Notes in Pain

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Published	09/30/2024	sample {{c1::pain}}
Published	09/30/2024	3a09194af45849ca976df27802ef0050-oa-1
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Published	09/30/2024	{{c1::Hyperalgesia}} is {{c2::in}}-creased sensitivity to painful stimulus
Published	09/30/2024	{{c1::Analgesia}} is {{c2::absence}} of sensitivity to painful stimulus
Published	09/30/2024	{{c1::Allodynia}} is pain produced by a {{c2::non-noxious}} stimulus
Published	09/30/2024	{{c1::Hypoesthesia}} is {{c2::de}}-creased sensation
Published	09/30/2024	{{c1::Parasthesia}} is {{c2::abnormal}} sensation, i.e. prickling
Published	09/30/2024	{{c1::Dysethesia}} is {{c2::impaired}}, disagreeable sensation
Published	09/30/2024	{{c1::Pain}} is the subjective awareness of tissue injury that begins with activation from {{c2::nociceptive}} stimuli
Published	09/30/2024	Pain pathway consists of {{c1::transduction}}, {{c2::transmission}}, {{c3::modulation}}, and {{c4::perception}}
Published	09/30/2024	{{c1::Nociception}} is the {{c2::unconscious}} detection of tissue injury and a function of first and second order neurons
Published	09/30/2024	{{c1::Aβ}} sensory neurons are {{c2::large::size}}, {{c3::myelinated::non-myelinated/myelinated}} fibers that transmit info about touch and pressure
Published	09/30/2024	{{c1::Aδ}} sensory neurons are {{c2::small::size}}, {{c3::myelinated::non-myelinated/myelinated}} fibers that carry info about touch and pressure
Published	09/30/2024	{{c1::C}} sensory neurons are {{c2::small}}, {{c3::non-myelinated::non-myelinated/myelinated}} fibers that carry info about touch and pressure
Published	09/30/2024	{{c1::Nociception}} is the unconscious detection of {{c2::tissue injury}} and a function of first and second order neurons
Published	09/30/2024	{{c1::Free nerve endings::pain receptor types}} are found in skin, muscle, joints, bone, and viscera
Published	09/30/2024	{{c1::Untreated}} pain sensitizes/activates normally {{c2::latent}} pain receptors, leading to {{c3::increased}} pain and inflammation
Published	09/30/2024	{{c1::Aδ}} pain fibers carry {{c2::fast}}, {{c3::sharp/prickly}} pain that is {{c4::well}} localized
Published	09/30/2024	{{c1::C}} pain fibers carry {{c2::slow}}, {{c3::dull/burning}} pain that is {{c4::poorly}} localized
Published	09/30/2024	{{c1::Aδ}} pain fibers are alternatively called type {{c2::III}} fibers
Published	09/30/2024	{{c1::C}} pain fibers are alternatively called type {{c2::IV}} fibers
Published	09/30/2024	{{c1::Afferent}} neurons in the dorsal horn receive nociceptive stimuli from {{c2::sensory nerve fibers}} that can be modulated via {{c3::inhibitory}}…
Published	09/30/2024	{{c1::Efferent}} neurons in the dorsal horn carry input from the {{c2::CNS}} that modulate nociceptive inputs
Published	09/30/2024	{{c1::Primary afferent}} neurons enter the spinal cord and can synapse on {{c2::second order}} neurons or {{c3::interneurons}}
Published	09/30/2024	Prolonged primary afferent neuron pain stimulus can result in {{c1::central sensitization}} in which pain transmission continues for minutes after the…
Published	09/30/2024	The {{c1::spinothalamic}} tract carries {{c2::pain}}, {{c3::temperature}}, and {{c4::pressure}}
Published	09/30/2024	The {{c1::spinoreticular}} tract is involved in {{c2::arousal}}
Published	09/30/2024	The {{c1::spinomesencephalic}} tract is involved in {{c2::affect}} and {{c3::emotions}} related to pain
Published	09/30/2024	The {{c1::spinohypothalamic}} tract is involved in {{c2::reflexes}} from pain
