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segmental sensory impulses From these cells of termination, second-order axons connect with ventral and lateral horn cells in the same and adjacent spinal segments and subserve both somatic and autonomic re exes The main bundle of secondary neurons subserving pain sensation projects contralaterally (and to a lesser extent ipsilaterally) to higher levels; this constitutes the spinothalamic tract, discussed below In recent years, a number of important observations have been made concerning the mode of transmission and modulation of pain impulses in the dorsal horn and brainstem Excitatory amino acids (glutamate, aspartate) and nucleotides such as adenosine triphosphate (ATP) are the putative transmitters at terminals of primary A- sensory afferents Also, A- pain afferents, when stimulated, release several neuromodulators that play a role in the transmission of pain sensation Slower neurotransmission by C neurons involves other substances, of which the most important is the 11 amino acid peptide known as substance P In animals, substance P has been shown to excite nociceptive dorsal root ganglion and dorsal horn neurons; furthermore, destruction of substance P bers produces analgesia In patients with the rare condition of congenital neuropathy and insensitivity to pain, there is a marked depletion of dorsal horn substance P A large body of evidence indicates that opiates are important modulators of pain impulses as they are relayed through the dorsal horn and through nuclei in the medulla and midbrain Thus, opiates have been noted to decrease substance P; at the same time, exor spinal re exes, which are evoked by segmental pain, are reduced Opiate receptors of three types are found on both presynaptic primary afferent terminals and postsynaptic dendrites of small neurons in lamina II Moreover, lamina II neurons, when activated, release enkephalins, endorphins, and dynorphins all of which are endogenous, morphine-like peptides that bind speci cally to opiate receptors and inhibit pain transmission at the dorsal horn level The subject of pain modulation by opiates and endogenous morphinelike substances is elaborated further on.

incorrect These steps could eventually be required to resolve the problem, but remember, always start with the easiest and most basic troubleshooting procedures first Suppose that the original application was at fault in this case If you went ahead and uninstalled, then reloaded, the printer driver, you would have performed a time-consuming procedure for nothing Alternatively, if the printer or its configuration were at fault, you would have reinstalled the application with no effect 14 B You should make sure the cable connection is tight Remember, when diagnosing a hardware problem, start with the outermost components and work your way into the computer After the monitor, the cable is the next component in the video system A, reattach the original monitor to the computer, is incorrect because both the monitor and another component might be at fault Use the monitor that you know is functioning until you can get the video system working, then reattach the original monitor C, ensure that the adapter card is properly seated in the expansion slot, and D, swap the adapter card, are incorrect because they both involve opening the computer and are more time consuming than a simple cable swap Always rule out easily installed components before you take the computer apart 15 A The configuration of the word processor and graphics programs is the most likely cause of the problem You should check that these programs are configured to print to the correct printer, using appropriate buffer sizes, resolutions, and any other print job related application settings B, the printer s device driver, C, the printer, and D, an improper network configuration, are all incorrect because these would all lead to the inability to print from any program Recall, however, that in this case, the user can print from a spreadsheet program This situation indicates that the printer is working and that the computer can access it 16 D You should check the speaker Ensure that it is receiving power and that the volume is turned up to a sufficient level In addition, make sure that the cables are properly attached and that the speaker is not near any EMI-causing devices These should be the first steps, since the speaker is the easiest component in the sound system to access (and the most likely to fail) A, the sound card s configuration, is incorrect Because the sound system worked at one time, you can assume that the sound card was properly configured Although the configuration might have become corrupt and caused this problem, it is more time-consuming to reconfigure the sound card than it is to physically check the speaker for power, volume, and connectivity B, the speaker s configuration, is incorrect Speakers simply amplify signals from the sound card and do not need to communicate with other components in the computer Therefore, the speakers do not need computer resources or drivers C, the sound card, is incorrect because this is a more time-consuming procedure than testing the speakers Because the sound card is internal, checking it requires you to shut down the computer and take it apart.

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