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Noiceception

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Based of PUM physiology presentations and own notes
Soheila Amri
Quiz by Soheila Amri, updated more than 1 year ago
Soheila Amri
Created by Soheila Amri almost 3 years ago
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Resource summary

Question 1

Question
Sherrington’s division of senses; choose correct
Answer
  • Exteroceptive, such as those that detect light, sound, odour, and tactile stimuli
  • Interoceptive, that detect events occurring in the interior of the organism.
  • Proprioceptive, exemplified by taste receptors, receptors in viscera;
  • Teleceptive (special) senses were excluded from above mentioned (vision, audition, olfaction, taste.

Question 2

Question
Sherrington’s division of senses - Choose correct
Answer
  • Teleception - special senses
  • Interoception - deep sensation
  • Exteroception - cutaneous sensation
  • Proprioception - visceral sensation
  • Nociception - pain sensation

Question 3

Question
Head’s division of senses; choose correct
Answer
  • Epicritic – determined accurately, precisely; said of cutaneous nerve fibers sensitive to fine variations of touch (related to senses conducted in dorsal columns).
  • Protopraxic – diffused, not precise, such as pain and sense of warm temperature (conducted through anterolateral system)
  • Epicritic – diffused, not precise, such as pain and sense of warm temperature (conducted through anterolateral system)
  • Protopraxic – determined accurately, precisely; said of cutaneous nerve fibers sensitive to fine variations of touch (related to senses conducted in dorsal columns).

Question 4

Question
Sense of pain; choose correct
Answer
  • Perception of proprioceptive stimuli from skin and internal organs, resultant from physical damages or diseases.
  • Perception of nociceptive stimuli from skin and internal organs, resultant from physical damages or diseases.
  • Pain is unpleasant sensory and emotional experience associated with actual and/or potential tissue damage or described in terms of such damage.
  • Sense of particular significance in biology of animals and humans, released as a warning signal.
  • Perception of teleceptive stimuli from skin and internal organs, resultant from physical damages or diseases.

Question 5

Question
Difficulties in assessment of pain; choose wrong
Answer
  • Pain cannot be evoked without direct stimuli
  • Allodynia - Pain produced by stimuli which usually do not elicit pain
  • Noxious stimuli present, but no pain felt.
  • Neuropathic pain - Pain initiated by primary lesion or dysfunction

Question 6

Question
Sense of pain; choose correct
Answer
  • Pain isn't a sensory phenomenon
  • Pain is the product of complex, central, nociception- induced processing, and not a primitive sensation (IASP).
  • Pain isn't an emotional experience
  • Pain is a conscious, aversive aspect of somatic awareness,

Question 7

Question
Sense of pain - features; choose correct
Answer
  • Adaptation phenomenon is observed
  • Produces specific emotional state related to fear, it is NOT modified by previous experience.
  • Produces several responses and reflexes preventing or reducing the influence of harmful, nociceptive factor and effects of its action (withdrawal reflex)
  • Plays warning function, signaling real or potential damage.

Question 8

Question
Factors affecting sense of pain; choose correct
Answer
  • Age - Younger people are more sensitive to pain
  • Gender - Males are more sensitive to pain
  • Age - Elder people are more sensitive to pain
  • Gender - Females are more sensitive to pain

Question 9

Question
Sense of pain - affecting factors; choose WRONG
Answer
  • Psychosocial factors
  • Fatigue – Humans often experience more pain when their body is stressed from lack of sleep.
  • Weather
  • Memory – How we have experienced pain in the past

Question 10

Question
Pain sensation does not depend on...?
Answer
  • Emotional status and type of personality,
  • Life experience
  • Functional status of entire PNS,
  • Acquired habits and education.

Question 11

Question
Pain threshold; choose correct
Answer
  • Is elevated by muscular contraction or work
  • Is lowered by nociceptive action in other regions of the organism.
  • Is elevated by conc. of one’s attention on non- nociceptive stimuli like touch, visual or auditory sensation.
  • Is lowered by muscular contraction or work,

Question 12

Question
Pain; choose correct
Answer
  • Pain can be receptor dependant or independant
  • Fast pathway (12-30 m/s) built with myelinated Aδ- fibers responsible for „bright”, acute, sharp, easily localised pain – last short.
  • Slow pathway (12-30 m/s) built with myelinated Aδ- fibers responsible for „bright”, acute, sharp, easily localised pain – last short.
  • Fast pathway (0.5-2 m/s) built with unmyelinated C- fibers responsible for chronic, dull, intense, diffused, poorly localized and unpleasant filling – last long.

