By Sinatra R.S., Ginsberg B., Viscusi E.
This textbook presents an summary of soreness administration precious to experts in addition to non-specialists, surgeons, and nursing employees.
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1) Peripheral noxious mediators activate nociceptor endings via a process termed transduction. (2) Noxious impulses are delivered to the spinal cord dorsal horn via the process of conduction in afferent fibers. (3) The process of transmission describes synaptic transfer of noxious impulses from primary afferents to second-order cells in the dorsal horn. (4) Modulation describes inhibitory and facilitory effects of spinal interneurons on noxious transmission. (5) Descending inhibition refers to descending brainstem, midbrain, and cortical inhibitor nerve endings that supress pain transmission.
24,81 Receptor-associated alterations mediating wind-up include upregulation and phosphorylation of AMPA receptors,82 as well as subtle conformational changes in AMPA GluR2 subunits and cation channels that facilitate Na+ flux. Several modulating proteins, including extracellular signal regulated kinase83 and calmodulin-dependent protein kinase,84 are responsible for activating tyrosine and threonine kinases that phosphorylate AMPA and NMDA and receptors. Transcription-dependent sensitization describes delayedonset, long-lasting, noxious facilitation that follows genomic activation, transcription of mRNA, and subsequent translational modifications.
1989;78(2):415–418. 64. Peyron R, Laurent B, Garcia-Larrea L. Functional imaging of brain responses to pain: a review and meta-analysis. Clin Neurophysiol. 2000;30(5):263–288. 65. Coghill RC, Sang CN, Berman KF, Bennett GJ, Iadarola MJ. Global cerebral blood flow decreases during pain. J Cerebral Blood Flow Metab. 1998;18(2):141–147. 66. Rainville P, Duncan GH, Price DD, Carrier B, Bushnell MC. Pain affect encoded in human anterior cingulate but not somatosensory cortex. Science. 1997;277(5328):968–971.
Acute Pain Management by Sinatra R.S., Ginsberg B., Viscusi E.