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Chronic Pain

Neuro of Chronic Pain

Ascending Pain Pathways and what they do = ? * All are parts to the Anterolateral System .... * Lateral Spinothalamic tract- Pain, temperature..... * Spinothalamic Tract Proper- (Neospinothalamic,lateral)-fast pain (hit hand with a hammer) ...... * Paleospinothalamic Tracts (medial)- slow pain
Spinothalamic Tract - Fast Pain basics = ? * Usu A-Deltas (fast pain fiber are primary afferents)
Spinobulbar Tracts - Slow pain basics = ? * secondary hyperalgesia... * Mostly by C-Fibers.... * Is a bilateral system
Responsible for Pain Discrimination = ? * Spinothalamic (made up of the somatosensory cortex)
Responsible for emotional and affective components and memory inherent to the painful experience = ? * Paleospinothalamic (limbic system)
Descending Pain Modulating Pathway = ? * role of a biological gate or filter reducing the transmission of pain impulses
Descending Central Inhibitory Pain Pathways = ? * Best Characterized: Cortex-PAG-RVM-Spinal cord..... * When PAG is stimulated --> activates RVM --> Release Serotonin To dampen pain at Dorsal horn (One is Sero and another is NE)
Dopamine and Pain ? * Dopamine is released in the striatum in response to pain..... * Deactivation of these structures results in hyperalgesia (great pain reduction)
Diffuse Noxious Inhibitory Control = ? * Pain inhibits Pain .... * When a noxious stimuli is sent and processed, the output is to reduce the pain
Gate Control Theory Segmental Inhibition = ? * Beta fibers = close the gate…rubbing hand, after it is hit activates the larger Beta fibers, which closes gate (inhibits pain)
Acute Pain = ? * Adaptive and Short Lived
Chronic Pain = ? * NOT Adaptive and Pain that continues when it should not
Chronic Pain is ______ driven ? * Centrally Driven.... * something has happened centrally causing the pain to persist, bc the area is healed up
Chronic Pain Conditions include = ? * neuralgias -- chronic fatigue syndrome -- endometriosis -- fibromyalgia -- inflammatory bowel disease -- interstitial cystitis -- TMJ dysfunction -- vulvodynia
Brain regions associated with pain = ? * Somatosensory areas S1 and S2 -- Anterior cingulate cortex (ACC) -- Insular cortex (IC) Prefrontal cortex (PFC) -- Thalamus -- Cerebellum.... * Basically the Limbic System, Thalamus, and the Cerebellum
Cortical Regions activated with pain: Anterior cingulate gyrus (ACC)basics = ? * affective-motivational dimension of pain.... * Stimulation leads to the noxious feeling and unpleasantness of pain.... * Lesion of the ACC = Pain wouldn't feel unpleasant
Cortical Regions activated with pain: Insular Cortex basics = ? * Responsible for the magnitude of pain (INTENSITY)…… * Lesion here = heightened pain thresholds or the condition of pain asymbolia... * also see lack of empathy in others that get hurt
ACC and IC are usually activated ? * together with pain and their functions overlap
Cortical Regions activated with pain: Prefrontal Cortex = ? * Has to do to telling your conscious you are in pain, and what you are going to do about it
What changes are observed in the CNS with Chronic Pain? * DECREASES IN: Gray Matter and Thalamus Volume..... * INCREASES IN: amygdala excitability and PAG Volume
Etiology of Chronic Pain = ? * Defective descending inhibitory pain pathways.... * DNIC pathway are affected (pain inhib pathways)
Comorbidities with Chronic Pain ? * Patients with one chronic pain condition have an increased incidence of having a second or third pain condition .... * may be explained by a shared defect in in descending inhibitory pain pathways
Created by: thamrick800