Question 13

Question
Division of pain;
Answer
  • Nociceptive system - System identifies are of damage (or potential damage)
  • Antinociceptive system - System of sensing, transmitting, recognizing and localizing of the nociceptive stimulus.
  • Antinociceptive system - modulating sense of pain at level of post. horn of spinal cord (peripheral modulation)
  • Nociceptive system - modulating sense of pain at various levels of spinothalamic tracts, thalamic nuclei & thalamo-cortical linkages (central modulation)

Question 14

Question
Division of pain; choose wrong
Answer
  • The closer to the brain the stimulus is applied, the greater the temporal separation of two components.
  • In the spinothalamic tract there are A-delta fiber types
  • Anterior horn of spinal cord conveys sensation of simple touch
  • Lateral side of the spinal cord conveys fast and slow pain (pain and temperature)

Question 15

Question
Division of pain;
Answer
  • Deep pain - is produced by chemical factors released in hypoxic muscles
  • Deep pain - is poorly localised, nauseating and associated with sweating and change in blood pressure.
  • Deep pain can be elicited from periosteum, ligaments, joints, fascias and blood vessels
  • Muscle pain is substernal pain in coronary disease and intermittent claudation

Question 16

Question
Choose correct match
Answer
  • A beta fibers - free nerve endings
  • A-delta and C - paciniform corpuscles and ruffini terminals
  • Type 4 (unmyelinated) fibers - free nerve endings
  • Type 3 (A-delta, myelinated) fibers - free nerve endings and some specialised endings

Question 17

Question
Choose correct about visceral pain
Answer
  • Visceral pain - Observed in torn ligaments and sore muscles
  • Visceral pain -released by chemical, mechanical and osmotic stimuli.
  • Visceral pain - Pain is poorly localised, but doesn't radiate.
  • Visceral pain - poorly localised, nauseating, associated with sweating, changes in blood pressure (hypotension)

Question 18

Question
Visceral Pain;
Answer
  • Visceral pain - deep somatic pain initiates reflex contraction of nearby skeletal muscles.
  • Visceral pain - goes through the ventral root ganglia to brain
  • Sensory neurons of the post. horn are not only converged by somatosensory protoneurons of skin sensation. They're converged by nociception originated from viscera.
  • Impulses conducted in visceral reflex arcs increase excitibility of neurons transmitting impulses from exteroceptors. They start to send nociceptive impulses

Question 19

Question
Visceral Referred Pain (VPR);
Answer
  • Divided into; Cervical, thoracic and lumbar
  • VRP areas of heart include left chest and left arm on medial side
  • VRP area of liver include right shoulder and clavicular area, as well as an area below the scapula
  • VRP of the stomach involves the lower back

Question 20

Question
Receptors of pain; correct features
Answer
  • No specialised receptor cells and they are slowly adapting receptors
  • Specialised receptor cells and they are slowly adapting receptors
  • No specialised receptor cells and they are rapidly adapting receptors
  • Free nerve endings sensitive to pain distributed in all the body organs (except for brain tissue and pulmonary parenchyma).

Question 21

Question
Receptors of pain;
Answer
  • Unimodal receptors located on Aδ-fibers - Thermoreceptors responding to high temperature.
  • Polymodal receptors located on C-fibers - Naked nerve endings responding to mechanical stimuli
  • Silent nociceptors - Stimulated by temperatures > 42?C , low pH, capsaicin and other chemicals.
  • RPV1 receptors (capsaicin receptor) - Respond to nocicceptive stimuli only when inflammatory substances are present.

Question 22

Question
Harmful factors of Nociceptive stimulus - choose WRONG
Answer
  • Hyperxemia (high O2 in tissues)
  • Physical trauma (mechanical, electrical or thermal damage)
  • Intrinsic chemicals (H+, K+, lactate, histamine, Ach, bradikinin, proteolytic enzymes, prostaglandins), capsaicin and extrinsic agents.
  • Inflammatory processes and neoplams

Question 23

Question
Substances producing pain VS facilitating pain; choose correct match
Answer
  • Facilitates pain - Bradykinin and leukotriens
  • Produces pain - Prostaglandins and cytokines (IL-1 & TNF-alpha)
  • Facilitates pain - SP and ATP
  • Produces pain - K+ and H+
  • Histamine is only facilitating pain, while serotonin only stimulates pain

Question 24

Question
Neurotransmitters of pain;
Answer
  • Substance P (SP)
  • Neurokinin A (NKA)
  • Calcitonin gene related peptide (CGRP)
  • Dopamine

Question 25

Question
Neuromediators and functions- choose correct match.
Answer
  • Glycine - suppresses the transmission of pain signals in the dorsal root ganglion.
  • Substance P - peptide (11 amino acids) released by C fibers; associated with intense, chronic persistent ("bad") pain.
  • Glutamate- suppresses the transmission of pain signals in the dorsal root ganglion.
  • Glycine - dominant neurotransmitter when the threshold to pain is first crossed; associated with acute ("good") pain.

