| Term 
 | Definition 
 
        | ASA and NSAIDs are (peripherally/centrally)-acting analgesics. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Acetaminophen and opiods are (peripherally/centrally)-acting analgesics. |  | 
        |  | 
        
        | Term 
 
        | afferent, efferentEnter away message text here. |  | Definition 
 
        | ___ neurons arrive at the brain. ___ neurons exit the brain. |  | 
        |  | 
        
        | Term 
 
        | intracellular = high [K], low [Na/Cl]; extracellular = low [K], high [Na/Cl] |  | Definition 
 
        | (Intra/extra)cellularl fluid contains high [K+] and low {Na+/Cl-]. (Intra/extra)cellular fluid contains low [K+] and high [Na+Cl-]. |  | 
        |  | 
        
        | Term 
 
        | 1st false (intracellular is highly negative), 2nd true |  | Definition 
 
        | T/F: The inside of a neuron is highly positive relative to the extracellular fluid. This different in electrical potential across the nerve cell is known as the resting potential. |  | 
        |  | 
        
        | Term 
 
        | rapid depolarization followed by slow repolarization |  | Definition 
 
        | The initial rapid positive rise in in the resting potential is ___ followed by ___ in which the neuron slowly becomes more negative. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ phase is rapid when the nerve becomes less negative. This is a result of the influx of sodium ions via sodium channels. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | What blocks sodium channels? |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | __ __ is the influx of sodium ions during depolarization. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ phase is a slower process where the nerve becomes more negative as a result of the efflux of potassium ions via potassium channels. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ ___ is the efflux of potassium ions. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | The __ phase is a slow process when the sodium-potassium ATP pump continues to exchange sodium and potassium and return the nerve to its resting potential. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ is the ability of a nerve cell to produce an action potential. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ stimulus is the minimum stimulus intensity needed to evoke an action potential. It is the "all-or-none-" stimulus. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ ___ ___ are areas along a mylelinated nerve where there is no myelin. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ ___ is the movement of an impulse along the axons from the node of ranvier to another. |  | 
        |  | 
        
        | Term 
 
        | Claudalis, a-delta and c-fibers |  | Definition 
 
        | ____ is the main relay site in the pathways responsible for pain from the face and mouth. Small diameter pain fibers (___ and ___ fibers) afferents terminate here. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Different parts of the brain (___ and ___) process the information and then send their responses to the periaqueductal gray matter. |  | 
        |  | 
        
        | Term 
 
        | Periaqueductal gray matter |  | Definition 
 
        | The ___ ___ ___ integrates the information sent and aggregates a response back to the oral tissue or spinal cord. These nerve from the brain carry information that can modify/inhibit the pain information being transmitted into the brain. |  | 
        |  | 
        
        | Term 
 
        | PeriAqueductal Gray matter |  | Definition 
 
        | The ___ ___ ___ modulates the pain sensation. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | A __ fibers are the smallest of the A fibers. It is lightly myelinated and part of the ascending pathway. They transmit intense, sharp and stinging pain. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ fibers are slow, unmyelinated and are the smallest of all pain fibers. They transmit dull, burning and aching pain. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ fibers have projections to reticular formation, thalamus and sensory cortex. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ fibers have projections to the thalamus, PAG and limbic structures |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Clinically, which sensation is lost first and last to recover? |  | 
        |  | 
        
        | Term 
 
        | pain, cold, warmth, touch and deep pressure |  | Definition 
 
        | Explain the order in which sensations are lost. |  | 
        |  | 
        
        | Term 
 
        | Sodium channels opening in the depolarization stage |  | Definition 
 
        | Local anesthetics block which step of the action potential? |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | T/F: Local anesthetics significantly alter the resting potential of the nerve membrane. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ ___ blocks the influence of stimulation on Na+ conductance. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Lidocaine, prilocaine, articaine, bupivacaine, etidocaine and mepivacaine are all ____ local anesthetics. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Tetracaine, propoxycaine and benzocaine, ___ local anesthetics, are not commonly used in infiltration. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | T/F: Cocaine is an ester local anesthetic. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ is a local anesthetic used for cough suppression. |  | 
        |  | 
        
