Pain transmission is facilitated.
Severe personality changes.
Enkephalin binds to opiate receptors in the central terminal of the 1st order neuron, leading to the opening of Cl channels.
It causes a loss of pain sensations.
Any technique to induce the absence of sensation in part of the body.
They are very potent analgesics
The spinal gate.
Large diameter 'touch' fibres (Aβ).
It is the theory that pain-carrying fibers from a diseased viscous and related somatic structures converge on the same SGR cells (Dorsal horn cells) and ascend to the same cortical neurons, causing the brain to perceive pain from the viscous as if it is coming from the somatic structure.
They are the cells where pain-carrying fibers from the diseased viscous and related somatic structures converge before ascending to the same cortical neurons.
In the substantia gelatinosa of Rolandi (SGR).
Using some drugs as painkillers.
In the lower neck and midline chest region.
Using drugs to relieve pain.
In the lower pons and upper medulla.
In the dorsal horn of the spinal cord.
Hyperpolarization.
Loss of consciousness and memory of the patient.
Opioid receptors (morphine receptors).
They are involved in presynaptic inhibition.
In the medulla.
Connections between the cerebral cortex, periventricular area, periaqueductal gray area, NRPG, NRM, and spinal cord.
Limbic system.
Enkephalinergic neuron.
Exposure to severe stress, particularly when associated with strong emotional excitement.
Temporary paralysis of the entire body muscles.
General anesthesia, Local anesthesia, Regional anesthesia.
In the same sites as enkephalin
Through collaterals.
In stress conditions, Beta-endorphins are secreted from the hypothalamus and pituitary to general circulation, reaching all the opiate receptors in the body and causing analgesia.
A Clinical Psychologist, a Physiotherapist, and a Medical Practitioner.
When activated, it can reduce or abolish pain sensation.
Cerebral cortex.
Presynaptic inhibition.
Enkephalin binds to opiate receptors in the postsynaptic 2nd order neuron in the pain pathway, leading to the opening of K channels.
Medically induced coma and loss of protective reflexes resulting from the administration of one or more general anesthetic agents.
Pro-opi-melano-corten (POMC) in the anterior pituitary and hypothalamus.
Pain Control System.
On the same SGR cells (Dorsal horn cells).
Periaqueductal Gray.
Encephalin release.
Opening of K channels.
Postsynaptic inhibition.
Opening of Cl channels -> Cl influx -> hyperpolarization -> block of Ca influx -> inhibit release of chemical transmitter from 1st order neuron.
Enkephalins, Endorphins, and Dynorphins.
General anesthesia.
Regional anesthesia.
It is believed that they are responsible for addiction to opiates
They increase the secretion of growth hormone and prolactin from the pituitary.
Delta receptors.
By activating large diameter 'touch' fibres (Aβ) without activating smaller diameter nociceptive fibres (Aδ and C).
The epigastric region, and it may also be referred to the right shoulder and neck.
Cutting of the peripheral nerves and prefrontal lobectomy.
It abolishes the emotional and psychogenic effect of pain.
In the medulla.
Electrical stimulation, application of opiates, and exposure to stress.
Local application of opiates such as morphine at particular regions in the nervous system.
Leuenkephalin and metenkephalin
At the level of the brain stem.
By stimulating the arcuate nucleus and some specific areas of the hypothalamus of the brain stem to secrete endorphins.
At the nuclei of the reticular formation.
It causes simultaneous suppression of pain transmission at the spinal pain-gate by acupuncture.
In the suprapubic region, to the peritoneum, or to the lower region of the neck.
The endogenous analgesic system.
In the Pons and upper medulla.
In the dorsal horns of the spinal cord.
Reticular formation.
Loss of consciousness and memory of the patient, loss of pain sensations, and temporary paralysis of the entire body muscles.
Severe stress, particularly when associated with strong emotional excitement.
Opening of K channels -> hyperpolarization -> inhibit their response to the pain chemical transmitter.
Opioid peptides.
Pain transmission is blocked.
Kappa receptors.
Analgesia, euphoria, respiratory depression, miosis, and constipation.
