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2 Common pains, aches, hurts, sores, injuries sick , ill, sickness, illness diseases

PAIN PHYSIOLOGY

0:10Skip to 0 minutes and 10 secondsIn this section, you will see

how pain is classified. Ari Contos will be used as an example to
describe how pain is detected or perceived in the body and to
show how pain signals are taken from around the body to the
brain. Pain is normally classified into two main types,
nociceptive, arising from being sensed by pain receptors called
nociceptors, and neuropathic, neuro meaning nerve and pathic
meaning disease or condition. Nociceptive pain can be acute,
such as touching a hot surface, or chronic, such as most back
pain. In addition, it is possible to have a mixture of nociceptive
and neuropathic pain. Sometimes the cause of the pain is not
nociceptive or neuropathic, and such pain is termed idiopathic.
1:07Skip to 1 minute and 7 secondsSome types of chronic pain
may be idiopathic. In this section, we will focus on nociceptive
pain. Nociceptive pain arises from activation of pain neurons,
that is neurons that carry pain signals in response to a noxious
stimulus that may be some sort of injury, disease, or
inflammation. Nociceptive pain is caused by the activation of
nociceptors. Nociceptors are receptors that respond to a
number of stimuli. When they respond to chemicals, they are
called chemoreceptors. Receptors that respond to temperature
changes are called thermoreceptors. And receptors that
respond to mechanical stimulation or movement are called
mechanoreceptors. Individual nociceptors can sometimes
respond to more than one type of stimuli. For example, there
are nociceptive called Transient Receptor Potential Vanilloid
type one, or TRPV1 receptors.
2:14Skip to 2 minutes and 14 secondsTRPV1 receptors exist all
over the body and respond to heat, but also to the chemical
capsaicin, which is the chemical in hot tasting foods like chilli
that causes a hot sensation when eaten. So eating foods
containing chilli causes a hot painful sensation because of the
activation of TRPV1 receptors. Thus, TRPV1 receptors are both
thermoreceptors because they respond to heat, and
chemoreceptors, because they respond to the chemical,
capsaicin. There’s a whole family of TRP receptors. And the
first of these nociceptors were only discovered in late 1980s.
And prior to this, it was not known how nociceptive pain was
detected. TRPV1 receptors are often found on neurons. And
their activation then leads to activation of the neuron.
3:15Skip to 3 minutes and 15 secondsThe neuron sends electrical
signals to the spinal cord, as we will see in a moment. The
effective TRPV1 receptor activation is felt very quickly in order
to alert a person to the source of the pain, so that hopefully it
can be alleviated. Chemoreceptors such as TRPV1 receptors
can be activated by chemicals that come into contact with the
skin, such as accidentally pouring acid onto the skin, or by
chemicals produced in the body. When tissues become
inflamed due to disease or injury, many different chemicals are
released from the inflamed tissue. These chemicals activate
various chemoreceptors in order to activate neurons that send
painful messages to the brain. As mentioned earlier, there are
nociceptors that are activated by movement called
mechanoreceptors.
4:09Skip to 4 minutes and 9 secondsThere are a number of
different types of structures that contain mechanoreceptors.
Some structures detect light touch, whereas others are
responsible for the detection of vibration or skin stretching. So
the are nociceptors in the sense of detecting painful stimuli, but
they can also sense non-painful sensations. So what about Ari’s
back pain? It may be the result of a strain in any of the
interconnecting structures in the back, such as the tendons,
muscles, and spinal discs. Straining of these structures can
cause inflammation, which produces heat and chemicals that
active TRPV1 receptors, or other similar receptor types. Ari’s
back pain may also be the result of mechanoreceptor
stimulation.
5:05Skip to 5 minutes and 5 secondsOften after an accident, there
is structural damage that means that mechanoreceptors are
activated by simple movement of the body that would not
normally cause pain. The precise way in which
mechanoreceptors sense movement of tissue is yet to be
completely identified. Mechanoreceptors may be similar in
structure to TRPV1 receptors. And their activation may, in fact,
involve the TRPV1 receptors as well. So when Ari feels pain in
his back, it is nociceptors on neurons in the area that he feels
the pain that are activated. These neurons are generally silent
in that they fire much less frequently when they are not being
stimulated.
5:54Skip to 5 minutes and 54 secondsOnce activated, these
sensory neurons transmit electrical signals much more
frequently from the site of the pain in the back to the spinal
cord. Here, the sensory neurons release neurotransmitters that
activate a secondary neuron that projects to the brain. This area
in the spinal cord is an important target for drugs used to treat
pain, called analgesics, as we’ll see in a later recording. These
secondary neurons transmit pain information via electrical
signals to various brain regions, and eventually to a brain region
called the somatosensory cortex. Let’s now look at the
somatosensory cortex in more detail. The somatosensory
cortex is a strip of tissue across the top of the brain where pain,
as well as touch and temperature, is actually felt.
6:51Skip to 6 minutes and 51 secondsEach part of the
somatosensory cortex represents a different part of the body.
This is perhaps better represented by this model called the
sensory homunculus. This shows what a person’s body would
look like if each part grew in proportion to the area of the
somatosensory cortex concerned with its sensory perception.
This highlights how some parts of the body are various
sensitive, such as the hands and lips, and how other parts of
the body are less sensitive, such as the arms and legs. So to
recap, you’ve seen how pain is classified, how pain is detected,
how pain signals are taken from around the body to the brain,
and how this pain is perceived in people experiencing pain, like
Ari.