5 items that do nociceptive activation and sensitization (in addition to various ions and other biochemical mediators that do this)
Substance P is made by cells of the spinal ganglia, and found at peripheral terminal of unmyelinated primary afferent fibers. Plays a role in ...?
increasing pain from GI, ureters, and urinary bladder
C fibers conduct what pain, how
dull and burning pain
slow conduction velocity, bc they're unmyelinated
A fibers conduct what pain, how?
fast, sharp, -- they're myelinated
from muscles, joints, bone
A and C ascending nociceptive fibers synapse with neurons where?
Dorsal horn has neurons that get hyperexcited by distinct types of stimuli from primary afferent nociceptors (A and C). There are 3 classes of cells responding here. What are they, what do they respond to?
class I - respond to low threshold mechanical and thermal impulse
class II - have a wide dynamic range
class III - respond to stim only from tissue damage
anterolateral pathway transmits what kind of sensory info?
temp, pain, crude touch, tickle, itch
does sensory that doesn't require speed, precise localization, or fine gradations of intensity from signal source
anterolateral fibers originate where? then do waht?
then cross in the anterior commissure to the opp. ant and lat white columns
upper terminus of anterolat pathway
throughout the reticular nuclei of brainstem
ventrobasal and introlaminar nuclei of thalamus
5 classes of pain meds
skeletal muscle relaxants
when to use opioids? what do they mix well with and why?
in refractory cases or pts w severe pain
use with NSAIDs bc they can enhance opioid analgesia and produce "dose sparing"
acetylsalicyclic acid, aka __
how does aspirin/ acetylsalicylic acid exert its therapeutic effect?
inhibit synth of eicosanoides
4 basic effects of eicosanoides (prostaglandines, thromboxanes, leukotriens)
inflam (increase local blood flow, capillary permiability, and effects of histamine)