Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Volume 1
Pain Pathways and Opiods
| Question | Answer |
|---|---|
| Describe A delta fibers. | free, naked, nerve endings, myelinated, diameter = 1-4 micrometers |
| What type of pain do A delta fibers transmit? | first pain or fast pain; well localized discriminative sensation (sharp, stinking, pricking), duration of pain coincides with duration of painful stimulus |
| Describe C fibers. | free, naked, nerve endings, unmyelinated, diambeter = 0.4-1.2 micrometers |
| What type of pain do C fibers transmit? | second pain or slow pain, diffuse and persistent burning, aching, throbbing sensation, duration of pain exceeds duration of stimulus |
| What are four types of pain? | somatic, superficial, deep, and visceral |
| Where does superficial pain originate? | cutaneous |
| Where does deep pain originate? | from muscles, tendons, joints, and fascia |
| Does deep pain involve first or second pain? | both |
| Where does visceral pain arise from? | either parietal peritoneum or viscera itself |
| Visceral Pain: Second pain from ___ is carried by C fibers. | viscera |
| Visceral Pain: first pain from ___- is carried by a delta fibers. | parietal peritoneum |
| The fast and slow pathways are activated in the periphery when what happens? | the free nerve endings of the A delta and C fibers are stimulated or damaged |
| The Where are the cell bodies of the A delta and C fiber afferents found? | in the dorsal root ganglion |
| Describe the path of A delta and C fibers. | The A delta and C fibers enter the dorsal cord, divide and ascend or descend 1-3 segments in the tract of Lissauer |
| Describe the pathway for fast sharp pain. | After leaving the tract of Lissauer, the axons of the A delta fibers enter the dorsal horn and terminate in Rexed's lamina I and V. Second order neurons leaving lamina I or V cross to the contralateral spinothalamic tract and ascend to the brain |
| Describe the pathway for slow chronic pain. | The C fibers terminate primarily in lamina II and III. Interneurons transmit C fiber impulses to lamina V from laminae II and III. Neurons leaving lamina V cross immediately to the contralateral lateral spinothalamic tract and ascend tot he brain. |
| Which lamina are the substantia gelatinosa? | II and III |
| What is the major neurotransmitter released from A delta fibers? | glutamate |
| What does glutamate bind to? | AMPA and NMDA |
| Where are the AMPA and NMDA receptors located? | the postsynaptic membrane |
| What is the major neurotransmitter released from C fibers? | substance P |
| What does substance P bind to? | NK-1 (neurokinin 1 |
| Where are NK-1 receptors located? | postsynaptic membrane |
| What is the ascending sensory spinal cord tract carrying pain and temperature? | lateral spinothalamic tract |
| The lateral spinothalamic tract is a component of what sensory system? | anterolateral sensory system |
| The dorsolateral funiculus is a (ascending/descending) tract? | descending |
| What is the function of the dorsolateral tract? | it modulates pain |
| The lateral spinothalamic tract carries __ and ___ modalities. | pain and temperature |
| C fiber afferents enter the spinal cord via the __ ___. | dorsal horn |
| The C fibers synapse just after entering the spinal cord with interneurons in lamina __ , __ , or lamina __. | V, II, or III |
| The interneurons from lamina II and III synapse with what? | second order neurons in lamina V |
| What happens to second order neurons leaving lamina V? | they cross immediately to the opposite side in the spinal cord and then ascend on the contralateral side |
| There is no sensory component to __. | C1 |
| C1 is purely ___. | motor |
| What is the site where pain impulses are attenuated? | the substantia gelatinosa |
| What is another name for the substantia gelatinosa? | Rexed's lamina II |
| The first neuron in the slow chronic pain pathway synapses with the interneurons in which two locations? | substantia gelatinosa and lamina III of the spinal cord |
| When the first neuron in the slow chronic pain pathway synapses with lamina II and III, what is released? | substance P |
| Is substance P excitatory or inhibitory? | excitatory |
| What other interneurons also synapse on the substance P releasing nerve terminal? | Enkephalin (E)-releasing interneurons |
| When enkephalin is released to the nerve terminal of the primary pain C fiber afferent, the release of substance P is increase or decreased? | decreased |
| Describe the sequence of events that occurs when the release of substance P is decreased. | the number of action potentials initiated in the interneuron of the pain pathway is reduced and, ultimately, the perception of pain is decreased. |
| Enkephalin may be considered the ___ in the __ control theory of pain. | gate, gate |
| Opiods stimulate the same receptors that are stimulated by what? | the body's endorphins and enkephalins |
| After an opiod such as morphine (Duramorph) is injected into the intrathecal or epidural space, where does it diffuse? | substantia gelatinosa (Rexed's lamina II) |
| The opiod then unites with opiod receptors on the nerve terminal of the __ __ ___. | primary pain afferent |
| When the opiod unites with the opiod receptor, is substance P reduced or increased? | release of substance P is reduced |
| When happens when substance P is reduced? | the transmission of impulses through the substantia gelatinosa is inhibited |
| Which receptors mediate spinal analgesia? | mu-1, mu-2, kappa, and delta receptors |
| What is spinal opiod analgesia mediated by? | primarily mu-2 receptors |
Created by:
valleyanesthesia
Popular Nursing sets