Neuroscience of Pain Perception and CSF

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Questions and Answers

What system is responsible for identifying the presence, character, location, and intensity of pain?

  • Cognitive evaluative system
  • Affective-motivational system
  • Sensory-discriminative system (correct)
  • None of the above

What is the role of the Affective-motivational system in pain perception?

  • It identifies the presence, character, location, and intensity of pain.
  • It determines the individual's learned behavior concerning the experience of pain.
  • It determines an individual's conditioned avoidance behaviors and emotional responses to pain. (correct)
  • It determines the pain threshold for individuals.

Which of the following factors can decrease pain tolerance?

  • Increased sleep
  • A calm environment
  • A positive attitude
  • Fatigue (correct)

What is pain threshold?

<p>A point where a stimulus is perceived as pain. (B)</p> Signup and view all the answers

Which brain structure is NOT directly involved in the affective-motivational system of pain perception?

<p>Cerebral Cortex (A)</p> Signup and view all the answers

What is the primary function of the cerebral peduncles in the midbrain?

<p>Carry efferent fibers for motor control from the cortex to the brainstem (A)</p> Signup and view all the answers

Which structure within the midbrain is responsible for carrying cerebrospinal fluid (CSF) between the third and fourth ventricles?

<p>Cerebral aqueduct (D)</p> Signup and view all the answers

Damage to which specific area of the midbrain can lead to akinetic mutism?

<p>Tegmentum near the hypothalamus and third ventricle (B)</p> Signup and view all the answers

Which of the following is NOT a characteristic of Parkinsonism?

<p>Hyperkinesia (D)</p> Signup and view all the answers

What specific role does the CSF play in protecting the brain?

<p>It acts as a shock absorber, cushioning the brain from impact. (A)</p> Signup and view all the answers

What is the primary function of the arachnoid villi?

<p>Act as one-way valves to allow CSF absorption into the blood (A)</p> Signup and view all the answers

Where is CSF primarily produced?

<p>Choroid plexus (C)</p> Signup and view all the answers

What is the primary site of CSF absorption?

<p>Arachnoid villi (D)</p> Signup and view all the answers

Which of the following areas is NOT where enkephalins are concentrated?

<p>Cerebral Cortex (A)</p> Signup and view all the answers

What is the primary function of Endorphins?

<p>Producing the most intense sense of euphoria among the opioid neuropeptides (D)</p> Signup and view all the answers

Which of the following opioid receptor types is Dynorphin most strongly associated with?

<p>κ Receptors (A)</p> Signup and view all the answers

In what circumstance can Dynorphins paradoxically contribute to pain sensation?

<p>When they are upregulated in the nervous system (C)</p> Signup and view all the answers

What is a seizure defined as?

<p>A sudden, temporary disruption of brain function caused by abnormal electrical activity (C)</p> Signup and view all the answers

Which of the following statements about Enkephalins is TRUE?

<p>They have two types: Methionine-enkephalin and Leucine-enkephalin (C)</p> Signup and view all the answers

Which of the following is NOT a symptom of a seizure?

<p>Increased respiratory rate (A)</p> Signup and view all the answers

What is the primary mechanism by which endogenous opioids, like Dynorphins, influence pain perception?

<p>By inhibiting transmission of pain impulses in the nervous system (C)</p> Signup and view all the answers

Which of the following is NOT a factor that can DECREASE pain tolerance?

<p>Warmth Application (A)</p> Signup and view all the answers

Which of the following is considered a medical emergency?

<p>A single seizure lasting for more than 30 minutes (C)</p> Signup and view all the answers

Which of the following activities can potentially INCREASE pain tolerance?

<p>Hypnosis (D)</p> Signup and view all the answers

Which of the following is NOT a potential long-term consequence of seizures?

<p>Improved cognitive function (A)</p> Signup and view all the answers

What is a common cause of status epilepticus?

<p>Abrupt discontinuation of antiseizure medications (C)</p> Signup and view all the answers

What is the primary genetic risk factor associated with late-onset Alzheimer's disease?

<p>Apolipoprotein E allele 4 (apoE4) (C)</p> Signup and view all the answers

Which of the following is NOT a clinical manifestation of Alzheimer's disease?

