Organization of nervous system : rapt 4) Ltistological . (eenree cecum! Meurones _ Glial cells ¢ Neuragh'a) Basic unit Supporting cells 6 Honthes (Oy! 19-50 bimes reurnber gradual x lgpess decrease 4 a] Aicroglial: scavenger celle Oligo dlendriles Ayelin shealy Astrocytes : mainbin KT i lel 3B Anatomical and Functiona| el CNS ve PNS OF Pr : =_—— é VP "Yligher broin Level Ganial nerves Fi bor . : Thsthyeg Rese Horning Speech. 7 ——™ a™\~ Lover Brota leve/ X75 Subcencious achiity : Cvs, 4 A Pos bere 4 ecutlibrlum Spinal cord level . Spinal nerves lonmediate 2zuloncnme ackvilies 4 1 Withdrawal reflexes 23 Bladder 5 rectum evacuahin OQ) Senscry division ae cc olor divister? RF of brain shen Thalamug Basal qangliz ® ten a = - : ~ a[Synapse| © Definition Site LI wcliet belusen é eyrertss i Ago Lerma ¢ presyeplie 3 posksynephic LETSIHIESIO! | Gey chanel path { Clechrie Rare in‘ humus ier lebrabes 2 Chemical Chemttal beresnitter Host excitable eS kowest Fhres! ” ee roll eared deol, ile of i of A: A ul oe Ys CF int Spreads fonerds 5 bechscord inkamalion Anatomy ° Fue tal eens qe ATP, yrthests, Zelie reap Smcgealeh be & Rectplas Pe Removal of ch. br, 4 Cle , Knob , Festsynap. neurone or glial celle [£PSP| TRSP Depol «— locahied pertel—s2lupenpolerizalion Maximal 4 -Seasec mse’ Duraltort Haxintdl 1-2 jason Ions basis ve Ca* Opvergin Cl aply Gd KE Graded.s Summeled Zz AP Space (Spe ial Tire ¢ Ternporaly sr 40-50 ERSP j= 7 3 8 =s “pmedbeneously@ Synaptic Potentials Cxcitatory postsynaptic polertia EPSP © Parkpal depolacigatiert e Time a5 4-5 2.5 misee © Aechanism Crone basit) Qpenin: , Ae ligand gubed channels iF G © Summazhin 40 ee A. potential” & by pes is -- --— == . Space (spatial) Tone (temporal) - itt =F a e| © Unhibibery paskeyreplie potential | IPSP @ Slight hyperpolarigatier?, ig g © Tin : e Aehanion vt g Closure (Ligand, gated charm 4, eo Summation } 5 , ae ES areousy : vn© Grand posksqraphie potential EPSP IPSR Oe Oee@) Cl) e four Fosgsbilitves: t p thove Aclion polenisls - EPSP> IPSP == Threshold 2 ~ Belaw —— Facilitabiort 3 IPSP> EPSP Aypupolanigatin 4 EPSP= IPSP ‘no change Action poten tials Posksyraptie potentials AM or nen Lt do rot obey all of rant laa! = cannot be graded = graded * AP Ol no ARP = cannot be summated = summnaled - Anaesthia blacks them not blocked by ansesthesia Propagated * nol propagated . Each lasts { msec Lasts 20 msection © Presgnaphie inhibi posksyraphit membane| x eg Pain cantrol system Bnd neurone serlenin exeita tory post syzaptic. xem braie eg Sensibigation of sezeapstf Glutamate released From Peesyraphie necrone Glubamnad) 0 ake | sage c vv ay Ms. cs On6 re lwnbea eae {| P A f ai ‘al 1a Beal fa Co, GGabnodali kinase L. am I Again, @ cherntal signal (nay be WO) may binds to AMPA s WADA receplorson * posksynaphe membrane leading by Achivabion of AMPA recepbee —» Depol. which : remaves Ha" block: WHOA receptors chanrel eS OF enkag —> a" cabwdahve i ——> , activates GLY calmodulin kanese which, ia bom 1 phosphorylates AHPA recep teas ixtcrezsin ile Con lance ko Yt i 2 roves mare AHPA receoloas tala the Syxaphe membrane. 6, A 25s From pastsynaphe neurone bo preypephye medrone » producra ie frm nee 7 it relexse of Tlewale AMPA Adenosine MonoPhosphate Adenylate NMDA N Methyl-0 Aspartate.1 ON syuies Bins wary >yr1424n] B “‘uhgtod ssiou aoueayjuais siseg 2140) T = thiodsay andguAsssog a snjfivins , apdewAsoudr | | i 1 Yeuranal. Foal i Bebrartion -f collection of neurons | . having the sanie Auction . is arty = Imporkarce : a -timphiFica tion 7 One cotkical cell ackivales 1000 4AHCs , b Distribution of signals . AUG ——o withdrial reHloe “Cortical cell Painful signal ae (2) [Convergence] =) eS = _—— lowortance a ‘Spatial summation =§ 5 Fianlis intensificabior- spain sensation » | Selection of important infermation ®||) gl Getadie Feel a B { Faeilitzbion Gore . @) / subliminal Fringe A=4 B24 ArB=0 diseherge gonr | et , Diseharae gor (Bere =png), acibtion resale Exc ibatron Field Aak Ban ABE |{E] [ceAibilory circuits SL ® [Lakers] inhibrlion . ° S/S stim, of central neurertes ~ Single input signal : \ nhubsitiont of labeaal y _ Hechanispt Achaniygs o—_—_—— ‘eure 2 excitalory inhybiters tran ant Two chemical _bransmithers Importance Sharpness of sensations. ey Horizontal cells in the retina © [pregative Redback inhibition} Sharpentug of mob ach .- - sind Cees yf eesfibe cell Corhibiteng ‘leet Prevents averexctialings ai = = ANG © LexpescscerpcTed 2g. of Iaberal inhibition excitabion ful signal pan flexeas ” thibrbe iC tahis = - [TB] [Aébivating etccuils] (after cischarge) | - Debinibion:|S ce i inpul i @O : output Discharge aftea ~ Lecharusms : © Post bebanic atler discharge « © Parallel circuits. © Reverbrabing cicuils. ¢clased chate circuits) onask tmportant \ input Derabier-i8.debermined bf: — - ~fakique C- eh. brani) “wakefudless 4 sles = Inhibitory or Facilitates impu les - Hamber of synapses. e clsES eee Properties oF receptors Specificit Specific sensation = Mullers law Specific stimulus = Adequate stimulus Excitability eceptor potential FP or Generator petential. GP| - LAechanism oF stimulation of receptors - AP RP a Amplitude \Fexgueney Feacinian™ corpusde | 4 ‘atonaty - Properties 1 Local state of — parkia/ clepolarig ation 2 Me A or non law : 3 graded. 4 AF 5 = semmated. 6 Lenger. ist duration then thal oF A poten bial + 5— 10 mec] # ——5 repeated action poterttials. 7 5+ RP—_+» spreads prssvely + AR, Amplitude Freguene Local partial depalarty tut sade of Feanvier CNSQD Gaaplation oF receplers “pain Lou ls a | : eae siete [eet or tonic Ry SS Pe y > ‘bP stand ba | moderately = § 7 uF (>, & boa P a z 1 capi ly | { PareTaTare aE, mevenientR) bude of RP-s Frequency of A poten. ° bone on ampli with constank continuous stimulds . e Importartce of rnfermabion. @ Gus: Gach has its own property of aduplatin a Rods and cones, eae ng the conc. oF their pigments. nt b Heckiroriceptors . Wwe °F Remodeling of be recep ler sbrucclure . _ : 7 bivakion of M8 channels. 