Pain and Nociception
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Questions and Answers

What is pain defined as by the International Association for the Study of Pain?

  • A response to actual or potential tissue damage
  • A sensation associated with actual or potential tissue damage
  • An unpleasant sensory and emotional experience associated with actual or potential tissue damage (correct)
  • An emotional experience associated with actual or potential tissue damage
  • What is the sequence of neurons involved in sensation and nociception?

  • Dorsal horn → receptor or free nerve ending → 1st order neuron
  • Receptor or free nerve ending → 1st order neuron → dorsal horn (correct)
  • Receptor or free nerve ending → 2nd order neuron → dorsal horn
  • Receptor or free nerve ending → dorsal horn → 2nd order neuron
  • What is the target of pain management in descending pathways?

  • Descending pathways (correct)
  • Ascending pathways
  • Spinal cord
  • Cortex
  • What is the mechanism by which peripheral nociceptors are desensitized?

    <p>Slow conduction velocity</p> Signup and view all the answers

    What is the gate control theory of pain modulation?

    <p>A mechanism that explains how a stimulus that activates only non-nociceptive nerves can inhibit pain</p> Signup and view all the answers

    What is the role of substantia gelatinosa in the gate control theory of pain modulation?

    <p>It inhibits the transmission of pain signals</p> Signup and view all the answers

    What is the term for pain modulation that occurs above the level of the spinal cord?

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

    What type of fibers are involved in the transmission of pain signals in the gate control theory?

    <p>A-b and C fibers</p> Signup and view all the answers

    Study Notes

    Pain Definition

    • Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.
    • Defined by the International Association for the Study of Pain.

    Pain Mechanism

    • Sensation and nociception involve a three-neuron sequence: receptor or free nerve ending → 1st order neuron (A-β, A-δ, C fibers) → dorsal horn.

    Descending Pathways

    • Activity (excitatory or inhibitory) occurs after the cortex receives input.
    • Pain can be managed by targeting descending pathways.

    Pain Control Theories

    Peripheral Pain Modulation

    • Desensitize peripheral nociceptors to manage pain.
    • Slow conduction velocity is usually achieved with cryotherapy.

    Spinal Level Pain Modulation

    • Gate control theory proposes a gating mechanism in the dorsal horn of the spinal cord.
    • A-β, A-δ, and C fibers all synapse with 2nd order neurons in the dorsal horn.
    • Substantia gelatinosa (SG) has inhibitory interneurons that inhibit transmission between 1st and 2nd order nociceptive neurons.
    • Enkephalin interneurons release enkephalin, a natural opioid, to inhibit pain transmission.
    • A-β impulses stimulate SG, resulting in enkephalin release and inhibition of A-δ and C fiber transmission to 2nd order neurons.

    Pain Modulation

    • Pain modulation involves both ascending and descending neural components.
    • Supraspinal refers to modulation that occurs above the level of the spinal cord.
    • Descending refers to modulation that travels from the brain to the spinal cord or brainstem.

    Noxious Pain Modulation

    • Noxious pain modulation involves the elicitation of C-fibers in af.

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    Pain.docx

    Description

    Explore the unpleasant sensory and emotional experience of pain, including its definition, sensation, and pathways. Learn about the three-neuron sequence and descending pathways that manage pain.

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