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Pain: Pathophysiology and Neuroscience

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Pain: Pathophysiology and Neuroscience PAIN: PATHOPHYSIOLOGY AND NEUROSCIENCE WWW. LP3 NETWORK. COM Pain: Pathophysiology and Neuroscience TABLE OF CONTENTS Accreditation ............................................................................................................................................................................... 4 Activity Description ........................................................................................................................................................................... 5 Learning Objectives .......................................................................................................................................................................... 5 Activity Facilitators ........................................................................................................................................................................... 7 Basic Structure and Function of the Nervous System ................................................................................................................... 8 Skeletal Structure of the Spinal Column & Vertebrae ..................................................................................................................... 10 Action Potential Conduction ........................................................................................................................................................... 12 Ion Channels ................................................................................................................................................................................... 14 Voltage-Dependent Calcium Channels ........................................................................................................................................... 14 Ligand-Gated Channels .................................................................................................................................................................. 16 Neurotransmitters .......................................................................................................................................................................... 18 Neurotransmitter Receptors ........................................................................................................................................................... 19 G Protein-Coupled Receptors .......................................................................................................................................................... 21 Secondary Messengers in Neurotransmitter Signaling .................................................................................................................. 23 Other Metabotropic Receptors ....................................................................................................................................................... 25 Neurotransmitter Reuptake ........................................................................................................................................................... 25 Neuromodulators ........................................................................................................................................................................... 25 Nerve Structure and Function .................................................................................................................................................... 26 Nociceptors ................................................................................................................................................................................ 28 Dermatomes .............................................................................................................................................................................. 29 Referred Pain ............................................................................................................................................................................. 30 Myofascial Trigger Points ............................................................................................................................................................... 31 The Physiology of Pain ............................................................................................................................................................... 32 Pain and the Brain .......................................................................................................................................................................... 32 The Brainstem ................................................................................................................................................................................ 33 The Spinal Cord ............................................................................................................................................................................... 34 Types of Pain ............................................................................................................................................................................. 36 Nociceptive Pain ............................................................................................................................................................................. 36 Neurogenic Pain ............................................................................................................................................................................. 36 Other Types of Pain ........................................................................................................................................................................ 38 Overview of Pain Pathways ....................................................................................................................................................... 40 1 DISCLAIMER: The information contained in this program, which may include treatment modalities, diagnostic and therapeutic information, and instructions related to regulatory guidelines and current standards of practice for pharmacy compounding, is FOR EDUCATIONAL PURPOSES ONLY and should not be taken as a treatment regimen, product indication, suggested treatment modality, or suggested standard of practice. NOTE TO MEDICAL OR ALLIED HEALTH PROFESSIONAL: Any treatments, therapies, or standards of practice must be fully investigated and prescribed by a duly licensed medical practitioner in accordance with accepted professional standards and compendia. Any regulatory or practice standard must be fully investigated by a licensed pharmacist in accordance with accepted professional practice standards and compendia. Pain: Pathophysiology and Neuroscience The Anatomical Pathways of Pain .................................................................................................................................................. 40 The Peripheral System ................................................................................................................................................................ 40 The Spinal and Medullary Dorsal Horn System .......................................................................................................................... 41 The Ascending System ................................................................................................................................................................ 44 The Supraspinal System.............................................................................................................................................................. 44 Descending Pathways ................................................................................................................................................................. 44 Nociceptive Pain Pathway .............................................................................................................................................................. 46 Inflammatory Pain .......................................................................................................................................................................... 48 Sensitization .............................................................................................................................................................................. 50 Peripheral Sensitization ............................................................................................................................................................. 50 Central Sensitization .................................................................................................................................................................. 50 Wind-up .......................................................................................................................................................................................... 51 Structural Reorganization .......................................................................................................................................................... 53 Disinhibition .............................................................................................................................................................................. 54 Pharmacological Treatment of Pain ........................................................................................................................................... 54 Peripheral
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