Mechanisms of Pain
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Questions and Answers

Which step of pain involves converting a noxious stimulus to an electrical impulse in sensory nerve endings?

  • Perception
  • Transmission
  • Transduction (correct)
  • Modulation

Where does modulation of pain occur?

  • In the dorsal horn of the spinal cord (correct)
  • In the thalamus
  • In the somatosensory cortex
  • In the sensory nerve endings

Which component of pain processing is responsible for altering pain transmission?

  • Modulation (correct)
  • Transduction
  • Transmission
  • Perception

In which case does pain occur in the absence of transduction of a chemical stimulus at a nociceptor?

<p>Pain from trigeminal neuralgia (B)</p> Signup and view all the answers

What phenomenon occurs in the absence of nociception or nociceptors?

<p>Phantom limb pain (C)</p> Signup and view all the answers

Which type of nociceptors typically respond to thermal, mechanical, and chemical stimuli?

<p>A-fiber nociceptive afferents (B)</p> Signup and view all the answers

Which nociceptor type is referred to as polymodal nociceptors?

<p>A-fiber nociceptive afferents (B)</p> Signup and view all the answers

What is the primary cause of sensitization of nociceptors?

<p>Release of endogenous chemicals (B)</p> Signup and view all the answers

Which outcome is associated with chronic pain due to unresolved inflammation?

<p>Hyperalgesia (B)</p> Signup and view all the answers

What contributes significantly to the process of nociception and neuronal sensitization during peripheral inflammation?

<p>Release of endogenous chemicals (B)</p> Signup and view all the answers

In chronic pain conditions, what leads to the sensitization of both peripheral and central pain signaling pathways?

<p>Unresolved inflammatory conditions (D)</p> Signup and view all the answers

Which step involves the adaptation of signaling pathways in primary sensory neurons induced by noxious stimuli?

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

Which of the following chemical mediators can directly activate nociceptors and induce sensitization to painful stimuli?

<p>Prostaglandin E2 (B)</p> Signup and view all the answers

Which chemical mediator leads to sensitization by activating inflammatory cells that release cytokines during inflammation?

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

What term is used to describe enhanced pain in response to a noxious stimulus following tissue injury and inflammation?

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

Which type of hyperalgesia occurs at the site of the original tissue injury?

<p>Primary hyperalgesia (A)</p> Signup and view all the answers

What differentiates primary hyperalgesia from secondary hyperalgesia in terms of pain response?

<p>Primary hyperalgesia responds to heat and mechanical stimuli. (C)</p> Signup and view all the answers

What is believed to be the cause of primary hyperalgesia following tissue injury?

<p>Activation of nociceptor receptors by proinflammatory mediators (C)</p> Signup and view all the answers

Which brain region functions as a relay center for nociceptive and other sensory activity?

<p>Spinal Dorsal Horn (C)</p> Signup and view all the answers

Which system may either depress or facilitate the integration of painful information in the spinal dorsal horn?

<p>PAG–RVM System (C)</p> Signup and view all the answers

Which region of the spinal cord is primarily responsible for the integration of peripheral nociceptive information?

<p>Lissauer tract (B)</p> Signup and view all the answers

Where do afferent C fibers primarily synapse on second-order neurons in the spinal cord?

<p>Lamina I (B)</p> Signup and view all the answers

What is the main function of inhibitory interneurons in the dorsal horn?

<p>Integrate and modulate incoming nociceptive information (B)</p> Signup and view all the answers

What is the function of descending axons that terminate in the dorsal horn of the spinal cord?

<p>Modulate integration of nociceptive information (A)</p> Signup and view all the answers

What is the principal transmitter used by inhibitory cells in the dorsal horn?

<p>GABA and/or glycine (C)</p> Signup and view all the answers

Which region of the spinal cord receives relatively large numbers of projection neurons?

<p>Lamina I (B)</p> Signup and view all the answers

Which theory was proposed by Melzack and Wall in 1965 to illustrate the neuronal network underlying pain modulation?

<p>Gate Control Theory of Pain (C)</p> Signup and view all the answers

What type of fibers are activated by rubbing the skin of a painful area according to the Gate Control Theory of Pain?

<p>Ab fibers (C)</p> Signup and view all the answers

What behavioral phenomenon can be observed in humans that mirrors wind-up in the dorsal horn neurons?

<p>Increased pain with each successive stimulus (D)</p> Signup and view all the answers

Which neuropeptides are co-released with glutamate from nociceptor central terminals during central sensitization?

<p>Substance P and CGRP (D)</p> Signup and view all the answers

After peripheral nerve injury, what phenomenon occurs where light touch produces pain?

<p>Allodynia (B)</p> Signup and view all the answers

What effect does repeated light touch have after peripheral nerve injury?