7 ‘- ‘hunol due to Fobigue; Adephabot ——-“Fabygue Rectory... Mapid + comple. Shou srreanplele, eagpania. Hol ‘aPlecled© [eding of sensory lormation| Sensery code. - [eer ~lype» y - Localié - Intensity . of sensatioor + Hadad. Secteity. ae acer Labeledbine principle eciFic pathwa J pore Specific sensation — Muller Jaw, Specific stimulus Adequate stimulus . [Locality __, Projection. Vhatever the cite oF the stimulus, the sensation is always projected bo the site of the receptor. © knsikg], Coded by change in : o! Thesnumber of receptors activaled Crecruitement) 2 The Freglency oF tmpulies ; a) Valen Pasha oe for hugher inbensities Frequency 0 Lheflog inkeresily oF lhe stiinules 1 2. 3 4 ae 4). Steverns-Power printiple APxKS 4 Gens aHl ® Touch. . ) Gude bouch ; 49 feelng of clothes hair cont Teed by a piece oF cobten paaed on he thin, (8 Fine touch: well localred - «many grodes of mnberesitres « Types, © Tactile _lecalspetion + ® Tackle _diveriviinabiess : , 7 2 ao. 3 2 i Ae Z Le A ‘preccatarcomagene reap Fld cceplors @ Teoture of materials : ® Skereognasis needs 1 All sersa tions’ ut pecially Fite bouch:: 2 Past cortical experiouce- 3 Tnlegiriby of hand muscles ® Pressure sensation Lapertamce ; — &: knobi'the werghts of obyecls. ~ . box. chiserigyhabe bélween weigher . — 40 maintain bedy pasture. 4B Weaghls..hPled-by) Lhe hand are keta muscle benim and length® Wibralion Sense ~ Ahythmic pressure sensation. ce, - Receptors pacetaran conpuscles: go0.sicke/ sec. erssner$ corpuscles : -B0 eycles/ sec. = Vibribiny: Lunin’y Fork ix put opposite “bani bon inemces g wagrity Lhe stimulas - Lmpetence:.,, some Whrabion sense. pork. column lesion, + helps bo localize lesions in the p. ed. ® Mickling and ehing, Tichlinag caused by local peated geiechenicg) shiet Liching caused by Chemite)) subslance cecrebed near the receptees 4g histamings kits, BI (Basiioriisentes| . Fropriocepbive senses. Fathuay + Dorsal column . Fonckions : Inform “( zinesthetic) position : 4 rate oP movement Sebation Receptors : - Sauly adapting : Rofhini end organs. Spreay bype ei lags. Racinian . » Rapidly aclapting « ® CNSThermal receptors : - Warm : Free n. endings C fhres- ~ Old , C fibres Free ni. endir - i ee OG. Ng della Fibres Small receplive Field “and are-uidely sipirated. Cold receptors — more numerous (4-10 Limes) __ more: supeahrore | (ander si in) . adapt darts lotuly..”* 3, Aedersbely'\ adap lizig redeptors hy. Ob EK / pt > ‘fingers >» brenh. Lechanitma of stimulation of thermal reeephes : Chemically te chdages in Lhe conc. oF metabolites - a 2 Folds chegge 1 conc of mel. “Cha ‘sf ‘her mal receplers : 1 2 Sensations Felt. and receptors chimulabed in Khe: range O- 50°C 0° Anesthestz Warm R, $215 Cold pain ” A tex | 19-43 Cold PP prt] 30-50 Warne j 45! Warm pain Tempribuire 4B Temperature sonsation depends om : 1 Ongmal skin femp> + 2 The abe of tem changes. 3 The surface of bhe shin exposed bothe temp changes ;(Patn] = Tissue damage Probeckive sensatiort (Receplors] eo Free nerve endings —<| o Types 4 | 7) Hechamical joain R. [3] Cherncal pain R - 1 2| Thermal pam R. 4 Poly m'dal pain'R. © Trensdiction of pat signals ° — Chénical medialoes — Channels ATP. Aeebyleholine Dejenerivee Gictyhinin Vartlovel LSS Acid sene . sélolornic _ Sakata ickawine = PPI 15 Ca infil e Distribati an gee - Lore. Porioskeunr 3 shin» sorts wo ackenles: eranial~sinuses | Falx. 5 entorieat cerchelli ess Deep Arssues « wheiveasponenchyrmta + Brains Lung alvert« Benes » z A delta Cc Slowely Cstabre = tonic Sty olin [pack pam 3 t Celaneous*®) © . 2 Deep. woo CNS 3 Visceral. ® 4 Neuropathic(A Cutaneous pain [Fact | Slow Immediake excube- chronic s noclous Share a poets Cay cera { Os | 2 | 4 second ext 3 Mech Aarrtal R. AU tapes of R. ie “Skin 3 coverings ~ Ad Pisses ® A delta Fibres C_ Fibres 1/6 Cnc in cerebral cotlee . nds in RF. Gbainilen’ : | eee aaleanic nue. 7 Wall [ebalived « Pearly” localised » Becta d by Ayponta apr. Blocked by cocaine Tash of pain i the same inall peopl, 45°C . Reactions to pain @ Somahe theres S Cabameodt'p @® “Auber zg Lions ° Cabaneous pain: - Mec ep-ayiwconsl pain : ® Zac reatlipnit cule in. Chiiomt pains Ragiily of He euajing et. oad flecks Hs ABP ; ng 2 ently ous Ss @ | Spinal allexos Fleior withdrawal retlex, Pussen ePbecls “AR 4 cA Gpressic7 «Seema CL Abes fa 1 of deep pain , of in whetiee When their blod “fe y a reduced « Tissue damage wir bridy kisi. issue damage. > Jello tis CA beep contin ely pain rept foes rtol- cause pa Qiftuse sbymula bin .. Seueae pain. OQObbres 1 Bu chin on. 2 Diffuse. ae] us. 3 Prien . 4 Poked herds densi ae a et aia] to nerve Pons disease or chmage . Cha a8 Pare) cee ic / buraing/ shooking /parasthesia — tH: opioid. Copter kecand “nevislgia clabdie “elBy C 3 Thzlam. 7 + verttrobasal nuclei| | C renee gptveal lemnisaus medial lemniscus ths nate cafe tet ‘Docsa) reat gang ‘Byeauny ¥ #19EA) f~ Vent. Sp. thalamic bp a Fi Fine P, Vibrato Crude touch s pressure Pain 8 Temprature eee Position eee Tichle « itch [Polym odalil Unimodality mechanoceplive i Spino thalamic (vent olateral) pathwed Dorsal column pathuey @y :—E———eES_ SC | “Majer sensory, lesions ag a no rascoperh ey ages ply neuropat te pemphoral rreury' 1S + Cloves “oad socks aethesc ' especially fa pain. © Gpinal ead. te: @® Perigheral nerve : opal Senseiy loss in be area supplied.(6) (Tebes dorealks = Cause. reuré iyphilis. - Leste: pask root central bs the gang lien - . severe pain , then, 2 dechitition loss of sensabens : Vader Fine bouch , po vibrate apropriccaphye Gr—-@ fess Ce tb He ond - Alexia Incomdalint of vol. moventedl In absente® of paralysis 4B Types of ataxia fesion. ‘1 Senso Nbacia dorsal coljmn pathued 2 Corebisllan atasiia . neocereballuat a Vestibulan abaxia . veshbulan eppratis tpabfreg 4 Llixed ataxia. 