Published	09/30/2024	{{c1::Modulation}} phase of the pain pathway is where {{c2::processing}} of signals occurs
Published	09/30/2024	Pain {{c1::tolerance}} occurs in the {{c2::modulation}} phase of the pain pathway
Published	09/30/2024	{{c1::Calcitonin gene related peptide (CGRP)}} is a neuropeptide in the {{c2::ascending}} nociceptive pathway that is implicated in {{c3::migraines::p…
Published	09/30/2024	{{c1::Glutamate}}, {{c2::neurokinin-1}}, {{c3::substance P}}, and {{c4::CGRP}} are neuropeptides involved in {{c5::propagation}} of pain signals
Published	09/30/2024	{{c1::GABA}}, {{c2::opioids}}, {{c3::norepinephrine}}, and {{c4::serotonin}} are neuropeptides involved in {{c5::cessation}} of pain signals
Published	09/30/2024	{{c1::Peripheral sensitization}} occurs when nociceptors in the PNS become more sensitive to stimuli following an injury
Published	09/30/2024	Peripheral sensitization is occurs due to {{c1::inflammatory}} mediators and recruitment of {{c2::Aδ}} and {{c2::C}} fibers
Published	09/30/2024	{{c1::Central sensitization}} occurs when the CNS becomes hypersensitive to pain signal, resulting in {{c2::allo}}-dynia and {{c2::hyper}}-dynia
Published	09/30/2024	Central sensitization is due to {{c1::increased}} activity in the {{c2::dorsal horn}}
Published	09/30/2024	{{c1::Nociceptive-induced}} inflammation is due to overactivation of primary afferents that stimulate release of {{c2::substance P}}, {{c3::histamine}…
Published	09/30/2024	{{c1::Viscerosomatic}} reflex occurs when pain/dysfunction in an {{c2::organ}} causes pain in {{c2::somatic tissues}} due to shared neural pathways
Published	09/30/2024	Viscerosomatic Reflex Spinal Facilitation1. {{c1::Peripheral irritation}}2. {{c2::CNS sensitization}}3. {{c3::Neighboring neuron sensitization}}4. {{c…
Published	09/30/2024	{{c1::Sensory-discriminative}} system in the pain matrix encodes the {{c2::location}} and {{c2::intensity}} of pain
Published	09/30/2024	{{c1::Affective-motivational}} system in the pain matrix encodes the {{c2::suffering}} associated with feelings of pain
Published	09/30/2024	{{c1::Cognitive-behavioral}} system in the pain matrix encodes the {{c2::conscious behavior}} towards a painful stimulus or ongoing painful experience
Published	09/30/2024	{{c1::Insular}} cortex is involved in {{c2::emotional}}, {{c3::cognitive}}, and {{c4::memory-related}} aspects of pain
Published	09/30/2024	{{c1::Posterior}} portion of the {{c2::insular}} cortex is involved in {{c3::sensory}} aspects of pain
Published	09/30/2024	{{c1::Hippocampus}} encodes {{c2::memory}} to painful stimuli
Published	09/30/2024	{{c1::Amygdala::brain structure}} is involved in {{c2::fear/anxiety}} related to pain and encodes emotional {{c3::salience}} to it
Published	09/30/2024	{{c1::Prefrontal}} cortex is involved in {{c2::cognitive}} aspects of pain, i.e. attention, interpretation, modulation, and coping strategies
Published	09/30/2024	The {{c1::prefrontal}} cortex and the {{c2::limbic}} system interact to modulate emotional response
Published	09/30/2024	{{c1::Anterior cingulate}} cortex is involved in the {{c2::unpleasantness}} and {{c3::anticipatory}} emotional aspects of pain
Published	09/30/2024	A lesion in the insular cortex results in {{c1::asymbolia}} in which a person can localize pain, but has no affective component
Published	09/30/2024	{{c1::Enkephalin}}, {{c2::endorphin}}, and {{c3::dynorphin}} are endogenous opioid peptides released in response to pain and stress
