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Human disease and therapeutics 2020 > Pain lecture 2 > Flashcards

Pain lecture 2 Flashcards

1
Q

What are pain tranducers known as?

A

-Nociceptors

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2
Q

What are the different types of nociceptors?

A
  • Mechanical
  • Thermal
  • Polymodal
  • Chemical
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3
Q

What are mechanical subtypes of nociceptors?

A
  • Force

- Trauma

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4
Q

What are the receptor types for nociceptors?

A
  • Transient receptor potential

- Prostaglandin/purino and pyrimidine receptors

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5
Q

What are the chemical subtype of nociceptors?

A

-H+ ions

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6
Q

What are the thermal subtypes of nociceptors?

A
  • Cold

- Heat

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7
Q

What receptor type is found in thermal nociceptors?

A

-TRP

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8
Q

What are polymodal subtypes of nociceptors?

A
  • Mechanical
  • Thermal
  • Chemical
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9
Q

What does Capsaicin activate?

A

-Polymodal nociceptors TRPV1

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10
Q

What is the transmitter for Capsaicin?

A

-Substance P

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11
Q

What is the positive feedback that causes secondary activation of nociceptor nerves?

A

-Chemical messengers released from activated nociceptor nerve endings act locally to release messengers that further activate the nociceptors

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12
Q

Action potentials propagate toward the cell body in the ______ and then enters the ______?

A
  • Dorsal root ganglion

- Spinal cord

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13
Q

What is sensitization?

A

-Increased sensitivity and response to stimuli in and near the injured area caused by chemical messengers that make the nociceptors more excitable

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14
Q

What is Hyperalgesia?

A

-Increased perception of pain in response to painful stimuli

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15
Q

What is Allodynia?

A

-Pain evoked by normally nonpainful stimuli

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16
Q

What are the major candidates for sensitization?

A
  • Substance P from nerve endings

- Prostaglandins from damaged cells

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17
Q

Prostaglandin receptor stimulation results in activation of what?

A

-Specific Na+ channels

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18
Q

What do you the activation of specific Na+ channels by PG receptor stimulations do?

A

-Makes the nociceptive nerve endings more excitable

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19
Q

Do we have selective COX-1 inhibitors?

A

-No

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20
Q

What is COX-1?

A

-Is constitutive (always present) in many tissues

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21
Q

What does COX-1 do?

A
  • GI cytoprotection
  • Platelet aggregation
  • Renal electrolyte homeostasis
  • Renal blood flow maintenance
22
Q

What are COX -1 inhibited by?

A

-NSAIDS

23
Q

What are some adverse effects of classic NSAIDS?

A
  • Bleeding
  • stomach irritation
  • GI side effects
24
Q

What does COX-2 do?

A
  • Pain (inducible)
  • Fever (inducible)
  • Inflammation (inducible)
  • Cardiovascular protection (constitutive)
25
Q

What is COX-2 inhibited by?

A
  • NSAIDS

- Selective COX-2 inhibitors (Celebrex)

26
Q

What stimulated COX-2?

A
  • Hormones
  • Growth Factors
  • Inflammatory mediators
27
Q

What do NSAIDS inhibit?

A

-Synthesis of prostaglandins that are involved in sensitizing the nociceptor nerve ending

28
Q

How are nociceptors in the viscera normally activated?

A

-Mechanical stimulation such and distention or contractions (visceral pain can be referred to outside areas)

29
Q

Do you take NSAIDS for visceral or somatic pain?

A

-Somatic

30
Q

Which pain pathways are small, myelinated, and fast conducting?

A

-A -delta

31
Q

What are A-delta fibers associated with?

A

-Mechanical and thermal nociceptors

32
Q

Are A-beta fibers pain associated?

A

-No they are proprioception fibers

33
Q

What pain fibers are small, unmyelinated, and slow conducting?

A

-C axons

34
Q

What are C- axons associated with?

A

-Polymodal nociceptors

35
Q

What are plexus of nerves in the tooth called?

A
  • Sub-odontoblastic plexus

- Plexus of Raschkow

36
Q

Which fiber gives you sharp pain?

A

-A-delta

37
Q

Which fiber gives you dull diffuse pain?

A

-Dull diffuse

38
Q

Nociceptive fibers synapse with “projection” neurons in what area?

A

-Dorsal horn

39
Q

What are important pain neurotransmitters in modulation?

A
  • Glutamate

- Substance P

40
Q

T/F Projection neurons send axons across midline

A

True

41
Q

Where do the ascending pathways ascend contralaterally?

A
  • Spinothalamic tract
  • Thalamus
  • Somatosensory relay
42
Q

Where does the trigeminal nucleus input to?

A

-Thalamus

43
Q

Where is nociceptive input heavily modulated at?

A

-=Dorsal horn with both facilitatory and inhibitory influences

44
Q

What is Central sensitization?

A

-Dorsal horn projection neurons also become sensitized and hyper-responsive to nociceptive input.

45
Q

T/F Prostaglandins can sensitize at the nociceptive level and at the spinal cord level (central sensitization)

A

True

46
Q

T/F The dorsal horn is a major site of action for analgesic drugs

A

True

47
Q

What is a second mechanism for the anti-nociceptive action of NSAIDS for central analgesia?

A

-Inhibits the synthesis of prostaglandins in the dorsal horn that participate in central sensitization

48
Q

T/F The dorsal horn is a major site of action of opioids

A

True

49
Q

Sometimes strong touch stimulation can inhibit what?

A

-Nociception

50
Q

T/F A Beta and A delta fibers never converge together

A

False

-They do converge

51
Q

Visceral afferent nociceptors ________ on the same pain projection neurons as the afferents from the somatic structures in which the pain is perceived?

A

-Converge

52
Q

What is a type of referred pain that can be thought of a possible dental problem?

A

-Sinusitis feels like tooth pain sometimes

Human disease and therapeutics 2020 (60 decks)

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