4) [Syringomyelia Cavity Pormition ¢ cervieo therzeie) :XS MS. . oN Nervous system controls egpid ackivitves eg mauscle conbare bets S 7 Endocrine system conlrols slur achivities recaiitly melebolisn RePlex are is He Functional unit of MS. . lkcensisls of receptay afferent neurmey inbegreted conlre eFberent rewrenes SPeclet cyan eg muscle or_glard. Srganiigation of MS: Al Histological organisation : biltens of colle are of 2 bypes: TH Heuwnes : basic unit of nervous Essuc Cansntt A potorbedl Haxinal number acears ak 6 monthes of ege te over 10 W eared Dead neurones are. rot place d by Neel ONES —» progreestve las of) A Glial cells (Weuraglia or supporting cells) ve matrix of MS? 10-50 Limes rember of neurones - & fypes! (@ Mécroglial cells : Scavenger cells of N5- fl Oligo dendriles : Frduce.s maintzin azepelie sheath, [1 Askrocyles + Hainkin conkent K around neurenes. Branches Form blood brave barrier. [B] Fucchimal s anatomical organigation : divided sto ff) Cental nervous system CNS 10 bain 4 sp.cord. There are Lyre mafor hevels of CNS . \ @ So.ed level controls Sinmediale aubomabe actiyrbres °g withdrawal reflexes 4 bladder reckel evacuation. Q Laver _brain level enbols subconctous ackivitres veg CVEs resp, posture. ,eguilrbriunt 5 emotional reachar Higher brain(cortical kre) conbrols Fine sexsalions y Fite movements , Hhinking , learning, mentory and speech 4 Peripheral nit, stem PNS + oid ee [ Afferent (senserd) meres ©(B) Cflerent molor nerves . Semabic XS. controls skeletal muscle, ~ Autonomic NS corthels cardiac ssrteath 10 , exocrinels endocrind gle Hale Sensory inlromabion are inntgraled ab sp.cd_, rebiculer hearate in brain shen cerebellurts thalamus and sersouy cater. Ltolar neurones supplying shelebal ts exisk in pre 1, ebieulsr Feamation in brainstem, cerebellar basal gergho ard snoleacciler : Synaptic Larisnnission © DeF. Sunclion bebreen axort terminal of presyrephe neuen and dendwrle, soma or inibjal part of axon of" postsynaptic reurme. @ funchinsot synapses: Fzctlibale 2, pehibit, amplify ce stare Mbermatiat) e gpes of sxjnaptic bratsmisstort + 2 : : leckric Lyansmuksicn El emical Gasmussior Gap unchen Clow resilerce pathy) vi release of ch. br: Vergy rare ise Janene commen O34 inverlebrabes | Lata bype rt husner Trensmils in TWO - direclens Fensnils in QE dis @ pes oF synapses shypes: (] 4e0-dendritic By somatte | S| Avoavonr'c 80 - 32. ds Less commen least. excitable Hast excitable (lwest Gresheudsmore 43" chan} Hales Some neurones mey receive up to 100.000 synephie hnobs. Aeon bernmal of presprap- neurone meq gite 100 keomina le © functional anatomy of yrapse 3 maint components : Eresynaphic berminal = sqnaplic CLerminal) Anoh + It contuns Bl Lilochendria : provide ATP For synthesis y release by exocylesis amd reuptake of Hie chemical Lraxsmite (ed, by (B) Synaptic vesicles ” conlait ch. 3 types: Q(] Small clear vesicles? contere egoiidly acking eh. br eg acely|choline 5 Glycine > Gi omate or GABA. Small _grenulor vesrcles : contarn calecholezmting 8) Longe granule vesicles: conktin slouly zelrng nrearopxpliles| [Cl Zio sxxare_p.roleins - T] v= smere (eynaplobrevity ont membrane of syraplee vesiles @) be snare csyttaxin) on pres/rtzphti mem be, Hale Vesicles discharge Lhe content ab KC, TWVE ‘ZONES, fe areas of mem. Liehaing wik laage aecnben oF volage - gaked QQ" channels [Zl Syoreplic_cleft 30-59 nm width contains extracel, Haid. Bl Lat sfnaplic znertbre ne contains 2 maor types of receatees fg] Jono brapic recepleas heoned & 1 A binding plt which unites with ch. br 2 Ligand gated N2, "LI or K* channels TB] Letabolronic recaphas : Serpentine Ge ph coupled thal +4 inbacell. IP, , DAG. 02 ~~ inbacedl. CAE Hales Qne nearone secrdles ONE lupe of a ch. banoni ter Cxctlelion on inbubsitton depends on receplog nol: on ch. bp. Glyerne and GABA aluzys produce tbe bition ta NS. l2] 7 Mechamist_of synaplre bannissiont: 4 events [l] Release of chemical 4anonilter A. polexteal reaches feminal haols of prenptap. neuree git epens volkege get GQ” channels. iar hake bs. a Heprakion of synaphe vesicles to achive Sone. b Fusion of v snare of vesicles wilh b-souzre af presynep- ea, c Open sreleare_ of ch. br into syraplie eleht ew Costr oOFo s| Vole, Amount of eb br. releaced o% amount of Ga" enkex 1 Q™ enters Y elecly -chemital gredieat. Alea release of cht y vesicle wall i: Laken 2 dy endoe lasts rel wilh chile. and cgtle peaks (Bell. 2| Union of ch. &. with ibs- specitic receplee : es it peuneehlty ‘oF pasts naplie nembrane 60 [0064 Development of postsynaphe po al. 2 bypes a less -ve "2 depal causing exciltlay puslsypre plea hale PSP b Hore ve pe Agperpol: causing iin poskign peli hie ele 4 mechan _—> chan i Removal of ch. tr trom syxz a Synaphe ce + Passive diff in exlracell at] awry Irma * b Past synap. neurone + ckfl: Lraclvotion by gpecikie ogame 0 ham kaminal of presyriyp neurone : Alive reuptake cl Remoral bef ; ghia celle | ee Types af syaptte olentrals : ask sepnapltc. enlealy Last only FEW. msecondr | qt L « focal parbral depolanigati focal pertial Ayperpolartg | «Reaches ths maximum afte, 1-150. 15-2 lasts 2-5 msec. oa | « lotic basis erunquel th and hed Na be ip ged ht C9 7 G" chan. (msinlys Ki chanels : 7 : 7) : . an OSU Vast" + Swnmabion, Texperal or Spalial| Temporal or Spabiel | To reach the Ureshold .valuz EPSP must be suronaled bys. Témmporal ( Time) sore or Spatial or Sp2ce str i tka ome Single knob i$ Fane Hert obs gre sbimule ebibirely up lo 50/msec “simillanesush uple Hho@ Grand posk- 4 FPSB = IPS 24 no change in FIP. Habe lnilection of acho pobentials at AKON HULLOCK FPP. occuring anywhere on-a nearone spreads electrotonite lf chy cinta ok i | 4 aepoleny Thus, ~ Porwarch in the axon. 2s 2 nerve impute cn. sugnal) ~ Backwards oven soma bo wij 8 Presynaplic potentials deel 4 bard. neurone tntldences LitSfaep. ent ple potentyz/ Def. 1b is HeSUtt of all LRA 5 IPSR occurin in ONE neurone ab gpproximakely He SAME tine Four possible outcomes of EPSP : 1 EPSB) IRSE and above-threshald —» debit polenty2/ 2 FPSB IPSB end belo Hreshold — Facilita biog 3 IPSB')S EPG > Mepegpolatts hier + lahibition 4 abundeare of vallege G2 44 channels) bo firing lere inutta ling ih potential Ws bevels CRB, aor hillock Cleast Ures hole fmt electrical, slinty. + ead 3 leaks minwbes. bo heurs lings fo produce eithes + 1 Pressnepke inhibition 2 Presynap ic Facilitation © viz. release of ch. bp @ Ltechenism Llechanism . . bahibsbon Excrtalory are neurone anaslomties wild anon Yeominel; | Seerba teratoma CEA, of an sxcilthany neurone — tt APP in aren beaming Mereleases irik biker ch br whic, —> Phos phergleks Pls in 5 pee Gtr cheduel eh a a Sent ~ Opens Ka fl pchan sels lene ape kh eae kimi At ol antral te ; a == a Ee ealee = (ae 2 oe : ~~ release of ch. Ep, | —_ 0 Sample ue ae ieee Paint conbral system . via ++ rélease of ch. bn Sensitigabiot of peopl: aa 10 Forwards direclion : From pe 4 pasksynaplic Heron Es 2} Synaptic deleey —: 0.5 spasec. Crused by : release of ch. br » tts union with rectplar, change iin tonic condaclene ssummgtion bo threshold value, number of synapses = Lentel dhey : Bow discharge of ‘pasksyfrap eure wjth npelitivestin. Guse 4 Mainly exhaustion of ch.be isn presnaptic Leaning 2 Inackivalion of paskrspraplre seceploes . Impotence Prevents overexcitalion in CNS. |. stops convulsion 1 epileptic LE. (AL Syxepha plasticitel : Def Ability to change modulate) synephe Lansmission accading & demand om basis af pask experience. be Shenglened on Wesher f Shaken a prleaged 1k is eencerned with higher Funchiots of CC Leg meen sheen Forms of z le, yptaphie plasbict + Sheek or Long lm. | A) Short berm tiie () Shek Lerm inhibition Chabitvation) + Gredual loss of response hoa benign stimulus ; : When repeated sevecal Limes at inbervals £7 701585 » onic basis . tnbrcell_ Gl, . release of ch. br Ih is caused by inaclivabion of Gthannels. [@ Shak berm frcildien Ofsk tebznie_potentiatin TP) Posksynaplic neurone contiquer bo dicchenge Fees sec. caminule after. slappage of bref. Lebenig ing, ‘mputbes sa press Hearone| [ere basts_ 44 an pres neue due bo weak G PeeSignit jeancc base oF iwtrmedizle meniory - @® Seasitigation. .. : a Lroleaged augmented report 4 7 sagivened maene of prskyreple neurne exused {by 2 noxigus shimuls accormpening a benign one bo whith Le subject has become haprtualed- lonic bases : Presynaphe Facilitatin (discuss). SigaeiFicamee : ae of- shat beam memory» w — erm plasticily : of [q] Long berm potentiation LTP) : Rapidly develpping ponstsling rele plone of, pulp. polentel response her repealed clin. off espraphe neurone - It occurs specifically ix the hippocampus, lonie basis: GLUTAMATE released hrm preyrgpte eure binds fo APA, NIDA raceplas on paslsynp. monbrnt heeded 4 Aebivalion oF AHPA receptors > TDpalarigation which > "removes g'Hocks en WHOA receplets channth_» GPenkay _ pen of Ca calmadalit —» zchieles Ca- calmed. kinase] which, in kerr, {@) phosphorglele AMPA pecepleas increasin i Bene 4 ie Ther mat» 4 syne. i Again, a chemical stgnel Cay be NO) may pass fare posts neurone bo presyropee neurone producing ling bert merease in release of P olubamake . [2] berm _clepression eee : Pralnged depression oF pasksynaphi: neurone erent shin. OF presyap- neurone. » Ht is opposite to LIP tonic basis Depa. dl ie re. neurone bo less Han 20M ive less Han He threshold value at which NDA reegh, mi and permit (a influx ——? contiracous elasurg of NADAhe beansmuising t . Tl Changes in compasttin—aF-1nbernal. enuironnent (CH + BY pH of blood and CSF : 1 Akalasis Bexcitabilily pit #8 > convulsion, | £9 Aypenvent. it pt with “epilepsy my precipitale 2 he. 1 2 Aerdesis E> excite billy 2, coma. og Drabelic coma « lb] Z2POxi2 : i Interruption of cerebral circublien I-5.SCC.» uncorscieusn ess 2 Prolonged brain tschemia og Urembosis 5 brain danege. c} AV glycemia: suhibrts syreplic bansmissiag « ZEPO caleemiz; —& synaplic bensmisiin deteny : By [2] Drags, a Thesphylline Leabromine , and cablemne : Fecit tebe synaphe Lransmission by dypl. poss . Nedrone. b Skrychnine ~ Compoles il iy ch. be al paslgpe-recepk leading to convulsions y uscle sparnt and deal. : Analgestis Anaesthelies s hepnabis steabilige cell mem. — ly erpolar and —— sfnlhent-s releae of oh. br (31 Diseases thal interfere with spnaphe bensmision, . a Tetanus toxin _— release of GH at prey inhibileag Fibres —, spastic paralysis ( oe Yen a Failure b Botulism toxin __ release of Aedlglehaling a WH yunclion —» Flaceid paralysis . Very small dose & used clivcally in Ht of mm spam condtbey Chemical bransmitbers (ch. 2) Ch by ly db bubed in NS. Aes CE OT Ne yee nee in shee BhOl Ir can ke spared bot Uilaad wnat oF AS { can produce effecls wher applied chieetly fo nerve cell, i= 15 secceled fin syraphe okt’, ECF on into blood» i = (Lisgendjcan shinulale ma sublypes of rece bores —» riliple clit Recepleas are located esually tr parbyneptre structures -| Some receptors 2re ymeplie, C2ulorece 1) asually tnhybibe - Recepleas art grouped accading lo Lheir sruckive s kenclet xs large families bul mer bred m Mei sensibir te] Lo ceatain drugs eg chehieagic acrenegre recepledy< — Hany receplers are 504 une we act 112 6 plas pla kinesa Other receptors are ton channels» = Pralenged — 4 Heir dyend_, gesensibigalion (repr ; Chemisty oP neuro brinsmifben > 50 ch. & 2re proved by ext In general, Yere we ® qrow oS of synaplic Lonmin = Small aolecules rapidly zehng ch. Large moletks shouily aching ch bp ~ Beck: aeule responses (Bl: peolaged eckons x Wo raph ty bansmis bed signals. Lynypsesy genes 2 ton channel. ~ Vesicles Famed in presyraphe Vescicles Framed in sone Hen Leeminds and reegeled « brnspeited by beaminal knobs a _ beclude:@B) categories + Inch different pelypenbides: + Atelylcholine. + Hypoth releting pide eg Thee Cah + Amines: Nevspiveph 1, chpamry,| Pibuclary Pophite eg ADU,TSH, CH, lenin 3 histamine. \. Opraid pooty : donna imme | Cpr apthies deh * Grcibabeey: Gllomale + GIT peplice 09 Asi IB gael Agparkle » her ppplides 0g cubsbane P, ANA Inbar GABA igibhnsie 1 Vip % BK Glycine @Yeureriel “pool 7 | E>, = Def: A callection oF neurmns having the same funebrcas in CNS eg cortical’ or cerebellar neurmal pool All pools share corlzin similaribies of argenigation which include : Divergence ONE. neuron stimulotes MANY neurons. [A Goavergence MANY neurons stimulate ONE neuron. [3] Excitation field , discharge gone s.subliminal Fringe . Functions « Amplification eg ont pyrmidal cell ir cortex, sbiaulaes hundreds of AHCs in sped viz inlernedranes b Distribution of signal eg a paint sigrtal stimuleles AUG > withdrawal reflex 4 stim. cells in bran stems cetler—s painsenial. Funckios a Intensification of a stimulus via spacial summation. eg conveagena aleg ascending sensord pathutay- b Callection of infrrnation caning From different sources bo pass important one and neglect Lhe eninpealant Excitetion Field Heurmes excited by one abberent neurme. Discherg gones Fcilibaled gue subliminal Fringe) Neurenes lie in the centre Nearanes lie in the peesphe receive: large rurther of knobs \ 5 receive Fey number of knobs. Ceitabio maches Urehod.s docherge | Only Fucilbebed . Hake The shronger the stimulus the wider the discharge s Gone This arrangement leads te development of tuo phenomtenz. Faciibabion Occlusion Simulbaneous shin. of bio aMerent neurons, ~ not else bo each obher ~ clase to each otter ~ by submaximal sbimali — by maximal shinall Discherge will be fare than Discharge will be Less tart art of outtome of balk if exch is shin. separe Due bo oveilgs ive Facitibalion gots e Waveaep it : —=—=as_refe] | (abubiiay errewds | ay labera) inhibibioe One encitalry input shin. cenbal neurons | and ithibike peripheral neurons Chringe gone) m2 sthibibeay valeonenms i Functions: Shappening of sensation, eng hanged cells in tba i T~ pthibit periphera! bypoler cells 0 sharpen Ge vision. i Or anbjcofugal Fibres desend From CC bo inhibit undesivd senshi Dave feedbeck inhibin Shimulaled mola neune gies off ! recurrent collabera/ that syrtapses with inbibileay inberteurme Renshaw cell) which tnhibils Phe mote neurm ibselEs ils searrauading meurones . Atelylcholine ts ctcovered in OMS. al: Renshaw coll Funclrons 1 Sharpening of molor achin. 