Physiology of Pain, Animation.
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- Опубликовано: 26 сен 2024
- (USMLE topics) Pain pathways: Spinothalamic and Spinoreticular pathway, Visceral and Referred pain.
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Basically, noxious signals send impulses to the spinal cord, which relays the information to the brain. The brain interprets the information as pain, localizes it, and sends back instructions for the body to react.
Pain sensation is mediated by pain receptors, or nociceptors, which are present in the skin, superficial tissues and virtually all organs, except for the brain. These receptors are essentially the nerve endings of so-called “first-order neurons” in the pain pathway. The axons of these neurons can be myelinated, A type, or, unmyelinated, C type. Myelinated A fibers conduct at FAST speeds and are responsible for the initial SHARP pain perceived at the time of injury. Unmyelinated C fibers conduct at SLOWER speeds and are responsible for a longer-lasting, dull, diffusing pain.
First-order neurons travel by way of spinal nerves to the spinal cord, where they synapse with second-order neurons in the dorsal horn. These second-order neurons cross over to the OTHER side of the cord, before ascending to the brain. This is how information of pain on the left side of the body is transmitted to the right side of the brain, and vice versa.
There are two major pathways that carry pain signals from the spinal cord to the brain:
- The spinothalamic tract: second-order neurons travel up within the spinothalamic tract to the thalamus where they synapse with third-order neurons; third-order neurons then project to their designated locations in the somatosensory cortex. This pathway is involved in LOCALIZATION of pain.
- The spinoreticular tract: second-order neurons ascend to the reticular formation of the brainstem, before running up to the thalamus, hypothalamus, and the cortex. This tract is responsible for the EMOTIONAL aspect of pain.
Pain signals from the face follow a DIFFERENT route to the thalamus. First-order neurons travel mainly via the trigeminal nerve to the brainstem, where they synapse with second-order neurons, which ascend to the thalamus.
Pain from the skin, muscles and joints is called SOMATIC pain, while pain from INTERNAL organs is known as VISCERAL pain. Visceral pain is often perceived at a DIFFERENT location in a phenomenon known as REFERRED pain. For example, pain from a heart attack may be felt in the left shoulder, arm or back, rather than in the chest, where the heart is located. This happens because of the CONVERGENCE of pain pathways at the spinal cord level.
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The pain of studying medicine
😂
I am speechless ( all your videos!!! ) I understood more concepts from your videos then from some of my nursing program classes. The simplicity but clear and intense method of explaining the subject is exceptional!
Wow, thank you!
Thank you Alila Medical, I now have an understanding of referred pain.
This video is golden
This video is so good. I had a class on pain management and understood close to nothing. Thank you for this video. I now understand half what that class was about
Thank you well explained
Excellent lectures.
This is brilliantly presented - a model of compact explanation. However, a couple of points for greater accuracy: as a surgeon, I can tell you that not all tissues are sensitive to cutting or burning. Skin, peritoneum and pleura and periosteum are very sensitive to this but muscle and internal organs are insensitive. Pain from these is triggered by different stimuli like distension of bowel, or falling pH in muscles. Second, referred pain is uncommon other than the heart example given. Visceral pain in general is poorly located by the sufferer - in the abdomen it's only to the hindgut (lower midline), midgut (middle midline) or foregut (upper midline). Innervation of visceral nociceptors is autonomic not somatic and perhaps radiates to different areas of the brain?
Umm...so can we reduce pain by regulating our breathing or triggering Adrenalin.
Another interesting point that must be considered: there is no such a thing as "pain receptors", thats oversimplification. Not always when you have nociceptive input you will have pain. And similarly, as in some conditions (chronic pain) you don't have any nociceptive input from the "pain receptors" , still you feel pain due to many other causes.
My pain is far greater than yours.
Marvellous exposition
very useful, thank you.
So it detect pain and goes to the brain and once brain recieve it he send it to the part where it hurt
Only nociception enters the body in the form of a noxious stimulus. When this stimulus reaches the brain (somatosensory cortex), the brain decides whether or not to create pain. An example is, an athlete, who sprains his ankle in a competitive game, may not feel pain and will want to keep running even when he has a noxious stimulus (ankle sprain), because his brain tells him to keep playing. On the other hand, there may be pain even when there is no noxious stimulus at all. A case study published in BMJ is an excellent example. A construction worker when working has a big nail through his boot but misses his skin of the foot. But, the worker feels that the nail has pierced his foot, and feels excruciating pain.
In short, we only receive nociceptive signals from our sensory organs, only the BRAIN decides whether to create pain.
@@saurab555 thanks sir
Really awesome 💯
good video good refresher in depth enough
wow what a great explain video...
Great video❤️
Nice explanation
Thank you!!!
thanks a lot for ur cls👍
I wonder if this pain pathway can be disabled on ppl with incurable, chronic pain
Yes it can. See a video called Taming the beast by Lorimer Moseley
I think its lateral spinothalamic tract# u showed anteriorST TRact#
Thank you
Very good
Very useful thanks
It blew my mind
The pathway started from the cornea😜
Thank you so much 🥰💟🥰
This doesn't completely explain pain. Explain how synapsis that are either switched on/off can ammount to a 'FEELING'?
Wooow
What did you just say?
What is the relation between synapsis and feeling ?
Very knowledgeable
I wish there was more help with answers to fibromyalgia related pain.
А на каком этапе появляется сознание?
И чем удовольствие отличается от боли?
И вообще, почему вы говорите что боль это благо, если она бывает мучительной, например в случае когда невозможно устранить её источник, либо чрезмерно сильной или чрезмерно долгой или чрезмерно резкой, чрезмерно повторяющейся. В мозге нет адекватной защиты от избытка бессмысленной боли, например у тех кто умирает от рака или их убивают пытками.
Woow great questions
@@mindVision55
Спасибо =)
so cool
قال رسول الله صلى الله عليه وسلم : "ما على الأرض رجل يقول : (لا إله إلا الله و الله أكبر و سبحان الله و الحمد لله و لا حول و لا قوة إلا بالله) ، إلا كُفِّرَت عنه ذنوبه و لو كانت أكثر من زبد البحر " . رواه الحاكم بإسناد صحيح
is there a video for descending pathway too?
They didn't explain what pain is
Why do we feel it?
Hey here is the new information ...for whom getting very pain in one side of headache - migrane ..
The best medicine curative is - eucalyptus inhaler immediately relieves within 5mins ,which useful for other pains also ..
It saves unwanted usage of antibiotics ,& all like sod valproate ,Nsaids ,other sedative drugs ..
I wish my nervous system wasn’t as advanced, I’d love to get pain in forms of emails instead of torturous tremors.
This is good but I didn’t understand visceral pain
Pain is the one who said " This world shall know pain. SHINRA TENSEI."
could you make a video about the cerebellar circuits
Kakashi Hatake you know pain 😅
1:33
Confusible
Ok , please , We need another translated vedios or speach with slower way
you can use selling to make the speech slower to be easier for you to understand, good luck
sorry I meant setting
الشرح سريع رغم أنه مترجم
Any one describe brain feel and brain sense are equal
Examination
Thank you, could you make vedios in slower speach ..... best wishes
in the bottom of the video, press on the setting icon. then press 'playback speed'. on playback speed, you can make it slower or faster. hope that helps for the future
Sooiperb
Im a girl
very thick accent
please !