1. Define Pain
    Pain is defined as an unpleasand sensory and emotional experience that is associated with actual or potential tissue damage
  2. Define Nociceptors
    pain receptors
  3. Explain the Protective Mechanism
    • When afferent impulses reach the spinal cord, a reflex loop is formed within one to to levels of the spinal input
    • Some info is sent back for reaction to the stimulus
    • Remaining impulses to go the brain to be processed as pain
  4. Name the Two types of nociceptors
    • Chemosensitive nociceptors
    • Mechanosensitive nociceptors
  5. Explain Mechanosensitive Nociceptors
    • Mechanical nociceptors are depolarized first
    • Mechanical stress or damage to the tissues excite mechanosensitive nociceptors
  6. Explain what happens after Nociceptors are activated
    • Painful impulse is continued by chemical irritation resulting from the inflammatory process
    • bradykinin, serotonin, hisamine, and prostaglandins
  7. Explain the sensitization of Nociceptors
    • nociceptors desplay sensitization to repeated or prolonged stimulation
    • during the inflammatory process the threshould required to initiate an action potential is lowered
  8. Explain what happens immediately after trauma
    Primary hyperalgesia occurs lowering the pain threshold no noxious stimuli and increasing the pain response
  9. Name the Two types of Nociceptors
    • C fiber - slow deeper small unmyelinated fibers
    • A-delta - larger, thinly myelinated faster fibers
    • cell bodies are located in the dorsal root ganglia
  10. Explain A-delta Fibers
    • triggered by strong mechanical pressure or intense heat
    • 10-25%
    • 30 meters/second
    • sensation is sparp and to the point
  11. Explain C-Fibers
    • slow 1-2.50meters per/second
    • 50-80%
    • Mild Pain
    • mechanical and chemical
  12. Define Protopathic Pain
    • first pain
    • a-delta
  13. Epicritic pain
    • Second pain
    • c fibers
  14. Explain a-beta fibers
    • a third type of peripheral afferent nerve fiber
    • large myelinated
    • low thershold
    • mechanoreceptors that respond to light touch
    • stimulation may interrupt nocieption in the dorsal horn of spinal cord
    • Break pain cycle
    • best friend in physical therapy
  15. Define First order neurons
    • ascending from peripheray to spinal cord
    • A-beta, A-delta, C-fibers
  16. Define Second Order Neurons
    • ascend from dorasl horn level of the spinal cord to the brain
    • nows as T-cells
  17. Why do we have spinothalamis tract
    The neopinothalamic tract sends immediate warning to the thalumus via a-delta and the paleospinothalamic tract sends slow reminder via c-fibers
  18. Explain neospinothalamic tract
    • receives input form a-delta
    • sympathetic and parasympatheitc to thalamus
    • automatic respones
    • ventral
  19. Explain the Paleospinothalamic tract
    • lateral
    • Recieves c-fibers
    • gives info to medulla, midbrain, hypothalamus, thalamus, limbis systme and periaqueductal gray
  20. Medulla Oblongata
    Controls autonomic funtions sucha s HR, respirations, and vomiting
  21. Midbrain
    Serves as center for many reflexes and assists in coordination movement and visual tracting
  22. Hypethalamus
    cortols the endocrine systems release of hormones through this mechanism the hypothalmus regulates metabolis and stress response
  23. Thalamus
    influences mood and body movement that are associated with fear, anxiety, and rage
  24. Limbic system
    • link to emotionsand thourgh the cingulate gyus control sthe visceral response to emations dn the senstaion of pain and pleasure
    • This is why ppl cry
  25. Periaqueductal Gray
    Hormonally control the release of endorphine and other pain reducing chemicals
  26. List the three analgesic mechanisms
    • Central Control (descending control)
    • A-delta and C fibers
    • Ascending A-beta Fibers
  27. Describe Central Control (Descending Control)
    • One the nozious stimuli have reached the higher centers of the brain the descenting control mechanisms are activated
    • Central Biasing
    • PAG
    • Upper meddula
  28. Define Endogenous opiates
    Pain inhibiting substances produced in the brian
  29. Explain Central Biasing
    • Chemicals released by the body to block the pain
    • impulses from the thalamus and brianstem (central biasing) via efferent fibers to the dorsal horn
    • impulses from the higher center act to close the gate and blcok transmission of the pain message at the dorsal horn synapse
  30. PAG
    • periaqueductal gray region
    • sends endorphins
  31. Medulla
    • sends serotonin - analgesia
    • enkephalins - blck transmission
  32. Explain A-delta and C-fibers in the analgesic mechanism
    stimulation of fibers causes of release of endogenous opiods
  33. Explain Ascending a -beta fibers
    • a-beta blocks a-delta and c-fibers
    • act as counterirritant
    • gate control theory
  34. Define Pain Threshold
    • Level of noxious stimulus required to alert the individual to an potentioal threat to tissue
    • can't be changed
  35. Define Pain Tolerance
    how much pain a person can take
  36. Types of pain
    • acute
    • subacute
    • chronic
    • referred
    • otehr aspects of pain (trigger points)
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