2 Dempens Be activity of motor nearae. 3 Prevents avenexcitahon- Gl Reciprocal simervation One sigetal stimulibes one muscle and inhibits ibs antegonst via inhibrleny inbeancaryre Funchin It allows éonbacled vues canny its Furchen withoul\ being opposed ‘by ih anslegonils eg Hexor withdraual reflex. B] Aetivating circuits Calter discharge) Def Oulput neurme continue to discherge aller shppage of stim. oF vip Ibis ceured by 1 of 3 arrangements 1 Systaplic_afler discharge te postbelame pobentiaticn. . 2 Parallel circuits inpul us connected bo oedput by parellel yy each circuit contain different number of inkaneurmess.so different noouber of syrea| 3 Reverberatory C aseillztary = clased curcuils . Out pul neurone sends collateral bo restinudate ibself Ce-ve Feed hack)» prolonged discharge its raion is debeemined, a Fabigue of synapses b Heber of spprepses in cireui= : —@ eres circuit 1s the bases of waheFulzess and sleep | c facilitalee | | and other benically dichergiag centres eg resplrelrry centres Sénsary syslem and sensory rece b icanties sensabions froma recopla bo eatex via 4 order neunntes Every sensation is accompanied by pleasent causphertnt Feel called tect. Recenleas are specialiged. shradure or modibed nerve entdirgs at petipheral lerrnination of blerents. | Functions of receplas: . 1 Detecteas : Deleck adeguek shinul se changes nernal enna men 2 Trensdacers: Tronshan’ shinulus encagy ttlo 2ction ipalentiofe. Clessiftezhion : Llecharareceplaas debecl mechenical delaomb 170 recepbesssun eg luchs pressure receplas 9 barereceplas, Lives a restibuler reteplos Cequilibritm) and Prapriscepls (x hyements aod d roinks( position 1) movementsrake af mov. yshelchs, Aexsion) Thermoreceptas — debeck arma Foon of energy eg cold ‘and. warm receptas Chema rece detect chemical chenges , eng baste 5 srnell, recep y peapherel. (scertral chemoreceptarr, oss and { glucorecepleas it bypebldarnar J 4 Pain pecepleas Cnael leas) ve free n endings respond la L, 5 Cleebro mazgnebe soealar deleck ipl Ceol and cones and detect elrelric damage oF bysues- Skructure and characlees of etkaneous receptors | 7) Free nerve endings present anywhere in th. There axe different Eypes fot pain lemp. » crude louch - bickle and ileh, sensalionWES 4. 4 [2] Hain follicles Chair end eogan) si hzirg shit Detect movement of abect on body surFrce. WI frespsulzbed nerve endings : Rapidly adapting receplat OLetssners enpuscles —@ecciinizoe ecapuseles Graal rpidy adgt) Nor hairy shin eg Nps ager pr +} Subeut.s deep t and yoink expouler Fine touch sensabion . Fine Pret popriospai: They hae smlreaphie frel.| Vide recosbive Fel Respond la loud frequency 80 High frequency tevibration Sone, FL panded nerve enditgs Slowly adzpting receploas @ Llerkels discs 2) Rublinit end organs Punctuste reeephie Field. Wide rept Geld . sternly it lips s Fagor byps,| Deep b and point capsules « ligaments, bebe continuous Jauehs pr: Ded shin heh. 4 @) Spray type endigs in pails skendons 5 resencble Golgi Lenden organ. Fropeaties of receploas 1) Specificity : = Haller’ Ine Ea shin. receplen gives rise bo one Spectlic Lape oF seasabuyt . irrspective of the method of shiqulbient. ” . Adequate stimulus Each reespler is most senatbive be one hagpe oF. shimehds Other frams of encupy can stinulabe Ae reepia, bit it need shroger 35° Gecitabilty te Receplen = Generiba polenta! [Par GP IF a: reeepber is. adegualely shivudlabed s th Flowing: occu - recepln generates local parka] depol. called re t 3 folds increase in Frequent Thés 1s krwun as EES 9 chen of receptoes 7 The taut ts domiled enly hither ‘alersitier of vibes aed bry she i B) Skeven power peep PR Crontin hlly = KSA Sc shimules ‘ulensily) K (Comctanty A is jase exeponerd: specific fa each sensor sratlilg : Paver lou is applied bo yug wide range of senszkins The intense of sencaliont varies as S tinercitey & +p a conlsin poum 4) Relibicn vs brnear ka skismud} rated Lo oposite 2.5 while ik shows 5 greed ’ obeys at by pl. SCAD I) s dik change af high tae+ ima Kocalily — depends 7 haw af PROJECTION « Lack pack of. body. hes seperale repriserttalin greg in. cerebya|, coy, When 2n impube reaches Lhe es ell. Care, @ sensation A prorected & the nciplen area event tf itis absenk 25 2 phartert bial, Sensahuns are either » Special senses , by General Samabé ody) somsalimas 2) Gegent as Gust hengersseehel, ) Smolumal 2 fear, sadness 3.10 ont. lassibjcation of somabic sensations + Analenpials Qkleroegplive serabins From body sualice eg bouch.. @ lukeocepbive sensations a@ Veycera|. b Deep . @ Fropriceplive senszbins ue Prsition sense + pressure strue , equilibriam ‘2 muck sense and lendet serie, Physiological 1@© Lechenoceptie sonsa byorts @ bachle _ touch. : crude touch, Fine bouch 3 bextrire of materials = Skertognasis ~ pressure. vibration sense. - ths bekling. b position senses. slide — kinehe . @ Theemorecepbive sensations a cold A warm. - @ Fawn sensahin » cutaneous, deep a visceral 8 headache. Classification and characters of somatic sensory nerves : ® Aecading bo Heir diameber: 1,11, Ml and IV. ®@ According bo their yelocily of comluction : Au, ws & and C. Gach bype oF sSensebion according bo its imponleree, has ils own fibyess ~ Fropriccephive sensation & eanitd on Fisted: hires Aye, - Slow pain ~ és canted on slowest fibyes C. | ©[ [Fiber [No. [Diameter | Velocity (| Modality al Aa T 12-20 [80-120 m/ second . Proprioception myelinat. Ay |W | 6-12 | 35-75 mV second » Fine touch- Steriognosis- Myelinat. pressure- vibratioit As {il [1-6 |5-30m/second + Fast pain- temperature- Myelinat nude touch Crea antenna ‘Slow pain- temp- tickle- Unmylinat | 0.5-2 mv second « itch Somabic sensery pathwads : 2 magor prthuta iS: Dorsal column [Spizothalami Cvenlralalhy back . 