        | Term 
 
        | lipid solubility --> potency, protein binding --> duration of action, pka --> rate of onset |  | Definition 
 
        | Lipid solubility of a local anesthetic affects the ____. ___ ___ affects the duration of action. ____ affects the rate of onset. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Cocaine is the only local anesthetic that (dilates/constricts) blood vessels. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ is the least lipid soluble local anesthetic and is therefore the least potent. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ is poorly bound to proteins and therefore has a relatively short duration of action. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Inflammation (pH ___-___) interferes with efficacy of local anesthetics. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ defines the proportion of drug that is non-ionized and can easily diffuse nerve sheaths and membranes. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | When pH falls in a tissue, the amount of non-ionized species (increases/decreases). |  | 
        |  | 
        
        | Term 
 
        | Pain fibers are the thinnest sensory fibers, whereas those conveying deep pressure sensation are the thickest |  | Definition 
 
        | Why is pain sensation usually the first to disappear? |  | 
        |  | 
        
        | Term 
 
        | 3, internodal distance is great in larger nerve fibers |  | Definition 
 
        | A minimum of __ consecutive nodes of nerve must be covered by the anesthetic solution to ensure thorough blockage. |  | 
        |  | 
        
        | Term 
 
        | True! This is because more channels are open. |  | Definition 
 
        | T/F: Nerve axons become more sensitive to local anesthetics' action as nerve activity increases. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ is a preservative used in local anesthetics with epinephrine. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | The __ __ of a sensory/afferent neuron consists of a nucleus and possessing one to several dozens of fibers of varying lengths. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | The ___ of an afferent neuron are branching processes that receive stimuli and conduct impulse generated toward the nerve cell body. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | the ___ of an afferent neuron is a single nerve fiber connecting to other nerve cells, gland or muscle |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Peripheral Alpha-beta sensory fibers can inhibit the spinothalamic neurons via the release of ____. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Noxious stimulus activates (primary/secondary) afferent neurons which then evokes action potentials, conducted to dorsal horn of the spinal cord which then releases neurotransmitters. |  | 
        |  | 
        
        | Term 
 
        | neurokinins (substance P), calcitonin gene-related peptide (CGRP) and excitatory amino acids (EEA --> glutamate) |  | Definition 
 
        | What neurontransmitters are released from the dorsal horn of the spinal cord? |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ___ activate contralateral spinothalamic neurons which transmit impulses via ascending pain pathways to the reticular formation, medulla, thalamus, limbic structures and cortex. |  | 
        |  | 
        
        | Term 
 
        | ascending, reticular formation, medulla, thalamus, limbic structures and cortex |  | Definition 
 
        | Contralateral spinothalamic neurons transmit pain impulses via the (ascending/descending) pain pathway to the ___ ___, ___, ___, ___ __ and ___. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Stimulation of ___ and ___ fibers activate spinal reflexes so you withdraw from a noxious stimulus before pain is recognized by higher structures. |  | 
        |  | 
        
        | Term 
 
        | projections to the sensory cortex |  | Definition 
 
        | What alerts an individual to the presence/anatomic location of pain? |  | 
        |  | 
        
        | Term 
 
        | projections to the limbic structures (amygdala) |  | Definition 
 
        | What enables an individual to experience discomfort, suffering and other emotional reactions to pain? |  | 
        |  | 
        
        | Term 
 
        | located in the midbrain, receives inputs from hypothalamus, cortex and thalamus |  | Definition 
 
        | PAG is located in the ___ as a small gray matter surrounding the central canal. It receives inputs from other brain regions including ___, ___ and ___. It is one of the gating mechanisms that control impulse trasmission into the dorsal horn. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Medullary neurons, ___ nerves, arising in the nucleus magnus raphae (NMR) are fibers running in the dorsolateral funiculus of the spinal cord which form synaptic connections on dorsal horn interneurons --> inhibit discharge of spinothalamic neurons. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Medullary neurons, ____, arising from the locus ceruleus form synaptic connections on dorsal horn interneurons --> discharge spinothalamic neurons. |  | 
        |  |