Slide 1

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(Causes of pain) :* * ** * : ** ( )** ** ** ****** ** ** **

() :* (Mechanical nociceptor) .* (Thermal nociceptor) : ** (Heat nociceptor) ** (Cold nociceptor)* (Chemical nociceptor) . .

(Types of pain)

:

* (Acute pain) (Fast pain)* (Chronic pain) (Slow pain)

(Acute pain)

. . A- : .

(Chronic pain)

. . . C . ( ...) .

A- 15 30 . C . (Acute pain) A- . (Chronic pain) C .

:* A- . . * C . ( ). .

Nociception:

(Free nerve endings) . ( ) . . (Nociceptor) .

*** ** * * * * ( )* ( )**

.

(CNS)

A- C ( ) . ( ). (Posterior horn) .

(Pain fibers)

( ):

:* A- * C

A- (CNS)

A- I V . I () . I V () . A- ( -) . ( ) A- (Reticular formation) . .

A- :

*** ( ) *

C (CNS) II III . II (Substantia gelatinosa) . V . V ( -) (RF) . . .

:

A: : (sharp.stabing.shooting)

:

C:

:* (RF)** *

. .

2

: pain-modifying barainstem 2

CNS

7 9 10 12 C1 C2 C3

Brainstem (VBSNC)

Dorsolateral Brainstem Pons

VNBC: Terigeminal Brainstem Sensory Nuclear Complex VNBC Brainstem

VNBC Brainstem

P :

5 5 first order primary second order Brainstem :chief main sensory nucleusspinal treigeminal nucleuos oralisspinal trigeminal nucleus interpolarisspinal tregeminal nucleus caudalis:

Trigemothalamic trigemoreticular

: PCGRP 16

A: :meissner`spacinianmerkel`sruffini

AC

(Centeral Sensitization)

Trigger Points TMJ (TDM) MFP TM tension-type CRPS complex regional pain syndrome

Trigger Points