7 y Shows unimodality . Shouts poly modality . fe all meckanocoplive sensatims | ~ Lateral spincthalrn br canties ~ Fine Louch and presurt. Pan’ 5 bemp- - Vibration. Gbeatognost. |. Ventral spincthaleruc & canciay ~ Posttion. Gutle bouch s Tickle and beh) Fibres: large myclinaled Ay addy |Fibves A delle red myelinated 8 C [ 1st order neurone onal rook genglon Ahaons vie medal pation via Labeal poaksen oF deasal root ascendsvi2 Gracie 3 Coteabe brs | thert ascends ot deonds Peat seg ates of jpsilateral dorsal column. 2nd cider neurone and order neurone Graciles Goneale nucler'n meddl Paskerva horn cells in peed hiats cross ba oppasite sides arrend;| Axons cross Lo gposile sitle 5 ascends in medral lernndeus tt kaksvett: sornothalamic beg 3rd oder neurone Ventrobasal nuclei oF the THYMUS Arms ascend i past: inh of the iviternal! capsule & reach is cenke: somaht sexy cortex NB Axons of past. han neurones canaying proprioceptive mpulks — seend iit p a ako ve spinocerthellr i 4 he cron +Sike occupies Brodmanrtt area 1, 2,3,5, # znd 40+ I parietal cortex sin behind central sulcus. Divided into 3 main areas : [A] Somatic sersory 2rea 1 (SSL) = Samasthelic cockx Site Past certral gyrus area 1, 2,3 Speljal orientation Body 1s nprseriled apsitle dowst wie Ferg Area 0 number of receplets te lagge aree hea Eutmbes ips. Funclons receives Following serrations trom oppasite sitle : 1 Fine louch: chile lecalsabin, lalile diveriaiae s kxbur ofa 2 Skeatograsis. 3 Vibration. 4 Discrimination of werghts (Fine pressurt) « 5 Duseriminatim of various gredes of Femperabure. 5 Sense of position and movenents of pointe « # Aaocaligation of fast Prins B] Samatic senwny areal (SSI) + Site Area yo behind and below (651) - Spalral orientation not as delatled o2 as complle 2s S51 Face anteriorly yams centrally and kegs pastenialy 7 Receive senscy scgnals from both sides of body + A : Funchion Begins fo give rteenings Fer sentry gral « (cl Somzlic_associatign areq : Site: Artes 5, of CC Behind lower part af SST. Gunections : It receives signal from: 1 Sls SSI. 2 Venbobacd webiaf Halemus « 3 her arc2s of thalamus 4 Virsa! cele 5 ube coatey. Functions Combines inbormation From multyple porns ‘Lo understand meaning of senscy als. @® |fd Tgpes of samc sensations ; Llechanoceptive sensakions Al Techile ‘sensations + Touch : @ Gude touch — Pooely localised! Kaus 1 grades af intbert Feeling of clobhes.s hair comb Tesled [by a piece oF | colle. Receplees : Free nerve endings + hair end cagan - Afferent: 4 della. Pathway: Ventral spinothalamic. ® Fine touch Well! lcalised Hany grades oF interad ®@ Tackle localigation Ability localize the point a Louch with bolk exes clased. © Lachle_discriminalnn = 2 polls discrimination. Ability bo feel 2 pomnks touched. streultarreously 252 Separate poitls with both eyes clased provided He diitance between 2 porrds tt above Larecholf Threshold at-Fg ches alps 2mnt al back 15-20m, Tackle lealsabons dicromanahon ws me accurate 1 the more He number of recepbets - 2 the smaller the receplin Bild Fy re ore allerenth| 3 Lhe Jesy He cenbral convergence oF afferent . 4 Phe greater the area of cortical represen tahiern . Mike 2 points dacebninalion ts mast accurate mn bres cenbale. | @ Texture af materi] billy Wh lage eg sill, cawool eben with bath eyes clased. Recwhns + Heisners s Herkeb- Abert : A bela. Pathway + Dorsal colamns ©Fine loucl and inte rly oF fand muscla Alferent + A beta Canede bacl): Receplas : Pacciman ecppuscles and pty lype - Altered : A aa | a Pe Palhuray : Dorsal colonn - Vibration sense 15 chthonic “hve preste sentir. Vibrating houng fork & put oppose bady prominencer b megnily Lhe stimulus» Receplas : Faccinien Sdoeyde/ite. Meitsner 80 exeles/sec- Ab event : A bela- Pathwag + Dorsal coluxtr- a oh past colenn 2g DIT, pemetous anemit(.vil G2) - Ib used ako bo localte site aF lesen of. Pp ad: Mehing cowed {by chemical secreled Lapa eg Aalamine, kinin and, | proteolytic COTY IES « Receplers : bree nerve endings. Alferent . C Abres dient from pain bres. Palhutty : Ventral spiro-lhalanttc Pasilion sensation ausareness oF pasitiot oF different parks of bedy te space and it relation to each obher Slereognosts Ability to recoynise 4 Faniliar abpecls pe vn lend with both eges claed-. If depends on all sentstbienes epee) Pathuy': Oeasal column C Bl Press sensabin allows weight dicaimnatin mith ened agpetl Signiizaree ~~ vibrilton sense 13 1 eaaly shyn of degeetet cal Tickling and ibching : Tickling local ropes cd mechanical shint. e.g movin wnecks. - @0) It depence on degree of zngulalton of penks Mo reeked :——~ew_eaeaeo Receptas + Slouly zdepling Rublni end argins.s spray bype endh a Rapidly degli Facciniin ct eee 4 Sile Joint capsules yb armnd roth + hyzments. Zlferent: A bela . Pathway + Doral column: Funchins Infewt CNS about : 1 Shake position senselion te paniten of different park of badly iin par s in‘relabicot bo each. other. 2 Kinehe (unethehc) sensalon re rate of moyement. Ereceptors + Warm: free n.endings attached bo C Filres. Cold : Free n. endige attached lo CsAdla y+ Characters of bherral recepler 1 located under the shirt srespard bo temp of subeul. £ Croat enviin 2 have small receptive Fields eae ~y fe witle area oF shin has bo be eepased 6 allout spoliel surcaration fo acer 3 Distribulion : more in dps > Fnges > brunh. 4 Gold recepbeer are 4-10 birmes more numerous Ohare ware recepleas. 5 Gold 4 adapt shes Hart warn reeyples Choth are onodeclely acop) Detection of Bermal sensabiog > 4 lypes of Hermal reegptas 1 Qld pain receplets stim. from §-15'C maximum at 5C . 