浙江大学医学院：止痛药（PPT讲稿）Analgesics

Analgesics MEX D Opioid analgesics a Synthetic opioid analgesics u Other analgesics

Analgesics Opioid analgesics Synthetic opioid analgesics Other analgesics

General Considerations Pain(疼痛) 躯体痛-快痛,慢痛 内脏痛 神经性痛 口 Analgesia(镇痛): 选择性抑制疼痛感觉, 不影响意识和其他感觉

General Considerations Pain (疼痛)： 躯体痛－快痛，慢痛 内脏痛 神经性痛 Analgesia (镇痛)： 选择性抑制疼痛感觉， 不影响意识和其他感觉

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The perception of somatic pain

Anterolateral tract ax

CGRP 8 Substance P Histamine Dorsal root Bradykinin ganglion neuron Lesion 5HT→ Prostaglandin K °·CGRP Substance P o(Blood vessel Spinal cord Peripheral mechanisms of pain

Peripheral mechanisms of pain

中央后回 内囊 Thalamus 脊髓丘脑束一 触觉小体 头面部感觉 球状小体 脑桥 游高神经末相 颈髓后角损伤出现 节段性感觉障碍 环层小体 延髓 颈髓 皮肤的感觉神经末梢 脊髓丘脑侧束 胸倒索 损伤出现 Conduction 脊髓丘脑传导束性 感觉障碍 pathways of pain 腰髓 脊髓丘脑束在同侧上升 1-2个节段后交又到对侧

Thalamus Conduction pathways of pain

Somatosensory Descend thalamic nuclei Ventroposterolateral Periaqueductal Neospinothalamic tract Rostroventral medulla Spinoreticular tract Descending pathways orsat Ascending pathways Dorsa Spinal cord Ascending

onere Froot A scope oce Cortical locations of pain Los Tempe 1be Sensory homunculus Motor homuncle

Cortical locations of pain

● Measurement of pain

Measurement of pain

Anterior cingulate Insula Noxious Cool grill Warm Noxious heat cold (cool and warm The fMrI imaging of pain

The fMRI imaging of pain