Electrical Currents for Pain Control

Lecture 6 // up to slide 10 - need to finish!!

SUBJECTIVE, not always tissue damage

What is pain?

nociceptive, neuropathic, somatoform

the three types of pain are _____, ______, and _____

Nociceptive

______ pain is stimulation of nerve fibers that respond to stimuli approaching or exceeding harmful intensity

Thermal, Mechanical, Chemical

Nociceptive pain can be _____, _____, or ______

nociceptive

Visceral pain is a type of ______ pain described as diffuse and dull, hard to locate

nociceptive

Deep somatic pain is a type of ______ pain typically in joints, tendons, or ligaments but the patient can’t usually pinpoint

nociceptive

Superficial Somatic pain is a type of _____ pain described as easy to locate typically found with burns

Neuropathic

_______ pain is described as “Burning, tingling, electrical, stabbing, pins & needles” or phantom limb pain and neuropathy

Somatoform

______ pain, also called psychogenic, is described as pain caused, increased, or prolonged by mental, emotional, or behavioral factors

Acute Pain

________ typically needs medial, pharmacologic, and rehab care (warning system and expectation of resolution)

Chronic

______ is less defined with no biologic benefit and is often pain that persists beyond the normal time of healing

F; only takes 3 months

T/F: it takes 6 months to determine if pain has switched to chronic state

A-alpha fibers, 80-120

_______ are myelinated fibers that carry proprioception info at ______m/s with a diameter of 13-20 micrometers

A-beta fibers, 35-90

______ are myelinated fibers that carry touch info at _____m/s with a diameter of 6-12 micrometers

A-delta fibers, 5-40

______ are myelinated fibers that carry pain (mech & thermal) info at _____m/s with a diameter of 1-5 micrometers

C fibers, 0.5-2

______ are non-myelinated fibers that carry pain (mech, thermal, and chem) info at _____m/s with a diameter of 0.2-1.5 micrometers

F; A-beta are faster with conduction speed of 35-90 m/s

T/F: C fibers conduct faster than A-beta fibers

C

All of the following are myelinated fibers EXCEPT:

• A-alpha

• A-beta

• A-delta

• C

Ascending, dorsal

_____ nociceptive pathways are for sensory and afferent info through the ______ root

Descending, ventral

______ nociceptive pathways are for motor and efferent info through the _____ root

A-delta, C

the ascending nociceptive pathway includes Fast and Slow fibers: _____ fibers and _____ fibers

fast and well-localized, withdrawal reflex

Myelinated A-delta fibers assist in _______ pain or ______ like touching a hot object

slow transmission/longer lasting

Non-myelinated C fibers assist in _______ pain also described as diffuse dull pain

• fun fact: this accounts for 70% of all nociceptive pain

CNS, top-down

Motor/efferent info starts in the ______ and diminishes the ascending signals via a ______ mechanism

opinion

Pain is not a reflexive response, it is an ______

Gate Control Theory

_______ of pain has 3 gates (spinal cord, brainstem, and prefrontal cortex)

• one gate gets closed and makes it harder for pain signal to get through to the other two

• may be ascending or descending

A-beta, inhibitory interneurons

E-Stim is the activation of ______ nerves and can also close a gate by activating _______ in the spinal cord

Endorphins

________ help to modulate the pain gates in the spinal cord

• bind to opioid receptors

• released during exercise and laughter

Black Torpedo Fish

Back in older times, the ________ was used to treat. conditions like gout and headaches