<p>Increased brain weight and volume (D)</p> Signup and view all the answers

Which of the following statements about early-onset familial Alzheimer's disease (FAD) is TRUE?

<p>It is caused by mutations in a single gene located on chromosome 21. (D)</p> Signup and view all the answers

Which of the following is a treatment for Alzheimer's disease aimed at maintaining cognitive function?

<p>Memory aids and strategies (C)</p> Signup and view all the answers

Which of the following is a diagnostic tool used to assess the progression of Alzheimer's disease?

<p>Brain imaging of structure and metabolism (B)</p> Signup and view all the answers

Which of the following is used to screen for early-onset Alzheimer's disease?

<p>Genetic susceptibility tests for PSEN1, PSEN2, and APP (B)</p> Signup and view all the answers

What is the primary mechanism by which amyloid beta protein fragments contribute to Alzheimer's disease pathology?

<p>They accumulate and form plaques that disrupt nerve impulse transmission and lead to neuron death. (B)</p> Signup and view all the answers

Which of the following is NOT a clinical criterion for brain death?

<p>Presence of a strong brain stem reflex. (C)</p> Signup and view all the answers

Which of the following injuries can lead to vomiting due to direct involvement of the central neural mechanism?

<p>Pyloric obstruction. (A)</p> Signup and view all the answers

What is the difference between brain death and cerebral brain death?

<p>Brain death involves irreversible damage to the entire brain, while cerebral brain death only affects the cerebral hemispheres. (B)</p> Signup and view all the answers

Which of the following is a sign of a diminished level of consciousness (LOC)?

<p>Confusion. (D)</p> Signup and view all the answers

Which of the following is a direct cause of vomiting in CNS disorders?

<p>All of the above. (D)</p> Signup and view all the answers

Why is a rising PaCO2 above 60mmhg without breathing efforts considered a clinical criterion for brain death?

<p>High CO2 levels indicate that the respiratory center in the brainstem is not functioning. (C)</p> Signup and view all the answers

What does the phrase "alert and oriented to self, others, place, and time" indicate?

<p>The individual is functioning at the highest level of consciousness. (A)</p> Signup and view all the answers

Which of the following statements is TRUE about vomiting, yawning, and hiccups?

<p>They are complex reflex motor responses integrated in the lower brainstem. (D)</p> Signup and view all the answers

Flashcards

Pain perception

The conscious awareness of pain generated by the brain's systems.

Sensory-discriminative system

Identifies presence, character, location, and intensity of pain via the somatosensory cortex.

Affective-motivational system

Determines emotional responses and avoidance behaviors related to pain.

Cognitive evaluative system

Influences pain perception based on learned behaviors and thoughts.

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Pain threshold

The point at which a stimulus is perceived as painful; generally consistent among individuals.

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Cerebral Peduncles

Efferent fibers connecting cortex to brainstem via corticospinal, corticobulbar, and corticopontocerebellar tracts.

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Cerebral Aqueduct

A canal that carries CSF between the 3rd and 4th ventricles, obstruction leads to hydrocephalus.

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Automatic Body Functions

Functions regulated by the hypothalamus in the midbrain, essential for homeostasis.

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Akinetic Mutism

Condition where a person cannot move or speak due to damage near hypothalamus and third ventricle.

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CSF Functions

Clear fluid that protects CNS structures, provides buoyancy, and cushions against shocks.

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Arachnoid Villi

Protrusions that act as one-way valves, directing CSF outflow into blood and preventing blood leakage.

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Hydrocephalus

Condition caused by CSF obstruction, leading to excessive accumulation in ventricles.

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Parkinsonism

Neurologic syndrome marked by tremors, rigidity, and postural instability due to basal ganglia degeneration.

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Level of Consciousness (LOC)

The degree to which an individual is awake and aware of themselves and their environment.

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Altered Consciousness

Changes in consciousness that may indicate improvement or worsening medical conditions.

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Vomiting in CNS injuries

Vomiting is a reflex response linked to certain central nervous system injuries.

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Medulla Oblongata Functions

Involved in controlling vital responses like vomiting; affected by various CNS conditions.

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Brain Death

Irreversible loss of all brain activity, including the brainstem and cerebellum, non-recoverable state.

