Frage 1
Frage
Sherrington’s division of senses; choose correct
Antworten
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Exteroceptive, such as those that detect light, sound, odour, and tactile stimuli
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Interoceptive, that detect events occurring in the interior of the organism.
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Proprioceptive, exemplified by taste receptors, receptors in viscera;
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Teleceptive (special) senses were excluded from above mentioned (vision, audition, olfaction, taste.
Frage 2
Frage
Sherrington’s division of senses - Choose correct
Antworten
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Teleception - special senses
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Interoception - deep sensation
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Exteroception - cutaneous sensation
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Proprioception - visceral sensation
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Nociception - pain sensation
Frage 3
Frage
Head’s division of senses; choose correct
Antworten
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Epicritic – determined accurately, precisely; said of cutaneous nerve fibers sensitive to fine variations of touch (related to senses conducted in dorsal columns).
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Protopraxic – diffused, not precise, such as pain and sense of warm temperature (conducted through anterolateral system)
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Epicritic – diffused, not precise, such as pain and sense of warm temperature (conducted through anterolateral system)
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Protopraxic – determined accurately, precisely; said of cutaneous nerve fibers sensitive to fine variations of touch (related to senses conducted in dorsal columns).
Frage 4
Frage
Sense of pain; choose correct
Antworten
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Perception of proprioceptive stimuli from skin and internal organs, resultant from physical damages or diseases.
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Perception of nociceptive stimuli from skin and internal organs, resultant from physical damages or diseases.
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Pain is unpleasant sensory and emotional experience associated with actual and/or potential tissue damage or described in terms of such damage.
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Sense of particular significance in biology of animals and humans, released as a warning signal.
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Perception of teleceptive stimuli from skin and internal organs, resultant from physical damages or diseases.
Frage 5
Frage
Difficulties in assessment of pain; choose wrong
Antworten
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Pain cannot be evoked without direct stimuli
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Allodynia - Pain produced by stimuli which usually do
not elicit pain
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Noxious stimuli present, but no pain felt.
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Neuropathic pain - Pain initiated by primary lesion or
dysfunction
Frage 6
Frage
Sense of pain; choose correct
Antworten
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Pain isn't a sensory phenomenon
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Pain is the product of complex, central, nociception- induced processing, and not a primitive sensation (IASP).
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Pain isn't an emotional experience
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Pain is a conscious, aversive aspect of somatic awareness,
Frage 7
Frage
Sense of pain - features; choose correct
Antworten
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Adaptation phenomenon is observed
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Produces specific emotional state related to fear, it is NOT modified by previous experience.
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Produces several responses and reflexes preventing or reducing the influence of harmful, nociceptive factor and effects of its action (withdrawal reflex)
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Plays warning function, signaling real or potential damage.
Frage 8
Frage
Factors affecting sense of pain; choose correct
Antworten
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Age - Younger people are more sensitive to pain
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Gender - Males are more sensitive to pain
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Age - Elder people are more sensitive to pain
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Gender - Females are more sensitive to pain
Frage 9
Frage
Sense of pain - affecting factors; choose WRONG
Frage 10
Frage
Pain sensation does not depend on...?
Antworten
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Emotional status and type of personality,
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Life experience
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Functional status of entire PNS,
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Acquired habits and education.
Frage 11
Frage
Pain threshold; choose correct
Antworten
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Is elevated by muscular contraction or work
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Is lowered by nociceptive action in other regions of the organism.
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Is elevated by conc. of one’s attention on non- nociceptive stimuli like touch, visual or auditory sensation.
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Is lowered by muscular contraction or work,
Frage 12
Frage
Pain; choose correct
Antworten
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Pain can be receptor dependant or independant
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Fast pathway (12-30 m/s) built with myelinated Aδ- fibers responsible for „bright”, acute, sharp, easily localised pain – last short.
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Slow pathway (12-30 m/s) built with myelinated Aδ- fibers responsible for „bright”, acute, sharp, easily localised pain – last short.
