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Cotransporter Nacc Nachr Nadolol Naloxone Narcolepsy N Definition N/OFQ Acetylcholine (ACh) is released from endothelial cells, keratinocytes and other cells following trauma and can Orphanin FQ activate nociceptors. In nociceptors, ACh can interact with either muscanic (mAChr) or nicotinic (nAChr) re- ceptors.Thenicotinictypecandirectlyinduceactionpo- tentials by the gating of ion channels. The muscarinic N2O type acts via G-protein coupled receptors to either up- regulate or down regulate nociceptor excitability. Nitrous Oxide Antinociception and Opioid Receptors Nociceptors in the Orofacial Region (Skin/Mucosa) Na+ Channel Nadolol Definition Definition Na+ Channel is a voltage-dependent permeation path- Nadolol is a beta-blocker. way for sodium ions. Migraine, Preventive Therapy Trafficking and Localization of Ion Channels Naloxone Na+K+Cl– Cotransporter Definition Definition Naloxone is an antagonist at the mu opioid receptor A transporter protein that mediates the transport of Na+, with a short duration of action (30–45 minutes). It can K+ and Cl– into cells encoded by the gene slc12a2. be administered for rapid reversal of opioid-induced GABA and Glycine in Spinal Nociceptive Processing sedation or respiratory depression, but its administra- tion will also reverse opioid-induced analgesia and may precipitate withdrawal symptoms. Alternative Medicine in Neuropathic Pain NAcc Cancer Pain Management, Opioid Side Effects, Un- common Side Effects Nociceptive Processing in the Nucleus Accumbens, Neurophysiology and Behavioral Studies Narcolepsy nAChr Definition Narcolepsy is a condition marked by an uncontrollable desire for sleep, or by sudden attacks of sleep occurring Synonym at intervals. Nicotinic receptors Hypothalamus and Nociceptive Pathways 1258 Narcotic Bowel Syndrome of infants, because the infant skull is thinner than that of Narcotic Bowel Syndrome the adult so that the optical signal is cleaner and easier to detect. Cancer Pain Management, Gastrointestinal Dysfunc- Infant Pain Mechanisms tion as Opioid Side Effects Narcotics, Major Analgesics Neck Pain Oral Opioids Definition Localised neck or back pain isthe symptom of a protrud- ing disk frequently heralding a cervical or lumbosacral Natural History radiculopathy in spondyloarthritis. Non-specific neck pain is a prominent feature of polymyalgia rheumatica. Definition Muscle Pain in Systemic Inflammation (Polymyalgia Rheumatica, Giant Cell Arteritis, Rheumatoid Arthri- Natural course of a disease or a symptom. tis) Placebo Analgesia and Descending Opioid Modula- Radiculopathies tion NCCP Necrosis Synonym Definition Non-cardiac chest pain Necrosis is the localized death of living cells. Sacroiliac Joint Pain Definition NCCP is a functional chest pain of esophageal origin without manifestation of pathology. The pain is very Negative Affectivity similar to cardiac angina. Visceral Pain Model: Esophageal Pain Definition The stable disposition to experience negative affect and Near-Infrared Spectroscopy low mood (neuroticism). Hypervigilance and Attention to Pain Synonym NIRS Negative Mucosal Potential Definition This is a relatively novel technique for measuring func- Definition tional activation in infants, which is both non-invasive Electricalpotentialrecordedfromtherespiratoryepithe- and localized. In order to measure a localized hemody- lium that reflects the excitation of nociceptive nerve ter- namicresponsewithinthebraininresponsetoperipheral minals. stimulation, paired near-infrared (NIR) light emitters Nociception in Nose and Oral Mucosa and detectors (‘optodes’) are placed symmetrically on each side of the head over the somatosensory cortex dur- ing stimulation. NIR light at 4 wavelengths is conveyed through the head, and a controlling computer calculates Negative or Punishing Responses the changes in optic absorption at each wavelength and converts these into changes in oxyhemoglobin, Definition deoxyhemoglobin, and total hemoglobin using known extinction coefficients. In studies on newborn infants, Negative or punishing responses (e.g. expressions of ir- the presence and amplitude of the hemodynamic re- ritation,ignoring)representathirdcategoryofresponses sponse is used to elucidate the maturation of cortical to the expression of pain. processing of stimuli. NIRS is ideally suited to the study Spouse, Role in Chronic Pain Nerve Compression 1259 Negative Reinforcement Neonate Definition Newborn Negative reinforcement is the removal of an aversive stimulus (tangible or non-tangible) following a behav- ior, with the goal of increasing future incidents of that behavior. Neospinothalamic Tract ImpactofFamilialFactorsonChildren’sChronicPain Operant Perspective of Pain Definition Lateral and phylogenetically younger componentof the spinothalamic tract, also known as the lateral