Ch. 13 - Pain
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Created by:
Cherylwriter on January 19, 2010
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Description:
Pain anatomy, theories, and neuromodulation
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25 terms
Terms | Definitions |
|---|---|
 sensory/discriminative system | processes info about strength, intensity, and time/space aspects of pain, results in prompt withdrawal from painful stimulus; mediated by afferent nerve fibers, spinal cord, brain stem, and higher brain centers |
| motivational/affective system | determines individual's conditioned or learned approach/avoidance behaviors; mediated by interaction of reticular formation, limbic system, adn brain stem |
| cognitive/evaluative system | overlies individual's learned behavior concerning experience of pain; may block, modulate, or enhance perception of pain |
| 3 systems that interact to produce pain | sensory/discriminative, motivational/affective , cognitive/evaluative |
| nociceptors | free nerve endings that respond to chemical, mechanical, and thermal stimuli |
| nociception | perception of pain |
| portions of nervous system responsible for sensation and perception of pain | afferent pathways, interpretive centers, efferent pathways |
| location afferent pathways | PNS, travel to spinal gate in dorsal horn, then ascend to higher centers in CNS |
| location interpretive centers | brainstem, midbrain, diencephalon, cerebral cortex |
| efferent pathways | descend from CNS back to dorsal horn of the spinal cord |
| A(delta) fibers | type of nociceptor, lightly myelinated afferent neurons, carry sharp, well-localized pain sensations, rapid transmission |
| C fibers | type of nociceptor, small unmyelinated , transmit burning or aching sensations, slow transmission |
| lateral neospinothalamic tract | carries acute pain info to lateral thalamus, then projets to somatosensory cortex which provides specific pain info |
| medial paleospinothalamic tract | carries dull and burning pain info to midbrain, is responsible for reflex responses to pain with changes in autonomic function, respiration, circulation, and endocrine function |
| ventromedial medulla | afferent stimulation of this portion of midbrain stimulates efferent pathways, which modulate or inhibit afferent pain signals at the dorsal horn |
| periaqueductal gray (PAG) | gray matter surrounding the cerebral aqueduct |
| periaqueductal gray (PAG) | afferent stimulation of this portion of midbrain stimulates efferent pathways, which modulate or inhibit afferent pain signals at the dorsal horn |
| specificity theory | pain intensity proportinoal to amount of tissue injury |
| gate control theory | stimulationof non-nociceptive A fibers (touch, vibration, thermal) causes cells in substantia gelatinosa to close itself off from pain impulses, which diminishes pain sensation |
| substantia gelatinosa | laminae in the dorsal horn of spinal cord; A and C fibers terminate here |
| neuromatrix theory of pain | when there is no discernable cause for chronic pain, the brain produces pattern of nerve impulses from widely distributed neural network; impulses can originate independently in brain w/o external input |
| endorphins | family of neuropeptides that inhibit transmissino of pain impuses in spinal cord and brain |
| endorphins bind to | mu, kappa, or delta opioid receptors |
| Beta-endorphin | potent endorphin released from hypohalamus and pituitary gland; may result in general sensations of well-being |
| enkephalin | endorphin found in neurons of brain and spinal cord, weaker analgesic than other endorphins, more potent and longer lasting than morphine |
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