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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.
Frage 13
Antworten
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Nociceptive system - System identifies are of damage (or potential damage)
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Antinociceptive system - System of sensing, transmitting, recognizing and localizing of the nociceptive stimulus.
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Antinociceptive system - modulating sense of pain at level of post. horn of spinal cord (peripheral modulation)
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Nociceptive system - modulating sense of pain at various levels of spinothalamic tracts, thalamic nuclei & thalamo-cortical linkages (central modulation)
Frage 14
Frage
Division of pain; choose wrong
Antworten
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The closer to the brain the stimulus is applied, the greater the temporal separation of two components.
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In the spinothalamic tract there are A-delta fiber types
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Anterior horn of spinal cord conveys sensation of simple touch
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Lateral side of the spinal cord conveys fast and slow pain (pain and temperature)
Frage 15
Antworten
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Deep pain - is produced by chemical factors released in hypoxic muscles
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Deep pain - is poorly localised, nauseating and associated with sweating and change in blood pressure.
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Deep pain can be elicited from periosteum, ligaments, joints, fascias and blood vessels
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Muscle pain is substernal pain in coronary disease and intermittent claudation
Frage 16
Frage
Choose correct match
Antworten
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A beta fibers - free nerve endings
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A-delta and C - paciniform corpuscles and ruffini terminals
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Type 4 (unmyelinated) fibers - free nerve endings
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Type 3 (A-delta, myelinated) fibers - free nerve endings and some specialised endings
Frage 17
Frage
Choose correct about visceral pain
Antworten
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Visceral pain - Observed in torn ligaments and sore muscles
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Visceral pain -released by chemical, mechanical and osmotic stimuli.
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Visceral pain - Pain is poorly localised, but doesn't radiate.
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Visceral pain - poorly localised, nauseating, associated with sweating, changes in blood pressure (hypotension)
Frage 18
Antworten
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Visceral pain - deep somatic pain initiates reflex contraction of nearby skeletal muscles.
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Visceral pain - goes through the ventral root ganglia to brain
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Sensory neurons of the post. horn are not only converged by somatosensory protoneurons of skin sensation. They're converged by nociception originated from viscera.
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Impulses conducted in visceral reflex arcs increase excitibility of neurons transmitting impulses from exteroceptors. They start to send nociceptive impulses
Frage 19
Frage
Visceral Referred Pain (VPR);
Antworten
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Divided into; Cervical, thoracic and lumbar
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VRP areas of heart include left chest and left arm on medial side
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VRP area of liver include right shoulder and clavicular area, as well as an area below the scapula
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VRP of the stomach involves the lower back
Frage 20
Frage
Receptors of pain; correct features
Antworten
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No specialised receptor cells and they are slowly adapting receptors
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Specialised receptor cells and they are slowly adapting receptors
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No specialised receptor cells and they are rapidly adapting receptors
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Free nerve endings sensitive to pain distributed in all the body organs (except for brain tissue and pulmonary parenchyma).
Frage 21
Antworten
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Unimodal receptors located on Aδ-fibers - Thermoreceptors responding to high temperature.
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Polymodal receptors located on C-fibers - Naked nerve endings responding to mechanical stimuli
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Silent nociceptors - Stimulated by temperatures > 42?C , low pH, capsaicin and other chemicals.
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RPV1 receptors (capsaicin receptor) - Respond to nocicceptive stimuli only when inflammatory substances are present.
Frage 22
Frage
Harmful factors of Nociceptive stimulus - choose WRONG
Antworten
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Hyperxemia (high O2 in tissues)
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Physical trauma (mechanical, electrical or thermal damage)
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Intrinsic chemicals (H+, K+, lactate, histamine, Ach, bradikinin, proteolytic enzymes, prostaglandins), capsaicin and extrinsic agents.
