T2 L11: Physiology of Pain 2 (AD)
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Questions and Answers

Which type of pain is caused by injury to the nervous system?

  • Chronic pain
  • Acute pain
  • Visceral pain
  • Neuropathic pain (correct)

    • What is the defining time period for acute pain?

  • 3-6 months
  • More than 12 months
  • 6-12 months
  • Less than 3 months (correct)

    • What are the underlying mechanisms of acute pain?

  • Direct activation of nerve receptors
  • Receptors responding to tissue injury (correct)
  • Peripheral sensitization
  • Hyperalgesia

    • Which type of drugs inhibit prostaglandin synthesis and reduce peripheral sensitization?

    <p>Nonsteroidal anti-inflammatory drugs</p> Signup and view all the answers

    Which type of pain medication is not anti-inflammatory?

    <p>Paracetamol</p> Signup and view all the answers

    Which receptors can paracetamol activate in the central nervous system?

    <p>Cannabinoid receptors</p> Signup and view all the answers

    Which cream contains capsaicin?

    <p>Capsaicin cream</p> Signup and view all the answers

    Where do opioids primarily work to relieve pain?

    <p>Central nervous system</p> Signup and view all the answers

    Which of the following is NOT a potential cause of neuropathic pain?

    <p>Hypoxia following a stroke</p> Signup and view all the answers

    What percentage of the population is estimated to be affected by neuropathic pain?

    <p>8-10%</p> Signup and view all the answers

    Which of the following words is NOT used by patients to describe neuropathic pain?

    <p>Numbness</p> Signup and view all the answers

    What are the two main peripheral mechanisms involved in neuropathic pain?

    <p>Sensitization and increased firing of afferents</p> Signup and view all the answers

    Which part of the nervous system do opioids work in to relieve pain?

    <p>Peripheral nervous system</p> Signup and view all the answers

    What is the mechanism called when blowing or rubbing an injury site reduces pain sensation?

    <p>Gate control</p> Signup and view all the answers

    Which of the following is a chronic pain condition?

    <p>Migraine</p> Signup and view all the answers

    What is the difference between nociceptive pain and neuropathic pain?

    <p>Nociceptive pain is caused by tissue injury, while neuropathic pain is caused by injury to the nervous system</p> Signup and view all the answers

    What is the difference between Hyperalgesia and Lavinia?

    <p>Hyperalgesia is the perception of light touch as painful, while Lavinia is a clinical term for neuropathic pain</p> Signup and view all the answers

    What is peripheral sensitization?

    <p>Changes in the kinetics of ion channels at the peripheral terminals of nociceptors</p> Signup and view all the answers

    How is pain characterized in the last lecture?

    <p>Noxious, passive, and neuropathic</p> Signup and view all the answers

    What is the focus of today's lecture?

    <p>The mechanism of hyperalgesia and peripheral sensitization</p> Signup and view all the answers

    Which branch of the nervous system can close down the spinal summit pathway?

    <p>Collateral branches that snap single inhibitory neurones in the dorsal hall</p> Signup and view all the answers

    What happens when the activated collateral branches close down the spinal summit pathway?

    <p>The spinal thalamic tracts become depolarized</p> Signup and view all the answers

    What is the role of the branches associated with second order neurones?

    <p>To release neurotransmitters when something is touched lightly</p> Signup and view all the answers

    What happens when AP two fibres are activated?

    <p>The second order neurones become activated</p> Signup and view all the answers

    What is the result of a sensitized nervous system?

    <p>Inhibition of the torso column medial meniscus pathway</p> Signup and view all the answers

    What do the collateral branches do when they are activated?

    <p>Close shut down the spinal summit pathway</p> Signup and view all the answers

    What is the mechanism responsible for spontaneous pain described by patients with phantom limb pain?

    <p>Spontaneous firing of ion channels in the spinal thalamic tracts</p> Signup and view all the answers

    What is the basis of phantom limb pain?

    <p>Spontaneous firing of noxious axons in the peripheral nerves</p> Signup and view all the answers

    What is central sensitisation?

    <p>An increase in the responsiveness of spinal thalamic neurons to second order neurons</p> Signup and view all the answers

    What are the consequences of prolonged depolarisation in second order neurons in the dorsal horn?

