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Somatic Sensation & Pain: Prof. Yasmeiny Yazir Dr. Nuraiza Meutia

This document discusses somatic sensation and pain. It describes the organization of the somatosensory system including receptors, pathways, and processing at the receptor, circuit, and perceptual levels. It then focuses on pain, defining it and describing the different types. The receptors, pathways, and characteristics of fast and slow pain are outlined. Finally, it discusses pain suppression systems in the brain and spinal cord.

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Adi Trisno
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160 views

Somatic Sensation & Pain: Prof. Yasmeiny Yazir Dr. Nuraiza Meutia

This document discusses somatic sensation and pain. It describes the organization of the somatosensory system including receptors, pathways, and processing at the receptor, circuit, and perceptual levels. It then focuses on pain, defining it and describing the different types. The receptors, pathways, and characteristics of fast and slow pain are outlined. Finally, it discusses pain suppression systems in the brain and spinal cord.

Uploaded by

Adi Trisno
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© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Somatic sensation & Pain

Prof. Yasmeiny Yazir dr. Nuraiza Meutia Dept. Fisiologi FK USU

From Sensation to Perception


Survival depends upon sensation and perception Sensation is the awareness of changes in the internal and external environment Perception is the conscious interpretation of those stimuli

Organization of the Somatosensory System


Input

comes from exteroceptors, proprioceptors, and interoceptors The three main levels of neural integration in the somatosensory system are:
Receptor level the sensor receptors Circuit level ascending pathways Perceptual level neuronal circuits in the cerebral cortex

Pathway for somatic sensation

Processing at the Receptor Level


The receptor must have specificity for the stimulus energy The receptors receptive field must be stimulated Stimulus energy must be converted into a graded potential A generator potential in the associated sensory neuron must reach threshold

Simple Receptors: Unencapsulated

Table 13.1.1

Simple Receptors: Encapsulated

Table 13.1.2

Simple Receptors: Encapsulated

Table 13.1.3

Simple Receptors: Encapsulated

Table 13.1.4

Processing at the Circuit Level


Chains of three neurons (first-, second-, and thirdorder) conduct sensory impulses upward to the brain First-order neurons soma reside in dorsal root or cranial ganglia, and conduct impulses from the skin to the spinal cord or brain stem

Second-order neurons soma reside in the dorsal horn of the spinal cord or medullary nuclei and transmit impulses to the thalamus or cerebellum Third-order neurons located in the thalamus and conduct impulses to the somatosensory cortex of the cerebrum

Processing at the Perceptual Level

The thalamus projects fibers to:

The somatosensory cortex Sensory association areas

First one modality is sent, then those considering more than one The result is an internal, conscious image of the stimulus

PAIN
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. (Pain, Suppl 3, 1986) Function : warning that something is wrong Cause : Physiologic / acute pain Pathologic : 1. inflammatory pain 2. neuropathic pain

Neuropathic pain arises from disordered, ectopic nerve signals. It is burning or shocklike pain. Classic cases are post-stroke pain and tumor invasion of the brachial plexus.

Receptors & Pathway

Receptors : naked nerve endings Categories of pain receptors :


1. 2. 3.

Mechanical nociceptors (cutting, crushing, pinching) Thermal nociceptors (temp.extremes) Polymodal nociceptors (irritating chemicals)

Fibers :
1. 2.

Myelinated A (2-5 m) Unmyelinated C (0.4-1.2 m)

Pathway
Pain receptors transmit stimuli through sensory nerves into the dorsal horn. These impulses synapse in the dorsal horn, cross the cord, and ascend by either the neospinothalamic tract (fast pain) or the paleospinothalamic tract (slow/dull pain).

The

neospinothalamic tract ascends to the thalamus (pain sensation) and proceeds further to the cortex (precision and discrimination).
paleospinothalamic tract ascends and branches into the brain stem (pons and medulla) and limbic system.

The

Function of the Reticular Formation, Thalamus, and Cerebral Cortex in the Appreciation of Pain

Pain impulses entering the brain stem reticular formation, the thalamus, and other lower brain centers cause conscious perception of pain. This does not mean that the cerebral cortex has nothing to do with normal pain appreciation; However, it is believed that the cortex plays an especially important role in interpreting pain quality, even though pain perception might be principally the function of lower centers.

Characteristic of Pain
Fast Pain Occurs on stimulation of mechanical & thermal nociceptors
Carried by myelinated A-delta fibers Produces sharp, prickling sensation Easily localized Occurs first

Slow Pain Occurs on stimulation of polymodal nociceptors


Carried by unmyelinated C fibers Produces dull, aching, burning sensation Poorly localized Occurs second; persist for longer time; more unpleasant.

Deep Pain
The deep structures is relative deficiency of A fibers. Poorly localized, nauseating, and frequently associated with sweating & changes in blood pressure.

Muscle spasm & Rigidity

Visceral pain can initiates reflex contraction of nearby skeletal muscle. Usually in the abdominal wall rigid.

Muscle Spasm as a Cause of Pain. This pain probably results from the direct effect of muscle spasm in stimulating mechanosensitive pain receptors, or effect of muscle spasm to compress the blood vessels and cause ischemia.

Referred Pain

Pain that is present in an area removed/distant from its point of origin. The area expressing the referred pain is supplied by the same spinal segment as the actual pain site.

Pain Suppression(Analgesia) System in the Brain and Spinal Cord

Several transmitter substances are involved in the analgesia system; especially are enkephalin and serotonin. Many nerve fibers derived from the periventricular nuclei and from the periaqueductal gray area secrete enkephalin at their endings. Thus, the endings of many fibers in the raphe magnus nucleus release enkephalin . Fibers originating in this area send signals to the dorsal horns of the spinal cord to secrete serotonin at their endings.

The serotonin causes local cord neurons to secrete enkephalin as well. The enkephalin is believed to cause both presynaptic and postsynaptic inhibition of incoming type C and type Ad pain fibers where they synapse in the dorsal horns. Thus, the analgesia system can block pain

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