Zusammenfassung der Ressource
Pain
- A sensation that alerts us to
damage to the body (internal
& external)
- Pain threshold= the level of stimulation at
which an individual will begin to perceive pain
- Proposed mechanism
- LIMBIC SYSTEM (memory e.g. can influence concept of pain based on
experiences)- PERIAQUEDUCTAL GREY (midbrain-releases
enkephalins-natural pain killer- can decrease or inhibit pain signals-interact
at NRM)-NUCLEUS RAPHE MAGNUS- causes release of 5HT to dorsal
horns of spinal cord-causes inhibition of substance P (neurotransmitter for
pain) release-pain ascending communication doesn't reach ventroposterior
nucleus in thalamus- INTERNEURONES IN LAMINA II OF SPINAL CORD
- Primary sensory cortex is involved with the
localisation of pain. (signals translated in
somatosensory cortex, and percieved-site
where stimulus can from (receptors))
- The thalmaus is the central switching
station of the brain. It is multi nucleate-
several nuclei are dedicated to pain.
Medial nuclei (pain), lateral uclei
(sensation/discrimination)
- Midbrain- most of the circuitry of the
medulla is involved in pain. Extensive
connections to the reticular brain stem-
PAG (periaqueductal grey), NRM
(nuclei raphe magnus)
- Aδ fibres
- Fast fibres, large, myelinated, large cell bodies
- A sharp pin prick- starts in superficial
tissues-conducted by the fast fibres (10m/sec)-to
the dorsal horn-they synapse & relay along the
spinothalamic tract-terminate mainly in the
thalamus projecting acrods the sensory cortex
- C fibres
- Slow, thin, unmyelinated, small cell bodies
- Aching pain from deep tissues-conducted by the slow fibres (1m/sec)-
to the dorsal horn-they synapse & relay along the spinothalamic
tract-terminate in the reticular nuclei in medulla, midbrain and thalamus-
relayed across the sensory cortex, frontal lobes & limbic system
- Neurotransmitter for both fibres is substance P
- Pain modulation
- Integration of painful information occurs in the CNS-
Opiods modulate pain transmission. Spinal cord is the
first site of integration. Thalamus -dorsal horn neurons
synpase onto projection neurone. Descending systems-
ability to modulate and inhibit activity in the spinal cord.
- Pain producing substances
- Bradykinin, capsciacin (main constitute in chilli
therefore stimulates temp fibres associated with
pain-if over stimulate=sweat as body responding),
substance P, Histamine & prostoglandins
- Released from damaged cells so
stimulating nocioceptors- vasoactive
properties (increased circ & inflammation)
- Endogenous opiods
- Endorphins
(neurohormones-psychological
responses to pain), enkephalins
(neurotransmitter, involved in analgesia),
Dynorphins (analgesia & sedation)
- Gate control theory
- Melzack & Wall in 1968- rubbing
injured region decreases pain
sensation- details wrong but useful
- Stimulated other receptors (not
nocioceptors)-causing release of
neurotransmitter etc has ability to inhibit
signals from reaching the cortex
- Descending inhibition
- Touch- cortico-thalamic pathway
(why we dont feel clothes)
- Pain (battle, sporting injuries, ecstasy)
- Microinjection of opiates into discrete regions of
CNS (PAG, limbic system) promotes analgesia.
Microstimulation tjere also produces analgesia.
Opioid peptides are present there. Electrical
stimulation of the PAG or NRM produces analgesia