Published	09/30/2024	Endogenous opioid peptides are found in the {{c1::brain}}, {{c2::spinal cord}}, {{c3::adrenal medulla}}, and {{c4::gut neural plexuses}}
Published	09/30/2024	{{c1::Met-enkephalin}} and {{c1::Leu-enkephalin}} are endogenous opioids that differ only in the terminal amino acid
Published	09/30/2024	Which opioid receptor do endorphins have the strongest binding to?{{c1::μ (mu)}}
Published	09/30/2024	Which opioid receptor do enkephalins have the strongest binding to?{{c1::δ (delta)}}
Published	09/30/2024	Which opioid receptor do dynorphins have the strongest binding to?{{c1::κ (kappa)}}
Published	09/30/2024	{{c1::Mu}}-opioid receptors are involved in {{c2::respiratory}} inhibition, slowed {{c3::GI}} transit, and modulation of {{c4::hormone/NT}} release
Published	09/30/2024	{{c1::kappa}}-opioid receptors are involved in {{c2::psychotomimetic}} effects and slowed {{c3::GI}} transit
Published	09/30/2024	Opioids reduce nociception by {{c2::inhibiting}} {{c1::afferent}} stimulation to the brain and {{c2::modulating}} {{c1::efferent}} stimulation from th…
Published	09/30/2024	Interneurons place an inhibitory tone on {{c1::primary afferent}} or {{c1::secondary}} (glutaminergic) neurons to inhibit ascension of nociceptive sig…
Published	09/30/2024	Which G-protein are opioid receptors linked to?{{c1::Gi (inhibitory)}}
Published	09/30/2024	On {{c1::pre}}-synaptic neurons, opioid receptors {{c2::decrease}} {{c3::Ca2+}} influx to {{c2::decrease}} {{c4::neurotransmitter}} release
Published	09/30/2024	On {{c1::post}}-synaptic neurons, opioid receptors {{c2::increase}} {{c3::K+}} efflux to cause {{c4::hyperpolarization}} of the neuron
Published	09/30/2024	Opioids directly {{c2::inhibit}} {{c1::GABA}}-ergic interneurons, thereby releasing the inhibitory break on "pain-inhibitory" neurons
Published	09/30/2024	{{c1::Morphine}} is purified from opium and is the standard of comparison for analgesics
Published	09/30/2024	Opioid-mediate respiratory depression is {{c1::dose}}-dependent and may initially present as {{c3::in}}-creased {{c2::PaCO2}}
Published	09/30/2024	Opioid-induced {{c1::hyperalgesia}} can occur with chronic use
Published	09/30/2024	{{c1::Truncal rigidity}} is a side effect of opioid use that is apparent with large, rapid IV doses of highly {{c2::lipid}}-soluble opioids, i.e. {{c3…
Published	09/30/2024	Administration of a {{c1::partial}} mu-opioid agonist with a {{c1::full}} mu-opioid agonist can precipitate {{c2::withdrawal}} symptoms
Published	09/30/2024	{{c1::Loperamide}} and {{c2::Diphenoxylate}} are mu-opioid {{c3::agonists}} that act as anti-{{c4::diarrheals}}
Published	09/30/2024	Opioids {{c1::decrease}} uterine tone and may cause {{c2::prolonged}} labor
Published	09/30/2024	{{c1::Naloxone}} is a mu-opioid {{c2::antagonist}} that exerts effects within {{c3::1-3}} minutes
Published	09/30/2024	{{c1::Naltrexone}} is a mu-opioid {{c2::antagonist}} that blocks virtually all effects of {{c3::heroin}} if administered every few days
Published	09/30/2024	Strong mu-opioid agonists include {{c1::Meperidine}}, {{c2::Methadone}}, {{c3::Morphine}}, {{c4::Hydropmorphone}}, and {{c5::Oxymorphone}}
Published	09/30/2024	Pentazocine is a mu {{c1::partial agonist}} and kappa {{c1::agonist}}
Published	09/30/2024	Nalbuphine is a mu {{c1::antagonist}} and kappa {{c1::full agonist}}
Published	09/30/2024	Buprenorphine is a mu {{c1::partial agonist}} and kappa {{c1::antagonist}}
Published	09/30/2024	Butorphanol is a mu {{c1::partial agonist}} and kappa {{c1::full agonist}}
