PAIN

PAIN
Unpleasant sensation caused by tissue damage. Purpose: Protective
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Types: 1) Fast Pain: Sharp, Picking, Acute, Electric 0.1 Sec Skin 2) Slow Pain: Burning, Aching, Throbbing, Nauseous, Chronic 0.1 Sec, Increase Slowly Skin + Deeper Tissues
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Pain Receptors
Free nerve ending Superficial layers of skin Periosteum, arterial walls, joint surfaces, falx and tentorium of cranial vault Other deep tissues Non-Adapting
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Stimuli For Pain Receptors

1. Mechanical 2. Thermal 3. Chemical Bradykinin, Serotonin, Histamine, K+, Acids, Acetyl-Choline, Proteolytic enzymes.
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Distribution curve obtained from a large number of persons showing the minimal skin temperature that will cause pain

Transmission of both "fast-sharp" and "slowchronic" pain signals into and through the spinal cord on their way to the brain.

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Transmission of pain signals into the brain stem, thalamus, and cerebral cortex by way of the fast pricking pain pathway and the slow burning pain pathway.

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Transmission of Pain Signals

1. Fast-Sharp Pain Pathway Neo-Spinothalamic Tract

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2.

Slow-Chronic Pain Pathway Paleo-Spino-Thalamic Tract

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Analgesia System
3 major components + some accessory components

Endorphins

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Image

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Referred Pain
Definition Importance Clinical Dx Location of referred pain
Above Distant
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Mechanism of Referred Pain

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Dermatome Rule

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Which Types of Pain can be Referred Pain

a. Visceral Pain

b. Deep Somatic Pain

(Superficial Pain is not referred)

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Mechanism
1. Roll of Convergence:

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2. Facilitation Theory

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Roll of both theories

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Localisation of Referred Pain

a. Dermotome Rule b. Roll of Experience c. Transmission pathways
Viceral Parietal
e.g. Acute Appendicitis

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Visceral Pain
Less Receptors Diffuse

Causes:
1. 2. 3. 4. Ischemia Chemical Spasm Distention
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Pain Insensitive Viscera

1. Liver Parnchyma 2. Lung Alveoli 3. Visceral Pericardium Visceral Peritonium

Visceral Pleura
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