1. Pain & Temperature Ascending Pathway in the Spinal Cord Spinothalamic Pathway Aka Anterolateral System

2. Sensory info From thermo- Receptors & nociceptors

5. Spinothalamic Tract DRGN enters dorsal horn at each spinal cord level Ascend/descend in Lissaur’s tract Synapse in Substantia Gelatinosa Decussate in ventral spinal cord Ascend ventrally in spinal cord as the Spinothalamic Tract Synapse in thalamus (Ventral Posterior and intralaminar Nuclei) Thalamic axons travel to S1 somatosensory cortex and synapse in layer 4.

7. Two fiber types for Temperature Two fiber types for pain C fibers unmyelinated convey dull achy pain A delta: thinly myelinated convey fast sharp pain

9. Types of Stimuli Mechanical stimulation Temperature extremes Oxygen deprivation Chemical exposure

10. Nociception & Pain Nociception is the sensory process that signals potential damage to body called nociceptors –Sore, stinging, throbbing, achy, mildly irritating, searing unbearable Activation of nociceptors generate action potential that trigger the feeling of pain

11. Nociceptive Ion Channels Ion channels that open when exposed to painful stimuli (extreme heat or cold, compression) Present in membrane of axons of nociceptor neurons Mechanically gated channels Temperature sensitive neurons called thermoreceptor neurons have temperature gated channels –Sense cold or warm: burning is sensed by different neurons called nociceptors which signal damaging temperature extremes

12. Polymodal Nociceptors Respond best to one but some to all –Thermal –Mechanical –Chemical NTs: glutamate and Substance P Capsaicin causes release of Sub P from nociceptor axons Large amounts of capsaicin cause analgesia due to depletion of sub P from synapses

13. Insert 12.26 and 27

15. Hyperalgesia Increased sensitivity to pain after tissue injury Damaged tissue also releases molecules sa bradykinin that gate other channels/bind receptors Secretion of substances, substance P, bradykinin, prostaglandin that cause inflammation Can cause long lasting intracellular changes that increased sensitivity of nociceptive ion channels

16. Insert 12.24 Aspirin suppresses synthesis of prostaglandins

17. Referred Pain Due to mixing of nociceptive axons from viscera with those from skin at the level of spinal cord. Perception of visceral information as coming from skin areas Angina: low oxygen in heart is perceived as chest and arm pain

18. Insert 12.28 and 29