Published	09/30/2024	Butorphanol is administered {{c1::parenterally}} and has a duration of {{c2::3-4}} hours
Published	09/30/2024	Buprenorophine is administered {{c1::parenterally}} or {{c1::sublingually}}, has a duration of {{c2::>8}} hours, and a half-life of {{c3::20-70}} h…
Published	09/30/2024	Nalbuphine is administered {{c1::parenterally}} and has a duration of {{c2::4-8}} hours
Published	09/30/2024	{{c1::kappa}}-opioid receptor agonists have {{c2::less}} potential for abuse
Published	09/30/2024	Naloxone has {{c1::poor}} oral absorption and a duration of {{c2::1-2}} hours
Published	09/30/2024	Naltrexone has {{c1::good}} oral absorption and a duration of {{c2::~48}} hours
Published	09/30/2024	Nalmefene is a mu {{c1::antagonist}} that is administered via IV and has a half-life of {{c1::8-10}} hours
Published	09/30/2024	Aliimopan and Methylnaltrexone are mu {{c1::antagonists}} that have poor {{c2::CNS}} penetration, thereby reversing {{c3::constipation}} without preci…
Published	09/30/2024	Opioids are distributed first in highly {{c1::perfused}} tissues and over time, reservoirs may develop in {{c2::muscle}} and {{c2::fat}}
Published	09/30/2024	Metabolism of opioids occurs via {{c1::glucoronidation}}, {{c2::N-methylation}}, {{c3::CYP3A4}}, and {{c4::CYP2D6}}
Published	09/30/2024	CYP{{c1::2D6}} metabolizes {{c2::codeine}} into {{c3::morphine}}
Published	09/30/2024	CYP{{c1::3A4}} oxidizes {{c2::phenylpiperidines}} in the {{c3::liver}} and {{c3::gut}}
Published	09/30/2024	{{c1::Nociceptive}} and {{c1::inflammatory}} pain represents a(n) {{c2::intact}} nervous system
Published	09/30/2024	{{c1::Neuropathic}} pain represents a(n) {{c2::damaged}} nervous system
Published	09/30/2024	{{c1::Acute}} pain serves a(n) {{c2::adaptive}} function whereas {{c1::chronic}} pain does not
Published	09/30/2024	Features of dysfunctional pain include1. {{c1::alterations in neurotransmission}}2. {{c2::decreased inhibition}}3. {{c3::structural reorganization}}4.…
Published	09/30/2024	{{c1::Glial}} cells are activated by {{c2::substance P}} to secrete {{c3::cytokines}}, {{c4::nitrous oxide}}, and {{c5::prostaglandins}}
Published	09/30/2024	{{c1::Primary}} hyperalgesia occurs at the site of {{c2::injury}}
Published	09/30/2024	{{c1::Secondary}} hyperalgesia occurs at the tissue surrounding the {{c2::injury}}
Published	09/30/2024	{{c1::Peripheral}} sensitization can become {{c1::central}} sensitization if left untreated, resulting in pain levels that don't correlate to the init…
Published	09/30/2024	{{c1::Peripheral}} sensitization is {{c2::heat}}-sensitive whereas {{c1::central}} sensitization is not
Published	09/30/2024	{{c1::Central}} sensitization responds well to {{c2::anti-epileptic}} and {{c2::anti-depressant}} drug classes
Published	09/30/2024	{{c1::Peripheral}} sensitization responds well to {{c2::NSAID}} drug class
Published	09/30/2024	Which drug class targets the brain, peripheral sensitization, and central sensitization? {{c1::TCAs}}
Published	09/30/2024	Drugs that target {{c2::peripheral}} sensitization block {{c1::Na+}} channels
Published	09/30/2024	Drugs that target {{c2::central}} sensitization block {{c1::Ca2+}} channels and {{c1::NMDA}} receptors
Published	09/30/2024	Can't-miss-diagnoses for pain include {{c1::cancer}}, {{c2::infection}}, {{c3::fracture}}, and {{c4::ongoing tissue damage (nerve compression)}}
Published	09/30/2024	Complex Regional Pain Syndrome presents with {{c1::neuropathic pain}}, {{c2::autonomic features}}, {{c3::trophic changes to skin/hair/nails}}, and {{c…
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