Cervero F
Department of Physiology, University of Bristol Medical School, UK.
Br Med Bull. 1991 Jul;47(3):549-60. doi: 10.1093/oxfordjournals.bmb.a072492.
Acute visceral pain is dull, aching, ill-defined, badly localized and often referred to remote areas of the body. These properties indicate that the representation of internal organs within the CNS is very imprecise. There is evidence for the existence of specific visceral nociceptors in some viscera and for the existence of non-specific receptors in other internal organs. Some visceral receptors are 'silent' in normal viscera but become active following acute injury or inflammation of the internal organ that they innervate. The number of nociceptive afferent fibres in viscera is very small but these few nociceptive afferents can excite many second order neurones in the spinal cord which in turn generate extensive divergence within the CNS, sometimes involving supraspinal loops. Such a divergent input activates several systems--sensory, motor and autonomic--and thus triggers the general reactions that are characteristic of visceral nociception: a diffuse and referred pain, and prolonged autonomic and motor activity.
急性内脏痛钝痛、隐痛、界限不清、定位不准确,且常牵涉到身体的其他部位。这些特性表明中枢神经系统(CNS)内对内脏的表征非常不精确。有证据表明,某些内脏中存在特定的内脏伤害感受器,而其他内脏器官中存在非特异性感受器。一些内脏感受器在正常内脏中是“沉默”的,但在它们所支配的内脏急性损伤或发炎后会变得活跃。内脏中伤害性传入纤维的数量非常少,但这少数的伤害性传入纤维可以兴奋脊髓中的许多二级神经元,进而在中枢神经系统内产生广泛的发散,有时涉及脊髓以上的环路。这种发散性输入激活了几个系统——感觉、运动和自主神经系统——从而触发了内脏伤害感受的一般反应:弥漫性牵涉痛以及自主神经和运动活动的延长。