Entry requirements

* Accepted examination results in Physiology, 6 credit points, and in Basic anatomy of the nervous system.

* 35 passed credit points

* All oral, written and practical examinations in physiotherapy from earlier terms have to be accomplished with a pass.

* If the examination consists of a report, this report has to be submitted before end of term and has to be accomplished with a pass the following term at the latest.

Aims

The aim of the course is to give basic knowledge in physiology related to pain and stress, and the proportions between both these systems.

After the course, the student should:

* be able to describe in detail the anatomy and the physiology behind pain experiences.

* be able to explain the concepts of pain and nociception.

* understand the difference between acute and chronic pain.

* be familiar with different types of pain (nociceptive/inflammatory, neurogenic, idiopathic and psychogenic pain) and understand and explain the mechanisms behind these types of pain.

* be able to explain the mechanisms behind the pain relieving systems of the body and understand the implication of peripheral, segmental and central pain modulation and the influence of psychological factors.

* be familiar with the most common forms of pharmacological and physical treatment and be able to relate the treatments to the physiology of the pain.

* be able to describe precisely the anatomy and the physiology behind stress response.

* know how stress can influence basic physiological functions and pain experiences.

* be able to describe generally clinical examples of diseases related to pain and stress, and be able to connect these diseases with physiological mechanisms.

* be able to prepare for seminar discussions and participate actively.

Content

* Definition of important concepts

* The anatomy and physiology of pain from periphery to cerebral cortex:

Nociceptors, primary afferent, the dorsal horns of the spinal cord, spinal reflectors, secondary nociceptive tracts, brain stem, tertiary nociceptive tracts, cerebrocortex.

* Classification of pain:

Acute and chronic pain, nociceptive and inflammatory pain, peripheral and central neurogenic pain, idiopathic pain, psychogenic pain.

* Pain modulation:

Peripheral pain modulation, gate control theory, descending pain relieving systems, effects of psychological factors.

* Pharmacological treatment

Analgesics with peripheral and central effect, local anaesthetic, antidepressive drugs, anti-convulsants, alpha-2-agonists.

* Physiological effects of physical treatment such as Heat - Cold, physical training, mobilisation, TENS, massage, acupuncture and similar treatment.

* Stress physiology:

Endocrine mechanisms behind stress, the function of corticosteroids and catecholamines at stress response, the effect of cortisol on physiological functions and on inflammation, physiological relation between stress response and pain.

* Clinical examples of common pain and stress-related diseases.

Instruction

Teaching is given as lectures and seminars.

Assessment

Satisfactory completion of the course requires:

Passed written examination

Compulsory attendance at seminar

Students who have not passed the examination are offered to sit for further examinations 4 times (=total of 5 examinations). If the student can adduce special reasons the programme committee can admit an additional examination. Every time the student actually sits for an examination will be counted as an examination. Submission of a so called blank test is counted as an examination.