Figure 33 Inflammation leads to the release of numerous chemicals from mast cells macrophages and injured cells that act directly or indirectly to alter the sensitivity of receptors and ion channels on peripheral nerve terminals

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amino-3-hydroxyl-5-methyl-4-propionic acid (AMPA) receptors and decreases the number of gamma-aminobutyric acid (GABA) receptors on the membrane of nociceptors leading to easier activation of the nociceptors and increases PGE2 production with a mechanism and effect similar to the ones in the thalamus.

Afferent Pain Fibers

The nociceptors have two types of axons either myelinated or unmyelinated and are divided into the C fibers and the A-delta fibers.

Brain

Cerebellum Spinal cord

Brachial plexus

Musculocutaneous nerve

Radial nerve

Median nerve Iliohypogastric nerve

Genitofemoral nerve Obturator nerve Ulnar nerve

Brain

Cerebellum Spinal cord

Radial nerve

Common peroneal nerve

Muscular branches of femoral nerve Saphenous nerve

Tibial nerve

Deep peroneal nerve

Superficial peroneal nerve

Figure 3.4 CNS in red and PNS in blue.

Common peroneal nerve

Deep peroneal nerve

Superficial peroneal nerve

Intercostal nerves

Subcostal nerve Lumbar plexus

Sacral plexus Femoral nerve Pudendal nerve Sciatic nerve

Muscular branches of femoral nerve Saphenous nerve

Tibial nerve

Figure 3.4 CNS in red and PNS in blue.

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