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CRIT5004 > Module 5 - Pain > Flashcards

Module 5 - Pain Flashcards

1
Q

Second pain (also known as slow pain) occurs via activation of which nerve fibre type?

  1. A β fibres
  2. A γ fibres
  3. A δ fibres
  4. A α fibres
  5. C fibres
A

C fibres

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2
Q

What is the term given to pain arising in response to a normally innocuous stimulus?

  1. Neuropathic pain
  2. Allodynia
  3. Hyperalgesia
  4. Sensitization
  5. Hysterical pain
A

Allodynia

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3
Q

What is the anatomical location of the secondary somatosensory cortex?

  1. Precentral gyrus
  2. Ventral posterior thalamic nucleus
  3. Sylvian fissure
  4. Thalamus
  5. Postcentral gyrus
A

Sylvian fissure

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4
Q

Which of the following is a recognised physiological effect of nociceptive pain?

  1. Decreased ACTH
  2. Decreased aldosterone
  3. Decreased coagulation activity
  4. Increased insulin
  5. Protein catabolism
A

Protein catabolism

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5
Q

For which agent/modality is there level 1 evidence of pre-emptive analgesic activity?

  1. Regional analgesia
  2. NMDA receptor antagonists
  3. Opioid agonists
  4. Centrally-acting alpha-2-agonists
  5. Epidural analgesia
A

Epidural analgesia

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6
Q

Activation of Aδ fibres is responsible for first pain sensation via the release of what neurotransmitter?

  1. Glutamate
  2. GABA
  3. Substance P
  4. Glycine
  5. Noradrenaline
A

Glutamate

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7
Q

What is the term given to an exaggerated response to a noxious stimulus?

  1. Hyperalgesia
  2. Allodynia
  3. Hysterical pain
  4. Neuropathic pain
  5. Sensitization
A

Hyperalgesia

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8
Q

There are many distinct differences between superficial and visceral pain. Which of the following is a characteristic of superficial pain?

  1. Radiating pain
  2. Rapid, sharp pain
  3. Associated with autonomic symptoms
  4. Radiating pain
  5. Poorly localised
A

Rapid, sharp pain

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9
Q

What medications would be considered first line therapy for neuropathic pain?

  1. Codeine
  2. Antidepressants
  3. Injection of corticosteroid
  4. Topical lignocaine
  5. Morphine
A

Antidepressants

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10
Q

Which of the following is a recognised physiological effect of nociceptive pain?

  1. Increased insulin
  2. Protein catabolism
  3. Decreased ACTH
  4. Decreased aldosterone
  5. Decreased coagulation activity
A

Protein catabolism

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11
Q

Which central pain modulatory system has been demonstrated to contribute to the mechanism of psychological pain management strategies including relaxation and distraction?

  1. Modified gate control theory system
  2. Modified gate control theory system
  3. Pontine noradrenergic system
  4. Periaqueductal grey-rostral ventrolateral medullary system
  5. Diffuse inhibitory noxious control system
A

Periaqueductal grey-rostral ventrolateral medullary system

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12
Q

With regard to the modulation of pain, what is the phenomenon of “wind-up”?

  1. Release of substance P from afferent terminals that sensitizes adjacent free nerve endings
  2. Increased micturition and defaecation
  3. Quicker withdrawal reflexes
  4. Sequential discharge of AB fibres to produce  mediated pain
  5. Repetitive firing of C fibres that produces a progressive increase in the number of action potentials in dorsal horn neurones
A

Repetitive firing of C fibres that produces a progressive increase in the number of action potentials in dorsal horn neurones

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13
Q

Which property is unique to a nociceptor?

  1. Do not respond to stimuli in the innocuous range
  2. Capable of sensitisation
  3. Unmyelinated axons
  4. Respond to stimuli only in the noxious range
  5. Unimodal receptors
A

Capable of sensitisation

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14
Q

What is the function of the neospinothalamic (lateral spinothalamic) tract?

  1. It produces the autonomic stimulation associated with pain
  2. It projects to the medial thalamus
  3. It conveys the location and intensity of pain
  4. It produces the unpleasant affective component of pain
  5. It projects mostly to the reticular system and increases arousal
A

It conveys the location and intensity of pain

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15
Q

With regard to modulation of pain, on what does the modified gate-control theory depend?

  1. Distraction posed by the need to pass urine
  2. Alpha-2 receptor blockade
  3. Activation of encephalin interneurons
  4. Downgrading of the autonomic nervous system response to pain
  5. Activation of large diameter A fibres in the area of pain
A

Activation of large diameter A fibres in the area of pain

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16
Q

Sensory receptors can be thought of as transducers that convert various forms of energy into action potentials in sensory nerves.

Match the type of receptor to the following description:

  1. Cutaneous receptors for touch and pressure
  2. Found in the rods and cones of the retina
  3. Detect sensations of warmth and cold
A
  1. Cutaneous receptors for touch and pressure - Mechanoreceptors
  2. Found in the rods and cones of the retina - Photoreceptor
  3. Detect sensations of warmth and cold - Thermoreceptor
17
Q

There is a wide variety of neurotransmitters released by nociceptors at their synapse with secondary afferent nociceptive neurons. What are the most common neurotransmitters?

A

Glutamate, Substance P, and CGRP

18
Q

PAG-RVM factors increasing pain

A
  • Attention toward pain
  • Anxiety
  • Infection
19
Q

PAG-RVM factors decreasing pain

A
  • Distraction or threatening situation
  • Hunger
  • Urgency or micturition
20
Q

Peripheral sensitisation

A

Tissue damage or inflammation release substances

Activate receptors on nociceptor

Secondary messengers lead to phosphorylation

Also increased transcription and translation leading to increased number of receptors

21
Q

Central sensitisation

A

Repetetive intense sustained noxious stimuli

Phosphorylation dependend changes of secondary order neuron

Increased transcription of receptors and channels leads to increased excitation and decreased inhibition

22
Q

Clinical manifestations of central sensitisation

A
  • Spontaneous pain
  • Allodynia
  • Secondary hyperalgesia
  • Tertiary hyperalgesia
  • Temporal summation
  • Aftersensations

CRIT5004 (7 decks)

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