2 Cold recephaas stimulsbed fran 10-480 maximunt al 25°C - 3 Warm recepbas stimulated From 30-500 maximum aC 4 Varn pain receptor start bo be shina] ab 454. , At sero 'C; no receplas ducharge ond a shale of znesthaste occu} Confak-cn eatraly yagone ie no femp. awareness exits arowtd 26. : it Lransiently with in Lemp Ah aap tll REIDLlechanism of shin. ot therytal receptors : Ther morecep teas are shin. chenacally teby chenge wt cone. of metaboliies| tn recyla. eg each 10°C changes meleballes cme. 2 Folds » emperature sensation pencetved depends on : 1 Original shin temp. Lg it higher, He person Ack cold. a ale of lonp. lenge 3 “tee oF shot expased bo bap Pain signal TISSUE DAMAGE. Pain isa probeckive sensalirt —+ rtachens to move pzin shomulis or seek medial adrte. Pain receptors Cnoctceplers) : © Free nerve endings altached bo A delltz 5 C fibres. ] Zechanical prin Rs shim by mechanical shady eg eaten bruer (2) Thermal | Pan reeeplets 1 shim. by extremes of | demp- O>45))- A Cherutal PP? + Stina. by chemical elements (6.9 Gaskné Hel [A Polyzodal pair reesplas : respord bo all types of stonuly’, © = Destribulion + + Hore in shiny pericsteum joints, arteria/ wallsy Falxs texleaiam of cranial cavibyy , wall oF cranial sinuses. - hess it other deeper hisuer. + hsenl sin liver paremchyne y hang alveoli, brain bare s bent, © adaptation Slowely or nenedaplive recephaas . eLensduckion oF pain signal : a ? Shim. of nacicepkas opens specific bransclucten channel: on receplas [2 Degenerin channels 5 opened 4 tryuctous mechanical wean [A Vanitlord channels 29 sna ere heat: CD45C) and Capsaicin Ca substance present txt hat: chilly thal ceeses, pit al Aull cones chanrels : gpened chesmrial stimu, ‘| cto Opening oF these channels cause N2"6 inflow» depol- G2) fo Se tesp» ehivation of pain afferent: ester —» release of alr A delta releases glubamzle 5 C Fibres relewe substance F| Chemical mediates of pain : Damaged bisues a currountling blood vessels release histamine, serobenin, K*, acebylehohine, ATF and keukatrienes from cell: nla ECF . Faint sensalim Types of prin sensation, : 1 Aocading fo site Forngit of pata: Cubzneous patty deep pai, visceral parn & neuropathic prt 2 Aecading fo quality of pain; cutenegus pain is of 2 Leper| Fast (immedizle, acute, shop aprithing| Slow heenicy Suanting, aching a Lhrobbing) Fell within 0-1 second » Fell ofter d lshet duration, Leng Dae ae Carried 4 della releasing glitamse . \ Carried by C Fibres releaning substorce Varese in Neopia flomit br 2 Transmitted in Pols spita alerts les Fibres end ia sonsary conten . | Fibres end 1x RE nortspeitié alone | eS «| cle hen pet Wale ceil Well localited pe) = : aanly localire Prodaced by « hil Rs. | Frduced by abe of pa recgpleg Occurs wswably in shi Occurs 1 shiny deep shoclures alo pleat, periteneumspenvardium | and yurcert. 4 synovial membrane. — Blocked by preguse 5.0, lack. Bhched by heal anes tent (cocaire). Pathway of pain sensation 2 separate pathways 1) Neospinothalarnic tract pathway for fast pain Ast order neuron: posterior root ganglia Dendrites: A delta fibers (that release glutamate to the spinal cord) Axons: Lateral division of dense root then, Lissaur’s tract; which ascends .et” desci @ Feu segments » 2nd order neuron: cells of dorsal horns in lamina1 (lamina marginalis) & V ‘Axons: cross in front of the central canal to from Lateral spino- thalamic tract, 3rd ortler neuron: Ventro-6as2/ thalamic nuclei. Axons: end in somatic sengery cortex. 2) Paleo spino- thalamic tract pathway for slow chronic pain Io Ist order neuron: The same as before except 2 —k Dendrites: C fibers (that releas substance P to the spinal cord) and few A delta .“Gnd order neurdn? Subsianiia pelatings a cells in layers it @iit ~~~ “~~ ” Axons: cross and ascend in lateral spino- thalamic tract. Termination: + 2) 9/10 of fibers i.e, C fibers, terminate in reticular formation of brain stem (). These fibers end in non- specific thalamus nuclei, Fibers then project to activate the whole cortex b) 1/10 of fibers i.e. A delta fibers, Pass to the thalamus then to the cortex . The pain pathway gives tributaries to: 1 AHC in the spinal coed for accompanying motor reflexes 2. RF for cortical activation i.e, arousal reaction 3- Hypothalamus for accompanying autonomic reactions 4- Limbic system (cingulate gyrus) for emotional reactions Perception of pain:- ~ Fast pain is perceived in thalamus and cortex. ~_ Slow pain is appreciated mainly in thalamus. Functions of the cortex in pain appreciation:- 1- Localization of pain. 2+ Discrimination of type of pain: sharp, throbbiiegy dull aching ,sp2smroché eke 3+ Modulation of pain by emotional aiid behavioral factors. Acousal reaction bo pain ts caused by projeckin oF intelemnal Cronspecthis) rtuclei oF thalamitss RF of brain shen hough ous be Lran This ts why seviae pain prevents sleep. Threshold oF pain, 45°C is the same in all people - Reaction bo _pain:dilfers from one peesca to another, Llotor refleses a Fask pain + withdrawal reflex. b Slow prin: tuscle (paring rigtel abore ixtPlammed ayn, Atolor reflexes are spinal reFleses. 2 Autonomic rating : a Acute pai: ++ HR 5 +4 ABP ; b Dronit visceral) pata — HR. ABP, nawey, vont ang scueabig [3] Emo himal + a Aube prt: Cying 4 zrexitle] b Cheome pat Depression Types oF pain sensation : I a Cutaneous prin : 2 spe refer bo table Pege 3 Unkke otter Lypes of Paity tt well located due to : @|@ High dennky of porn receplets in skin. 4 Fast pain (4 delle) Fibres reach sersery carter. ¢ Tach svition help localigztion. [8 Deco pain emduced alag C_hibres. Produced fron muscles, tenders, ig ements, yoirel a peniisteon Causes Inflamnation , Ischemie or. muscle pun. Ischemit_pzin : : - Guse + _. blood! Float bo a tisue due bo bhyornbasts, snblaranzl! oF vecsel wall—p remouing ot p.onvesels e.g bamnour Lechanism : accunuldlion of tachi acil or release of, C pratedly be ensgymes from ischemic litrue. Ut zagrevated by +p melobalirah eg sell 4 a= by ret. Gczmples : Ischemiz of candite musk + Angina pector. tchemia oF skeletal muscle: Iatermllent claudtation. (F Visceral paint . Due Z Feu pain receptets tn viscera, & shape cut in nicera desi cause pain while dibtiae stim. -ceuses severe burning pair. — Dual pathway of visceral pain ; = Visceral pain is conducted along C_ Fibres (preel locelted). « Perittal pain fram pleway pouleneun s peattancliant a conducked a lag A della fibres (well Jocaled shayp sacuke pay) Tlscherm'a due bo ++ acitht melebale product as Sealy Aint . 