<p>Increasing pain progressively (C)</p> Signup and view all the answers

What form of central sensitization can cause low-threshold sensory fibers to activate high-threshold nociceptive neurons?

<p>Heterosynaptic central sensitization (B)</p> Signup and view all the answers

What is the term for the phenomenon where peripheral noxious stimuli lead to transcriptional changes in proteins involved in pain transmission?

<p>Transcription-dependent sensitization (D)</p> Signup and view all the answers

Which factor contributes to nerve injury-induced tactile allodynia?

<p>Sprouting of injured myelinated Ab fibers (C)</p> Signup and view all the answers

From which spinal dorsal horn neurons do the fibers traveling in the spinothalamic tract (STT) primarily originate?

<p>Lamina I, IV, and V (B)</p> Signup and view all the answers

In which spinal cord laminae do neurons receiving input primarily from large-diameter Ab fibers from the skin reside?

<p>Lamina IV and V (C)</p> Signup and view all the answers

On which side of the body are about 85% to 90% of neuronal cells with projections extending through the spinothalamic tract (STT) found?

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

From which laminae do the anterior STT cells predominantly originate?

<p>Lamina V (B)</p> Signup and view all the answers

Where do ascending spinobulbar projections mainly terminate to provide homeostatic feedback?

<p>Brainstem (B)</p> Signup and view all the answers

What is the primary function of spinal projections to the brainstem?

<p>Integration of nociceptive activity with homeostasis and behavior (B)</p> Signup and view all the answers

What is the function of the descending inhibition pathway (DI) from supraspinal regions?

<p>Suppressing nociceptive transmission (B)</p> Signup and view all the answers

Which brain regions are established as critical for descending pain modulation?

<p>PAG and RVM (C)</p> Signup and view all the answers

Which physiological response is associated with urinary retention during the surgical stress response?

<p>Reflex inhibition of visceral smooth muscle (D)</p> Signup and view all the answers

What is a key factor contributing to the risk for perioperative infection following cancer resection?

<p>Reduced cytotoxicity of killer T cells (A)</p> Signup and view all the answers

Which factor plays a major role in the prevention vs. treatment approach in attenuating the surgical stress response?

<p>Pre/intraoperative techniques (D)</p> Signup and view all the answers

How does general anesthesia typically impact the neuroendocrine response during the surgical stress response?

<p>Has no significant impact on the neuroendocrine response (D)</p> Signup and view all the answers

What is a notable benefit associated with regional anesthesia in attenuating the surgical stress response?

<p>Reduced postsurgical complications (A)</p> Signup and view all the answers

At what gestational age does pain perception develop in a human fetus?

<p>23 weeks (B)</p> Signup and view all the answers

What is a characteristic of neonates and infants regarding pain threshold compared to adults?

<p>They have a significantly lower pain threshold (B)</p> Signup and view all the answers

What are the potential consequences of untreated pain during early childhood?

<p>Long-lasting consequences (D)</p> Signup and view all the answers

What effect can increased catecholamines have on expected pain sensation?

<p>Increase sensitization of nociceptors (D)</p> Signup and view all the answers

Which response is characteristic of myocardial ischemia in the context of surgical stress response?

<p>Coronary vasoconstriction (A)</p> Signup and view all the answers

What can lead to hypercoagulability in the context of the surgical stress response?

<p>Increased blood viscosity (D)</p> Signup and view all the answers

What effect does pain-induced increased skeletal/accessory muscle tension have on ventilation?

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

Which factor inhibits gastrointestinal (GI) function in the surgical stress response?

<p>Sympathetic hyperactivity (B)</p> Signup and view all the answers

What is a potential consequence of increased pulmonary extracellular fluid in the context of the surgical stress response?

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

What is a proposed mechanism for the transition from acute to chronic pain?

<p>Sensitization of peripheral and central nocisponsive neurons (A)</p> Signup and view all the answers

Which syndrome is more common, CRPS I or CRPS II?

<p>CRPS I (B)</p> Signup and view all the answers

What is a characteristic of neuropathic pain?

<p>Reduced nociceptive threshold (C)</p> Signup and view all the answers

Which factor is responsible for causing visceral pain?

<p>Activation of nociceptors (C)</p> Signup and view all the answers

What is the hallmark of CRPS I (Reflex Sympathetic Dystrophy)?

<p>Allodynia/hyperalgesia disproportionate to the inciting event (C)</p> Signup and view all the answers

What is a feature of CRPS II (Causalgia)?

<p>'Causalgia' is limited to the territory of the injured nerve (B)</p> Signup and view all the answers

What differentiates visceral pain from somatic pain?

<p>'Visceral pain' is associated with autonomic reactions, unlike 'somatic pain' (B)</p> Signup and view all the answers

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