
| c-fibers | Unmyelinated, small diameter fibers Thermal, mechanical, chemical Noxious stimuli |
| alpha-beta afferents | Specifically related to touch Not painful Large and myelinated Bifurcates onto anterolateral pathways |
| first vs. second pain | Initial sharp pain delivered via alpha delta fibers vs. Aching pain delivered by C fibers. Metabolically cheaper to continue delivering messages with these |
| 1. spinothalamic tract 2. spinoreticular tract 3. spinomesencephalic tract | 1. Spine to thalamus, then to cortex. When & where pain is 2. To thalamus & reticular formation. Then cortex. Increases arousal. 3. To limbic system via midbrain, periaqueductal grey area. Suppress pain. |
| hyperalgesia vs. allodynia | Increase pain sensation from damaged tissue (ex. touching a sunburn) vs. Increase perception of pain to non-noxious stimuli (undamaged tissue) |
| peripheral pain mechanism | 1. Damage to tissue, releases inflammation response 2. Produce AP to spinal cord & release SubP 3. Substance P released & activates mast cells to release histamines 4. More inflammation to immobilize tissue, also vasodilation |
| central pain mechanism | 1. Pain neuron goes to dorsal horn 2. Presynaptic neuron releases glutamate into space 3. Glutamate binds to AMPA that allows Na to flow in |
| wind up- central pain mechanism | 1. Multiple AP 2. Releases glutamate & substance P 3. Both bind to AMPA & NMDA 4. Receptors open & allows Na & Ca to enter 5. Ca causes 2nd messenger cascade 6. More AMPA receptors onto post synaptic space |
| sensory gate theory | 1. A beta & C fiber synapses onto projection neuron 2. A beta (+) & C fiber (-) synapse onto interneuron 3. A beta is activated, then activates inhibitory neuron to suppress projection neuron (holding painful area suppresses pain) |
| opiate system | Opiate receptors throughout brain, but high conc in periaqueductal gray region, raphe nuclei, spinal cord Morphine derived from opium & activates receptors Receptors activated by endorphins (like morphine) |
| opiate system process | 1. Endorphins don't synapse directly, are neuromodulators 2. Endorphin binds to Ca channel & decrease Ca influx- less NT release 3. Endorphin binds to post synaptic, change conductance to K- hyperpolarizes the cell |
| what activates endorphin system | Physical & psychological stress |
| chronic pain | Occurs despite no activation of pain receptors Intractable- can't remove May be due to long term adaptation following prolonged period of persistent pain |
Created by:
craftycats_
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