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Vegetative State

Condition where individual shows no signs of awareness but may have sleep-wake cycles.

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Apnea in Brain Death

Condition of no spontaneous breathing even with elevated CO2 levels, indicating brain function loss.

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Diplopia and Vomiting

Double vision may accompany injuries affecting vestibular nuclei and can trigger vomiting.

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Endogenous Opioids

Family of morphine-like neuropeptides that inhibit pain transmission.

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Enkephalins

The most prevalent endogenous opioids, concentrated in brain regions.

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Endorphins

Endogenous morphine that provides substantial pain relief and a sense of exhilaration.

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Dynorphins

Most potent endogenous neurohormones that can both impede and incite pain.

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Endomorphins

Potent analgesic effects related to pain relief, GI function, and inflammation.

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Tolerance to Pain

The body's adaptation to pain, which can vary with sensitivity.

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Pain Management Techniques

Methods such as hypnosis, warmth, and distraction that can reduce pain perception.

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Opioid Receptors

Receptors that endogenous opioids bind to, affecting various body systems.

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Amyloid Beta Accumulation

Build-up of toxic amyloid beta fragments leading to neural damage.

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Diffuse Neuritic Plaques

Clumps of amyloid beta that disrupt nerve function.

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Apolipoprotein E (ApoE4)

Genetic risk factor that impairs amyloid beta clearance in Alzheimer's.

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Early-Onset Familial Alzheimer's Disease (FAD)

A rare, inherited form of Alzheimer's linked to specific genetic mutations.

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Clinical Diagnosis of Alzheimer's

Made by ruling out other causes and assessing clinical history and symptoms.

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Cholinesterase Inhibitors

Medications used to treat mild to moderate Alzheimer's by enhancing neurotransmitter function.

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NMDA Receptor Antagonist

Blocks glutamate activity to slow progression of moderate to severe Alzheimer's disease.

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Genetic Susceptibility Tests

Tests used to screen for early-onset Alzheimer's by identifying mutations.

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Seizure

A transient alteration of brain function caused by an explosion of cerebral neurons.

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Status Epilepticus

A state of continuous seizures lasting more than 5 minutes, or rapidly recurring seizures without recovery.

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Signs and Symptoms of Seizures

Loss of consciousness, apnea, hypoxia, acidosis, and potential brain injury.

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Causes of Status Epilepticus

Often due to abrupt stopping of antiseizure medications or inadequate treatment of seizure disorders.

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Complications of Status Epilepticus

Can result in neuronal death, injury, and alteration of neuronal networks over time.

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Study Notes

Pathologic Alterations: Organs and Systems

  • Afferent nerves transmit signals toward the spinal cord, while efferent nerves transmit signals away from the spinal cord.
  • The cerebral cortex is the largest part of the brain, responsible for higher-level functions like reasoning and personality.
  • The cerebellum is responsible for coordination and balance.
  • Myelinated nerve fibers in the peripheral nervous system (PNS) are capable of regeneration.

Nerves Capable of Regenerating

  • Local changes occur when an axon is cut, including retraction of the cut ends and phagocytosis of damaged tissue by macrophages and Schwann cells.
  • The cell body undergoes chromotolysis, a phenomenon of swelling and loss of internal structures (nissl bodies).
  • Antegrade (Wallerian) degeneration occurs in the distal axon, beginning within a few days.
  • Retrograde changes occur at the proximal end of the injured axon, similar to antegrade changes.
  • Regeneration occurs at a rate of approximately 1mm per day, limited to myelinated fibers in the peripheral nervous system.
  • The closer to the cell body the injury is, the less likely the nerve cell will regenerate.

Brain Anatomy Review

  • The forebrain, midbrain, and hindbrain are the three major divisions of the brain.
  • The forebrain (prosencephalon) has two main divisions, telencephalon and diencephalon.
  • The midbrain (mesencephalon) is responsible for connecting the hindbrain with the forebrain.
  • The hindbrain (rhombencephalon) has two main divisions, metencephalon and myelencephalon.
  • The reticular activating system is responsible for wakefulness and arousal.
  • The brain weighs approximately 3 pounds.

Three Major Divisions of the Brain

  • A detailed listing of each major aspect for the different parts of the brain.

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