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What is the neospinothalamic tract?
- Direct connection from SC to thalamus
- **localized pain
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What is the Paleospinothalamic tract?
- Indirect connection from SC to thalamic nucleus
- **poorly localized pain
- **emotion, feelings, etc...tied to pain
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What is dysesthesia?
sensation without stimulus
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What is hypesthesia?
Lowered sensation
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What is paresthesia?
abnormal sensation (pain, prick, burn, tickle...)
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What is hyperalgesia?
Excessive pain
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What is hypalgesia?
Diminished sense of pain
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What is allodynia?
Pain from extreme innocuous sensation (e.g. sunburn from >45C temp or cold from <17C temp)
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What type of free nerve endings are within the ALS?
- Nociceptor
- non-nociceptor thermoreceptor: warm/cold
- non-noxious mechanoreceptor: pinch, rub, stretch, scratch, etc...
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What type of peripheral nerves are in the ALS?
A-delta and C-fibers (since all of nociceptor origin)
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How many A-delta fiber spots in the peripheral ALS neurons?
2-30 (micrometer diameter)
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How many C-fiber spots in the peripheral ALS neurons?
1-2 (mm diameter)
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What part of the SC do the central nerves travel through?
posterolateral fasciculus
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What do the descending branches participate in?
spinal reflexes
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Where do the ascending branches synapse?
posterior horn
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What lamina contains the majority of A-delta and C-fibers?
- A-delta: Lamina I
- C-fibers: Lamina V
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List the pathway of pain inhibition for the ALS?
Periaqueductal grey in Midbrain - descending fibers to Nucleus Raphe Magnus - descending Raphespinal tract = inhibition of ALS in Posterior Horn of SC
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How does the Gate Theory modulate pain?
- Squeeze painful area manually
- A-alpha and A-beta fibers release opiates
- Opiates inhibit nociceptive pain fibers
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What commisure do the secondary nerve fibers utilize to decussate to their respective ALS sites?
Anterior white commissure
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