To the right iliac fossa when the peritoneal covering is involved.
The pain sensation is projected to or felt in the somatic structure.
It helps in pain inhibition.
The midbrain.
Acupuncture.
It is involved in the gate control of pain or pain inhibition at the SGR cells.
By descending inhibitory impulses through the pain control system activating enkephalin-secreting interneurons and by stimulation of large diameter fibers terminating peripherally in mechanoreceptors.
Rubbing the skin excites tactile and pressure receptors, which can block pain transmission.
Smaller diameter nociceptive fibres (Aδ and C).
The epigastric region in the wall of the abdomen.
Around the aqueduct of Sylvius in the midbrain and pons.
Ascending pain pathway.
Opioid receptors.
1. Electrical stimulation of certain regions of the pain control system. 2. Local application of opiates (such as morphine) at particular regions in the nervous system (pharmacological anesthesia).
Proenkephalins
Gates through which pain transmission can be facilitated (if the gate is open) or blocked (if the gate is closed).
The PAG area is involved in the pain control system and its activation leads to the release of endogenous opioid peptides.
In the midbrain and Pons.
Hypothalamus.
Enkephalin release.
Hyperpolarization.
It inhibits the response to pain by causing hyperpolarization and blocking the release of pain chemical transmitters.
Brain stem, spinal cord, and limbic system
Local anesthesia.
Mostly type A sensory nerve.
Beta-endorphin, which consists of 30 amino acids.
They activate enkephalin-secreting interneurons.
At the SGR (Substantia Gelatinosa of Rolando).
A psychologically based rehabilitation programme delivered in a group setting by an interdisciplinary team.
Muta receptors.
1. Physiological method (endogenous analgesic system), 2. Pharmacological, 3. Surgical.
Because the cortical sensory areas are accustomed to receiving pain impulses from the somatic structure, so when the viscous is injured or diseased, the impulses are perceived by the cortex as if coming from the somatic structure.
In severe cases, such as terminal stages of severely painful conditions like tumors.
When activated, it can reduce or even completely abolish pain sensation.
In the pons.
Cerebral cortex, Periventricular area, Periaqueductal gray area, Nucleus reticularis paragiganto-cellularis (NRPG), Nucleus raphe magnus (NRM), Spinal cord.
Opening of Cl- channels.
Opioid receptors.
It blocks Ca2+ channels.
It inhibits the release of chemical transmitters by blocking Ca influx.
Prodynorphin
1. Pain control system (as before) 2. Other mechanisms: A) Collaterals from large sensory nerves (A alpha and A beta) B) Acupuncture
The secretion of Beta-endorphins from the hypothalamus and pituitary to general circulation, causing analgesia.
Omega receptors.
Transcutaneous Electrical Nerve Stimulation
By stimulating certain regions of the pain control system.
Anesthesia affecting a large part of the body, such as a limb or the lower half of the body.
Three classes.
A alpha and A beta nerves.
Analgesia, sedation, diuresis, and miosis.
Sigma receptors.
The retrosternal region, base of the left side of the neck, inner side of the arm, forearm, or even in the little finger. It may also be felt in the epigastric region.
Acupuncture is one of the other mechanisms for pain inhibition at the SGR cells.
To deliver electrical currents across the intact surface of the skin.
Pain arisen in a viscous and felt in a related somatic structure (both the viscous and somatic structure originated from the same embryonic segment and supplied by the same spinal dorsal roots).
It terminates peripherally in mechanoreceptors, such as tactile receptors or proprioceptors, which can block pain transmission.
At neurons of PVLNT (Posterior Ventral Lateral Nucleus of the Thalamus) and intralaminar thalamic nuclei.
To reduce the disability and distress caused by chronic pain by teaching sufferers physical, psychological, and practical techniques to improve quality of life.
In the skin area surrounding the umbilicus.
1. Excitation of certain sensory neural pathways which activate the PAG area involved in the pain control system, with the release of endogenous opioid peptides. 2. Simultaneous suppression of pain transmission at the spinal pain-gate by acupuncture.
The back behind the kidney, and it may also be referred to the anterior abdominal wall near the injured region.