2| LoeAlaemation due to accunutlalyen of hye engi mes » lorrtatin of pealeneal coveang of wnlermd agen: bf Hef» ” nn case of peitnated) pope ulcer « Inblleralion of vicere by tumours. @ ®@ Spam oP holes nice 0g gulgal Bede, eee eon | s ee4. ® Overdulension of hollow vitcus eq Urinerd bledden » Mechanism of 546 Hechawicadl slim. of pain reepfoas lechernit dee oblibertlint of bhu by spormalle conbec ion Characters of visceral pain (slew pain 7) Dull aching or rhythmic eromps ccobits) « 2} ithe re pacaly /oralied 3] Depressea zulememnic chenger He -- HR ABP. rewsea a vomiting Rugidily of ovelying onuscler Cguarcling nyiily) : Referred to ‘bodef suaBace it reFerred pain Cditciii) . [D] Hearopathir pain : - Bet. chronic pola clue bo damage ry pathology in verve libes Cin prriphea! a central nerwus syste) - Searle : Trigeminal neurdlyia a. Drabeke aeurspathy Herpes goster » Sciahta 3 Phentom hink pan 1- Exeruciating, electric, buriing or shooting pain. 2- Occurring in bouts or paroxysms « 3- Accompanied by hyperalgesia & parasthesig - sz ourfiPartialig esponstveltocopigldahtepy + Reférred pain.’ Meee Definition; Pain is felt on a surface area originating from the same dermatome of the diseased viscus i.e. supplied by the same posterior root (dermatomal rule) « t of Examples: 2 ; 1- Cardinc pain is felt retrosternal, root of the neck, outer part of the ches! of the left arm & epigastrium. 4 2 Gull-bladder-pain‘is felt in:epigastriymé tip of right scapula - 3+ Appendix.pdin is felt around the ushbilicus. 4- Giistri¢ Pain is felt between the xiphoid process and the umblicus. 5- Renal Pain is felt in the back, inguinabyegion =. - ish ‘ . ~ Chzrsileas, Mechaninm of referred pain: zonyergenco projection| ea halt © event pain fibers fthm}Heypkin and wisous converge on the same cells of substantia telalinom of Rolandi or the thalamus and will finally activate the same:cortical neuron. Whatever may be the souraesof ipa ill project it ag if it is coming from the skin, being:tH®cbinognest source of pain duc to: . ~ Skin is rich in pain receptas « = @)~ SRin is mer are by sheulattent ~ Skin is call, represented tn calex while viscere are 70 @ Fanti” oo Atberent prin Thre from déeased viscus, give sublirainal Fringe by SOR ees) alterent pain Fibres Front skin), increasing 10s exeitailly —p Pain ts Fell shin ate and. P Lewenng of pozir Aresheld 1'¢ hypeaalyest2 referred pain Al Beadache of _tntracranial origins eo Stim of pain rteeples in inbacanta struc lure ~ above tenborvon —p Frrttal headrche referred vie trigeminal n. ~ below 5, —» occipital x 4 wa end eevital y i eo Bran is insensitive to prin. hakecanial, | painseraitive areas ares ] Yertous siruses _, Dura/ arteries expecilly middle memrgeal q antag al shall bse Ganial nerves Vy Ik, x. , benberiun xdua " e pe Couses of sntracranit) headache headache : SH of causes oF Aesdah ) Hteningitts . due bo inflammelion of dura -s venous siruses| 2 eee 4| Lligraine Aeningeal treume 2fter operztion. Lteningeal ttrvtalion 4 boction by brain bemnours . ligraine aay be eat muy be dea lo obon fo abnounal vascular phenomenon” . Emotion a bension — vasospasm oF central vs, szchemia of bain ared—» sensagy Aalluctveztias te s prcadentta « Lchemta oF vasculer wall, Hacer Alacer calomit) 108 pelea bile vessel with blood presuré—_> severe headache « Lypeatension Headache ws relaled ba puke Pressares Leap CSF pressun £7 atten lumbar jitoslare —> bain clescent —» braclion on durts vendo reach hezdache- @ Alcoholic hangortt heedecke _Aleohalirctale men8 Constipation : Toxins absorbed bom ntclam innitele breie meniages | [2] stezdoche of exbarcrinizl artgins : 35/4 Sensations fram past pact of seals Chehind cay) ran it 2nd corvital nerve » 9 ant part of 4 5 Fece run in brrgemiual nerve Causes of extracranial headache : 957 oF causes of Aeadecht t €ye + Errors of rehachion or gluccmd, 2 €or: Olibx medig, 3 Hese + Inflammation oF nose a nasal simases 4 Louth : Toothache . 5 Scalp sneck muscles pes be emolina| a bension headychd, 6 Tageminal neupdlgia - % Systemic diades eg anemit. Pain perception ts tabthrted it CNS. This os pooved by» 1 Peescnal reaction bo pain vartes, greatly from ene zpowen fa zratley 2 Inyurtes caused it aceiclenks ca ina baltle Frebl eae igri | 3 Irritation of shin ovedlyin a deeased vitcus rel fever pzint Pain signals in CNS are inhil ited | by ag, poise conbrol system. GATE THEORY SCR cells i dorsal horr of ped: ack as a GATE fea pain transmission bo bart. , This gate can be pzrlly or completely olased by : t Opiord peptides 2 Supaspinal analgesic sytem 3 Spinal impulses. Op ioid peplttles Morphine Isa poweahul exogenus analgesic: Foard in plum. lt acts oy binding 4 gpiotd receptors in ONS. 12 endogenous Spiel it mammal 3 are more inpcients[7 Zrckepalins : Zeb 5 Lew exthephalins ze penlapeplriles Gay) They are derived! Front tage pa prcerhephalite = Theg are present parbicalarly 0 atop gy se sSiRep snelgeya - do vealed a bnbianton > sees well beiag Exdorphing: B. endnphine @aa polypep tele » 7 Drived Fran caeden alg - glands bypolhal - Aypothalartus, tb acs as neurobransmilter in areas oF bye prytcting bo Fhalamus 5 sporiaguccluctal gray ae tn bratent « (1 ant: piturlery, ihacls as necrohamene secreled wilh ACTH to general circulation fo gpiete receptor —p stress analgesia Dynorohin ; @aa derived Gum prodynorghin . ~ Very potent analgesic secreled 1a ONS. + Also responsible Fae addictions tulerance hr gorates. Opiate receptors 4 Della : High ablinity bo enkephalin, xzlyesta. 2Aa in 4 9 exderphin > Aaalgesiz , eapheuz, . depresion 1, ecastypabiin A melasts . 3 Kappa: Argh ahnrly be dynaph. > Analgesia, sedabion, dyspherte diuresis 4 mitosis» 7] Suupraspinal axtalyesit syslent 3 major compontentts o tsk peri-agueduelal arta ( butlbral + Upperpons). Meurones are sensitive Lo ondeyphine 3 send. sigeedl ‘Lo: @ 2 Raphe magnus niscleisg (lower pones & upper medulla) . Neurons send their signals down the dorsolateral Column to + 3° Pain inhibitory complex area (in the dorsal hom of spinal cord) « It consists of many interneurories, which release enkephalin + ‘They cause presynaptic inhibition of pain nerve terminals, the latter, in turn, will stop __Teleasing P substance that normally stimulateSGR = a- The neurons of the peri-anueductal gray,atea are stimylated by B endorphin reaching them fron hypothalanqus (neurons of periventricular area i.e. chemical transmitter) or pituitary. (through blood i.e. neurohormone)” b- Fibers of peri-aqueductal and interneurones of spinal cord secrete enkephalip.