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What is the neospinothalamic tract?
- Direct connection from SC to thalamus
- **localized pain
What is the Paleospinothalamic tract?
- Indirect connection from SC to thalamic nucleus
- **poorly localized pain
- **emotion, feelings, etc...tied to pain
What is dysesthesia?
sensation without stimulus
What is hypesthesia?
What is paresthesia?
abnormal sensation (pain, prick, burn, tickle...)
What is hyperalgesia?
What is hypalgesia?
Diminished sense of pain
What is allodynia?
Pain from extreme innocuous sensation (e.g. sunburn from >45C temp or cold from <17C temp)
What type of free nerve endings are within the ALS?
- non-nociceptor thermoreceptor: warm/cold
- non-noxious mechanoreceptor: pinch, rub, stretch, scratch, etc...
What type of peripheral nerves are in the ALS?
A-delta and C-fibers (since all of nociceptor origin)
How many A-delta fiber spots in the peripheral ALS neurons?
2-30 (micrometer diameter)
How many C-fiber spots in the peripheral ALS neurons?
1-2 (mm diameter)
What part of the SC do the central nerves travel through?
What do the descending branches participate in?
Where do the ascending branches synapse?
What lamina contains the majority of A-delta and C-fibers?
- A-delta: Lamina I
- C-fibers: Lamina V
List the pathway of pain inhibition for the ALS?
Periaqueductal grey in Midbrain - descending fibers to Nucleus Raphe Magnus - descending Raphespinal tract = inhibition of ALS in Posterior Horn of SC
How does the Gate Theory modulate pain?
- Squeeze painful area manually
- A-alpha and A-beta fibers release opiates
- Opiates inhibit nociceptive pain fibers
What commisure do the secondary nerve fibers utilize to decussate to their respective ALS sites?
Anterior white commissure