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Differentiate between nociceptive and neuropathic pain.
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Nociceptive pain is linked to tissue damage or potential damage, often leads to chronic pain if untreated. Neuropathic pain is the result of neuron changes or damage, often chronic, without a clear underlying cause.
List the main types of medications used for pain management and their mechanisms.
NSAIDs: Block Cox enzymes, reducing prostaglandin production and inflammation. Opioids: Mimic endogenous opioids but have addictive properties and other side effects. Antidepressants: Block reuptake of serotonin and noradrenaline, also block sodium and calcium channels. Anticonvulsants: Block calcium channels to inhibit neurotransmitter release.
What types of fibers are involved in transmitting pain signals and what are their characteristics?
A-delta fibers: Thin, poorly myelinated, fast signal (~15 m/s), sharp/stabbing pain. C fibers: Thinner, unmyelinated, slow signal (~0.5-1 m/s), dull/aching pain.
What differentiates pain from other sensory stimuli like touch, sight, sound, or taste?
The emotional component of pain differentiates it from other sensory stimuli.
What is Brown-Sicard Syndrome and how does it affect sensory perception?
Brown-Sicard Syndrome is damage to one side of the spinal cord that affects touch and pain differently on each side of the body below the lesion.
Describe the descending inhibitory pathway in pain modulation.
The descending inhibitory pathway involves serotonin and noradrenaline, promoting the release of endogenous opioids like endorphins, enkephalins, and dynorphins which reduce pain by inhibiting neurotransmitter release or binding.
Define pain as per the International Association for the Study of Pain.
Pain is an unpleasant sensory and emotional experience linked to tissue damage or potential tissue damage.
Summarize the Pain Gate Theory.
The Pain Gate Theory suggests that rubbing an injured area stimulates touch receptors which inhibit pain signals via interneurons.
What chemicals are involved in the peripheral modulation of pain?
Glutamate, Substance P, Potassium, Bradykinin, Prostaglandins.
List the three main triggers for pain.
Mechanical stimuli (pressure, physical force), Thermal stimuli (temperature), Chemical stimuli (chemicals released due to damage).
Differentiate between high-threshold mechanical receptors, mechano-thermal receptors, and polymodal receptors.
High-threshold mechanical receptors respond to mechanical stimuli. Mechano-thermal receptors respond to mechanical and temperature stimuli. Polymodal receptors respond to mechanical, thermal, and chemical stimuli.
Describe the role of the thalamus in the pathway of pain.
All pain pathways ultimately synapse in the thalamus, which then relays the signals to the cortex for processing.
Explain the concept of central sensitization in chronic pain.
Central sensitization is the decreased threshold and increased receptor density in central neurons leading to chronic pain.
Explain the neo spinothalamic and paleo spinothalamic pathways.
Neo spinothalamic pathway: A-delta fibers, localized, sharp pain. Paleo spinothalamic pathway: C fibers, diffuse, aching pain.
Define analgesia, allodynia, hyperalgesia, and hypoalgesia.
Analgesia: Absence of pain. Allodynia: Pain from stimuli that usually don’t provoke pain. Hyperalgesia: Increased pain response. Hypoalgesia: Decreased pain response.
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