spinotha- Negative Responding lamic tract. It is comprised of the axons nociceptive- specific and wide dynamic range neurons. It projects Spouse, Role in Chronic Pain to the ventral posterolateral nucleus of the thalamus and is responsible for the discriminative aspects of pain (location, intensity, duration). Negative Sensory Phenomenon Acute Pain Mechanisms Parafascicular Nucleus, Pain Modulation Definition Somatic Pain Negative sensory phenomenon is a clinical sign that is interpreted by the patient as less than when compared to normal bodily function and experiences. Nerve Blocks by Local Anesthetic Drugs Hypoalgesia, Assessment N Hypoesthesia, Assessment Definition Nerve blocks by local anesthetic drugs stop nerve im- Nematode pulse conduction in nerve cells, inhibiting pain impulses from reaching the central nervous system (CNS). They Definition will often also make the pain-free body part numb, with weak or paralyzed muscles. Nematodeisaroundworm, anon-segmented wormphy- Cancer Pain Management, Anesthesiologic Interven- lum. tions Species Differences in Skin Nociception Epidural Steroid Injections for Chronic Back Pain Postoperative Pain, Acute Pain Management, Princi- ples Neocortical Definition Belonging to the top, approximately 2 mm thick layer Nerve Compression of the two hemispheres of the brain. Prefrontal Cortex, Effects on Pain-Related Behavior Definition Nerve compression or nerve entrapment is caused by mechanical obstruction. They usually involve mixed Neonatal Inflammation nerves so the symptoms are motor sensory. Compres- sion of pure motor nerves, which carry muscle and Visceral Pain Model, Irritable Bowel Syndrome joint afferents, may produce deep diffuse discomfort. Model Pain in the referred territory, numbness, exacerbated by movements are the main symptoms. Nerve compres- sion is more acute than (chronic) nerve entrapment. The Neonatal Pain treatment of choice is decompression, either pharma- cological (dexamethasone) or surgical. Nerve blocks Visceral Pain Model, Irritable Bowel Syndrome are also useful. Model Cancer Pain 1260 Nerve Conduction Nerve Conduction Nerve Growth Factor Overexpressing Mice as Models of Inflammatory Pain Definition DEREK C. MOLLIVER,KATHRYN M. ALBERS Nerve conduction is a clinical test of named peripheral Department of Medicine, University of Pittsburgh nerves, in which all axons are stimulated to threshold, School of Medicine, Pittsburgh, PA, USA and the responses of the largest cohort of myelinated ax- [email protected] ons are measured. Electrodiagnosis and EMG Synonyms Hereditary Neuropathies Transgenic Mice; NGF-OE mice Definitions Nerve Growth Factor NGF and Inflammatory Pain In peripheral tissues, the level of nerve growth factor (NGF) expression is often elevated following inflam- Synonym mation or injury (Heumann et al. 1987; Weskamp and NGF Otten 1987). Studies using rodents have shown that injection of NGF causes behavioral thermal and me- Definition chanical hyperalgesia (Lewin et al. 1993; Lewin et al. 1994). Increased NGF expression is also accompanied Nerve growth factor (NGF) belongs to a family of by elevation of other inflammatory mediators such as polypeptide growth factors. It consists of alpha, beta bradykinin, prostaglandins, serotonin, ATP and protons and gamma subunits. NGF is a target-derived factor (Bennett 2001). These changes in the periphery are and is essential for survival, differentiation,and mainte- thought to collectively contribute to sensitization of nance of sympathetic and afferent neurons. In inflamed sensory afferents and central pain processing pathways. tissue, NGF biosynthesis is rapidly increased leading The link between NGF and inflammatory pain signal- to elevated concentrations of NGF in inflamed tissues. ing can be examined using a transgenic mouse model It has been shown that NGF is a mediator of inflam- (see Nerve Growth Factor Overexpressing Mice as matory hyperalgesia and also a modulator of immune Models of Inflammatory Pain) in which NGF is overex- cell function. An enhanced retrograde transport of NGF pressed in the skin, a major target of sensory afferents. to the DRG leads to an increase in the production of In these mice (NGF-OE mice), NGF is overexpressed brain-derived neurotrophic factor (BDNF) at the level in basal keratinocytes of stratified, keratinizing tissues of gene expression, mainly in trkA-expressing small- such as the skin and oral epithelium, using the human and medium-sized neurons. During embryonic and keratin K14 promoter and enhancer region to drive ex- early postnatal stages, sensory neurons are dependent pression of the mouse NGF cDNA (Albers et al. 1994). on NGF for survival. Although adult sensory neurons As described below, the increase in NGF expression do not depend on NGF for survival, the functional
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