Question 26

Question
Afference of pain; General axons of dorsal horn neurons
Answer
  • Enter anterolateral system (lateral spinothalamic tract)
  • Enter anteromedial system (medial spinothalamic tract)
  • Enter posterolateral portion of the cord
  • Enter posteromedial portion of the cord

Question 27

Question
Afference of pain; Ascending fibers - Choose WRONG
Answer
  • Ascend to specific sensory relay nuclei of thalamus, to areas S1, S2 and cingulate gyrus
  • Ascend to Hypothalamus
  • Ascend to Cerebellum
  • Ascend to reticular nuclei of brain stem, tectal area of mesencephalon and periaqueductal gray.
  • Ascend to the midline and intralaminar nonspecific nuclei of the thalamus and cortex

Question 28

Question
Afference of pain:
Answer
  • Spinal nerves - through VPM of thalamus to somatosensory cortex (3, 1, 2 Brodman’s area)
  • Trigeminal (cranial input) nerves - through VPL of thalamus to somatosensory cortex (3, 1, 2 Brodman’s area)
  • Trigeminal (cranial input) - nerves through VPM of thalamus to somatosensory cortex (3, 1, 2 Brodman’s area)
  • Spinal nerves - through VPL of thalamus to somatosensory cortex (3, 1, 2 Brodman’s area)

Question 29

Question
Afference of pain; lateral STT vs spinoreticular tract;
Answer
  • Lamina 1, 4 & 5 are origin of Lateral STT and Spinoreticulartract
  • Spino-reticular tract follows the somatotopic organisation
  • Lateral STT has bilateral body representation
  • Only Spinoreticular tract synapse in reticular formation
  • Spino-reticular tract has sub-cortical targets in autonomic centres, limbic system and hypothalamus

Question 30

Question
Afference of pain; lateral STT vs spinoreticular tract;
Answer
  • Lateral STT goes to VPL of the thalamic nuclei
  • Lateral STT has cortical location in parietal lobe (S1)
  • Spinoreticular tract goes to intralaminar and other midline nuclei of the thalamic nuclei
  • Spinoreticular tract has cortical location in parietal lobe (S1)
  • Role of Spinoreticular tract is dicriminative pain (quality, intensity & location)

Question 31

Question
Afference of pain; Slow (indirect) VS Fast (Direct)
Answer
  • Direct (fast) - Lateral STT
  • Direct (fast) - BIlateral
  • Indirect (slow) - Subcortical regions are Autonomic centres, limbic system, hypothalamus
  • Direct (fast) - perceives temperature and simple touch
  • Indirect (slow) - Thalamic nuclei is VPL

Question 32

Question
Modulation of pain;
Answer
  • Afferent stimulation from sensory protoneurons reduces the pain in mechanism of presynaptic inhibition, preventing of excessive release of SP.
  • Efferent stimulation from sensory protoneurons reduces the pain in mechanism of presynaptic inhibition, preventing of excessive release of SP.
  • Afferent stimulation from antinociceptive centres in nucleus reticularis paragigantocellularis and nucleus raphe magnus.
  • Efferent stimulation from antinociceptive centres in nucleus reticularis paragigantocellularis and nucleus raphe magnus.

Question 33

Question
Modulation of pain;
Answer
  • Antinociceptive system converging on dorsal horn are periaqueductal grey matter-nucleus raphe magnus - 5HT
  • Antinociceptive system converging on dorsal horn are Periaqueductal grey matter - ENK
  • Antinociceptive system converging on ventral horn are locus ceruleus - NE
  • Antinociceptive system converging on ventral horn are Periaqueductal grey matter - ENK

Question 34

Question
Modulation of pain; opioids
Answer
  • Met-enkephalin(Tyr-Gly-Gly-Phe-Met) is a natural ligand
  • Leu-enkephalin (Tyr-Gly-Gly-Phe-Leu) is NOT a natural ligand
  • There are two natural ligands
  • Opioids bind to receptors on interneurons of the pain pathways in the CNS

Question 35

Question
Modulation of pain - opiods;
Answer
  • Enkephalins hyperpolarize the presynaptic membrane thus inhibiting it from transmitting these pain signals.
  • The enkephalin synapse with a dendrite or cell body.
  • Enkephalins are released at synapses of neurons involved in transmitting pain signals to the brain.
  • Enkephalins depolarise the presynaptic membrane thus inhibiting it from transmitting these pain signals.
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