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Inflammatory processes and neoplams
Frage 23
Frage
Substances producing pain VS facilitating pain; choose correct match
Antworten
-
Facilitates pain - Bradykinin and leukotriens
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Produces pain - Prostaglandins and cytokines (IL-1 & TNF-alpha)
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Facilitates pain - SP and ATP
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Produces pain - K+ and H+
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Histamine is only facilitating pain, while serotonin only stimulates pain
Frage 24
Frage
Neurotransmitters of pain;
Frage 25
Frage
Neuromediators and functions- choose correct match.
Antworten
-
Glycine - suppresses the transmission of pain signals in the dorsal root ganglion.
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Substance P - peptide (11 amino acids) released by C fibers; associated with intense, chronic persistent ("bad") pain.
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Glutamate- suppresses the transmission of pain signals in the dorsal root ganglion.
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Glycine - dominant neurotransmitter when the threshold to pain is first crossed; associated with acute ("good") pain.
Frage 26
Frage
Afference of pain; General axons of dorsal horn neurons
Antworten
-
Enter anterolateral system (lateral spinothalamic tract)
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Enter anteromedial system (medial spinothalamic tract)
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Enter posterolateral portion of the cord
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Enter posteromedial portion of the cord
Frage 27
Frage
Afference of pain; Ascending fibers - Choose WRONG
Antworten
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Ascend to specific sensory relay nuclei of thalamus, to areas S1, S2 and cingulate gyrus
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Ascend to Hypothalamus
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Ascend to Cerebellum
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Ascend to reticular nuclei of brain stem, tectal area of mesencephalon and periaqueductal gray.
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Ascend to the midline and intralaminar nonspecific nuclei of the thalamus and cortex
Frage 28
Antworten
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Spinal nerves - through VPM of thalamus to somatosensory cortex (3, 1, 2 Brodman’s area)
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Trigeminal (cranial input) nerves - through VPL of thalamus to somatosensory cortex (3, 1, 2 Brodman’s area)
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Trigeminal (cranial input) - nerves through VPM of thalamus to somatosensory cortex (3, 1, 2 Brodman’s area)
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Spinal nerves - through VPL of thalamus to somatosensory cortex (3, 1, 2 Brodman’s area)
Frage 29
Frage
Afference of pain; lateral STT vs spinoreticular tract;
Antworten
-
Lamina 1, 4 & 5 are origin of Lateral STT and Spinoreticulartract
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Spino-reticular tract follows the somatotopic organisation
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Lateral STT has bilateral body representation
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Only Spinoreticular tract synapse in reticular formation
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Spino-reticular tract has sub-cortical targets in autonomic centres, limbic system and hypothalamus
Frage 30
Frage
Afference of pain; lateral STT vs spinoreticular tract;
Antworten
-
Lateral STT goes to VPL of the thalamic nuclei
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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)
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Role of Spinoreticular tract is dicriminative pain (quality, intensity & location)
Frage 31
Frage
Afference of pain; Slow (indirect) VS Fast (Direct)
Antworten
-
Direct (fast) - Lateral STT
-
Direct (fast) - BIlateral
-
Indirect (slow) - Subcortical regions are Autonomic centres, limbic system, hypothalamus
-
Direct (fast) - perceives temperature and simple touch
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Indirect (slow) - Thalamic nuclei is VPL
Frage 32
Frage
Modulation of pain;
Antworten
-
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.
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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.
Frage 33
Frage
Modulation of pain;
Antworten
-
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
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Antinociceptive system converging on ventral horn are locus ceruleus - NE
-
Antinociceptive system converging on ventral horn are Periaqueductal grey matter - ENK
Frage 34
Frage
Modulation of pain; opioids
Antworten
-
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
Frage 35
Frage
Modulation of pain - opiods;
Antworten
-
Enkephalins hyperpolarize the presynaptic membrane thus inhibiting it from transmitting these pain signals.
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The enkephalin synapse with a dendrite or cell body.
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Enkephalins are released at synapses of neurons involved in transmitting pain signals to the brain.
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Enkephalins depolarise the presynaptic membrane thus inhibiting it from transmitting these pain signals.