_ order neuron: sensory to SC
first
_ order neuron: SC to Th
Second
_ order neuron: To other ctx
third
Spinal gray matter enlarges at _ and _ sections due to the presence of limbs
lumbar
sacral
C fibers target lamina _
1, 2
Peptidergic C fibers target _
lamina 1, outer lamina 2
Nonpeptidergic C fibers target _
inner lamina 2
A delta myelinated fibers target _
lamina 1, 4, 5
A beta myelinated fibers target _
lamina 3-6 and PKCy+
A alpha myelinated fibers target _
lamina 6, 7, 9
Pain fibers of CN-V enter the SC and _ before crossing and ascending to Th
descend to the spinal nucleus
Touch fibers of CN-V enter SC and _
synapse and join the ML
Substance P binds to _
NK1
Substance P is _ to humans
inneffective
CGRP binds to _
ramp1
CGRP is used to _
treat migraines in clinical trials
BDNF is a _ of nociceptive responses in _
endogenous modulator
DRG neurons
The lateral STT receives input from _ and projects to _, _, _, _, _, _
contralateral lamina I (C) PAG Th Cing Insula SI BS
Spinomesencephalic tract
SC -> PAG -> limbic system
OR
SC -> parabrachial area -> limbic system
Classical Pathway
Where
Slow
Dorsal Th, SI
Central Pain Path
Non-Classical Pathway
What
Fast
Ventral Th
Object information
STT originates from lamina _
1, 2
STT Dorsal Th -> _
insula, ant. cingulate
STT ventral Th -> _
SI/SII -> amygdala, cing, PFC
STT SC -> _, _, or _.
Dorsal Th
Ventral Th
PAG
Descending STT: Ctx -> _, _, _
PAG
RVM
Dorsal Horn
Islet interneuron NT
GABA, Gly
Radial, Vertical interneuron NT
Glu
Central interneuron NT
GABA, Gly, Glu
Spino-parabrachial pathway bypasses the _ and projects straight to the _.
thalamus
limbic area
WGA acts as a tracer for _
nonpeptidergic nonciceptors
Loss of lamina 1 neurons that express substance P results in _
pain alleviation
PAG
site of endogenous pain control NT
Pain control NT (in PAG) are _ and _
opiod and cannabinoids
RVM
rostral ventromedial medulla
DLPT
Dorsolateral pontine tegmentum
RVM has _ innervation
serotenergic
DLPT has _ innervation of the _ thought to be inhibitory
noradrenergic
dorsal horn
PAG controls _ via RVM and DLPT
spinal nociceotive neurons
RVM ON-CELLS are _ and _ by morphine
excitatory
inhibited
RVM OFF-CELLS are _ and _ by morphine
inhibitory
excited
RVM ON-CELL spikes _ after activation
linger
RVM OFF-CELL spikes _ after activation
diminish quickly
PAG neurons activate _ neurons
opioid
A --_ circuit produces a placebo analgesia
PFC-PAG-RVM
_ and _ are central to driving analgesia responses.
opioids
cannabinoids
_ promotes descending facilitation within the PAG and is involved in the _ effect.
cholecytokinin (CCK)
Nocebo
Activation of _ and _ result in placebo effect
PFC
PAG
The _ is the sole supplier of serotonin to the dorsal horn.
RVM
_ in the dorsal horn modulates the effect of pain and is believed to _.
promote pain
NE causes inhibition when binding to _
alpha2 receptors
NE causes excitation when binding to _ or _
alpha1
beta1/2
Alpha1 receptors cause _ and release _
excitation
gaba/gly
Alpha2 receptors cause _ and release _
inhibition
Glu
SNRI
Serotonin and norepinephrine reuptake inhibitor
_ relieves pain and improves function for fibromyalgia
duloxetine
chronic low back pain causes _ in the cortex
decreased gray matter density
_ decreases cortical thickness in discrete brain regions
fibromyalgia
nociceptive input to the amygdala goes to the _ nucleus
central anterior
nociceptive input to the _ expands the noxious receptive field of amygdala neurons to the entire body
right amygdala
pain results in _
cognitive impairment
acute treatment of pain doesn’t treat _ induced attention deficits
plasticity