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What is pain defined as by the International Association for the Study of Pain?
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?
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?
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?
What is the mechanism by which peripheral nociceptors are desensitized?
What is the gate control theory of pain modulation?
What is the gate control theory of pain modulation?
What is the role of substantia gelatinosa in the gate control theory of pain modulation?
What is the role of substantia gelatinosa in the gate control theory of pain modulation?
What is the term for pain modulation that occurs above the level of the spinal cord?
What is the term for pain modulation that occurs above the level of the spinal cord?
What type of fibers are involved in the transmission of pain signals in the gate control theory?
What type of fibers are involved in the transmission of pain signals in the gate control theory?
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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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