    <p>Activation of NMDA receptors and influx of calcium</p> Signup and view all the answers

    Which of the following is a characteristic of clinical pain?

    <p>It is associated with damage to tissues</p> Signup and view all the answers

    What is the defining time period for chronic pain according to the International Association for the Study of Pain?

    <p>3 months</p> Signup and view all the answers

    Which of the following is NOT a potential cause of acute pain?

    <p>Peripheral sensitization</p> Signup and view all the answers

    What is the primary site of action for acute pain treatments?

    <p>Peripheral nervous system (PNS)</p> Signup and view all the answers

    Which of the following substances can reduce the threshold of heat-activated channels (TRPV1) and contribute to hyperalgesia in acute pain?

    <p>Bradykinin</p> Signup and view all the answers

    What is the mechanism responsible for the excitation of nociceptors in acute pain?

    <p>Direct activation</p> Signup and view all the answers

    Which of the following is NOT a characteristic of neuropathic pain?

    <p>Lasts for a short duration</p> Signup and view all the answers

    Where do opioids primarily work to relieve pain?

    <p>Central nervous system (CNS)</p> Signup and view all the answers

    What is the result of peripheral sensitization in acute pain?

    <p>Hyperalgesia</p> Signup and view all the answers

    Which of the following is a characteristic of acute pain?

    <p>Normal functioning of nociceptors</p> Signup and view all the answers

    Which of the following drugs acts within the central nervous system and inhibits cyclooxygenase enzymes?

    <p>Aspirin</p> Signup and view all the answers

    Which of the following drugs is a TRPV1 agonist and acts in the periphery by topically applying it to the skin?

    <p>Capsaicin</p> Signup and view all the answers

    Which of the following drugs prevents nociceptor firing by blocking sodium channels?

    <p>Lidocaine</p> Signup and view all the answers

    Which of the following drugs is NOT a non-steroidal anti-inflammatory drug (NSAID)?

    <p>Paracetamol</p> Signup and view all the answers

    Which of the following drugs is an example of an opioid?

    <p>Morphine</p> Signup and view all the answers

    Which of the following mechanisms is responsible for reducing pain sensation by the simultaneous activation of low threshold mechanoreceptors?

    <p>Gate control theory</p> Signup and view all the answers

    Which of the following is a common chronic pain condition?

    <p>Osteoarthritis</p> Signup and view all the answers

    Which of the following is NOT a main peripheral mechanism involved in neuropathic pain?

    <p>Central sensitization</p> Signup and view all the answers

    Which of the following is a potential cause of neuropathic pain?

    <p>Tissue injury</p> Signup and view all the answers

    Which of the following is the mechanism responsible for spontaneous pain and phantom limb pain in the damaged tips of regenerating nerve endings?

    <p>Intact nociceptor firing</p> Signup and view all the answers

    Which of the following is NOT a potential treatment for chronic pain?

    <p>Physical therapies</p> Signup and view all the answers

    What is the mechanism of action of tricyclic antidepressants in the treatment of chronic pain?

    <p>Inhibit reuptake of serotonin and noradrenaline</p> Signup and view all the answers

    Which of the following is NOT a characteristic of central sensitization?

    <p>Constant firing of axons from the periphery</p> Signup and view all the answers

    What is the first-line treatment recommended by NICE guidelines for neuropathic pain?

    <p>Amitriptyline</p> Signup and view all the answers

    What is the proposed mechanism of action of anticonvulsants in the treatment of chronic pain?

    <p>Block calcium and sodium channels</p> Signup and view all the answers

    What is the primary focus of chronic pain treatments?

    <p>Managing primary condition</p> Signup and view all the answers

    Which of the following is NOT a potential cause of central sensitization?

    <p>Constant firing of axons from the periphery</p> Signup and view all the answers

    What is the primary mechanism of action of tricyclic antidepressants in the treatment of chronic pain?

    <p>Inhibit reuptake of serotonin and noradrenaline</p> Signup and view all the answers

    Which of the following is NOT a potential treatment for acute pain?

    <p>Tricyclic antidepressants</p> Signup and view all the answers

    What is the second-line treatment recommended by NICE guidelines for neuropathic pain?

    <p>Duloxetine</p> Signup and view all the answers

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