Professional Documents
Culture Documents
PHYSIOLOGY
FIFTEEN
APRILA
FAJRIN
BAG
FKK-FFUJ
Learning Object???
DeniBon
Nociceptor
Nerves
types
Pain
types
Allodynia
vs
Hyperalgesia
Pain
pathway
Pain DeniBon?
Noxious
SBmulus?
Pain
causing
Chemical
Mechanical
Thermal
Heat
(>42
oC)
Cold
(<10
oC)
Nociceptor
Pain
detecBng
Found
throughout
the
body
NOCICEPTION
the
detecBon
of
Bssue
damage
by
specialised
transducers
a^ached
to
nociceptor
(A
delta
and
C
bres)
Nociceptor
Bradykinin
K+
Prostaglandins
C fibers
Injury
Histamine
A fibers
To spinal cord
Mast
Cell
patien
b)
wheth
shoul
not b
neuro
c)
lus th
increa
patien
bation
centra
d)
tion,
neous
sitiza
act sp
can b
Cen
The s
Aerent
(sensory)
A
Beta
sensory,
large
diameter
with
myelin
(30-50
m/s
Fastest)
A
Delta
pain
bers,
smaller
with
less
myelin
(5-25
m/s)
C
pain,
smallest,
non
myelinated
(<2
m/s),
slow
pain
Nerve Types
Eerent
(motory)
Gamma
motor
neuron
A
beta
A
delta
CNS
Note:
First
pain
is
from
A
delta
(faster),
second
pain
is
C
Allodynia
vs
Hyperalgesia
Allodynia
pain
due
to
a
sBmulus
that
does
not
normally
provoke
pain
Hyperalgesia
An
increased
response
to
a
sBmulus
that
is
normally
painful.
Intensity
The
intensity
of
pain
oers
perhaps
the
least
desirable
system
for
classifying
pain,
because
intensity
varies
for
most
paBents
over
Bme
and
is
uniquely
subjecBve.
A
paBent
might
rate
the
experience
of
pain
resulBng
from
some
pathologic
condiBon
as
a
10,
whereas
another
paBent
with
the
same
pathology
might
describe
the
intensity
of
pain
only
as
a
5,
both
using
a
0
to
10
scale
(with
0
signifying
no
pain
at
all
and
10
represenBng
the
worse
pain
imaginable)
Pain CHART
Remember???
Cell
body
(in
ganglion)
nucleus
Body
Dendrites
Synapse
axon
Dendrite
Chronic
Acute
PAIN
Nyeri akut
Nyeri kronik
Lama
Peredaan nyeri
Sangat diinginkan
Sangat diinginkan
Ketergantungan
thd
obat
Tidak biasa
sering
Komponen
psikologis
Umumnya
Bdak
ada
Sering
merupakan
masalah
utama
Kontribusi
lingkungan
dan
keluarga
Kecil
signikan
Insomnia
Jarang
sering
fungsionalisasi
Inammatory
NocicepBve
PAIN
NeurophaBc
NocicepBve Pain
Inammatory Pain
Neuropathic Pain
NocicepBon-TransducBon
- the
conversion
of
a
noxious
sBmulus
into
electrical
acBvity
in
the
peripheral
terminals
of
nociceptor
sensory
bers.
- Mediated
by
specic
receptor
ion
channels
expressed
only
by
nociceptors
- Noxious
sBmulus
converted
into
Ca2+
mediated
electrical
depolarizaBon
eurons to pain.
Nociceptor AcBvators
Nociceptor AcBvators
NocicepBon-Transmission
- The
passage
of
acBon
potenBals
from
the
peripheral
terminal
along
axons
to
the
central
terminal
of
nociceptors
in
the
central
nervous
system
- The
synapBc
transfer
- Release
of
neurotransmi^er-
induced
pain
Glutamate,
substance
P
NocicepBon-ModulaBon
Balancing
between
exitatory
mediators
and
the
inhibitory
eect
of
endogenous
analgesics
Adjust
K
inux
and
Na
eux
Endogenous
analgesics,
including
enkephalin
(ENK),
norepinephrine
(NE),
and
-
aminobutyric
acid
(GABA),
acBvate
opioid,
alpha
adrenergic,
and
other
receptors
that
either
inhibit
release
of
Glu
NocicepBon-PercepBon
A-delta
ber
C
ber
Spinal
cord
Brain
Response
aduhhh
tarik
tangan
Drug
target
for
Pain