Multi Choice Questions

Question 1

Properties of a delta?

Answer 1

Thin, myelinated, sharp, pricking,

Question 2

What is primary hyperalgaesia and why?

Answer 2

The awakening of sleeping nociceptors (poly modal), because c poly modal receptors can develop easily evoked or spontaneous discharge.

Question 3

Most a delta and c fibres have free nerve endings without specialised structure, true or false?

Answer 3

True.

Question 4

What does muscle pain feel like? What is the most relevant stimuli for muscle nociceptors?

Answer 4

Deep highly unpleasant cramping and poorly localised. Most relevant is chemical and mechanical to induce muscle pain.

Question 5

Firing frequency of which type of cell depends on the stimulus being applied?

Answer 5

Wide dynamic range fire faster with more noxious stimuli. Repetitive c fibre stimulation produces increase in firing frequency.

Question 6

Which tract is the motivational and affective? Involving what systems?

Answer 6

PAleospinothalamic tract. Reticular and limbic system.

Question 7

What is the neospinothakmi tract?

Answer 7

A tract that conveys information related to detection, perception and quality of nocioception. E.g. Intensity, location, duration.

Question 8

What does stress do to help pain?

Answer 8

Stress can produce opioid and non opioid analgesia

Question 9

How does analgesia help inhibit pain?

Answer 9

The defending analgesia system can inhibit the activity of dorsal horn Neurons, both directly and indirectly as well as reduce the release of neurotransmitters from primary afferent nociceptors.( pain gate theory, both directly and indirectly pre and post synaptic. )

Question 10

What can contribute to neuropathic pain?

Answer 10

Inflammation and neuroma. Needs to be a lesion to the nerve, needs to be damaged.

Question 11

Where does transduction occur?

Answer 11

at the periphery.

Question 12

Nociceptive pain is

Answer 12

From things you expect to be painful, so noxious stimuli and involves tissue damage. A normal acute pain sensation.

Question 13

Neuropathic and inflammatory pain result in what two pain properties?

Answer 13

Allodynia and hyperalgaesia.

Question 14

How does the anterior cingulate cortex contribute to chronic pain?

Answer 14

By being constantly active, establishing emotional valence of pain and co ordinating a motor response.

Question 15

Changes that occur in the dorsal horn with central sens decease in the magnitude and duration of response to stimuli that are above the threshold strnength, t or f

Answer 15

False.

Question 16

What makes silent nociceptors …louder?

Answer 16

Inflammation and chemical sensitization

Question 17

Managing pain.. What effect does physical activity and therapy have on it?

Answer 17

May allow nervous system functioning and retraining of skills.

Question 18

What happens to the receptive field during central sensitization?

Answer 18

It increases in size.

Question 19

What is a more important link in the transition from acute to chronic pain, modulation or modification?

Answer 19

Modification.

Question 20

What are the three changes that occur as a result of central sensitization at the dorsal horn?

Answer 20

Reduction in threshold, increase in magnitude and duration of stimuli and expansion of receptor field size.

Question 21

What do the large fibres in gate control theory do?

Answer 21

They control tactile sensation and inhibit pain sensation when activated.

Question 22

When does neuroplasti ity occur?

Answer 22

During acute pain.

Question 23

What occurs after a reduction in blood supply to myelinated fibres?

Answer 23

Ectopic impulses due to demyelination perceived as sharp shooting or burning pain.

Question 24

What and when is the flexion relaxation response seen?

Answer 24

at full flexion the lumbar spine muscles relax in pain free people. Eight of torso is balanced by non contractile units and once this is achieved it is terminal trunk flexion

Question 25

Does pain cause increased activity at rest and contraction?

Answer 25

Only at rest but will not cause increased activity during contraction.

Question 26

Sub maximal muscle force during normal pain free conditions can be matched in conditions of pain why?

Answer 26

Increased voluntary effort activates additional motor units to match the force.

Question 27

Can maximal isometric muscle force during a normal pain free condition be matched in conditions of pain?

Answer 27

In conditions of pain cannot be maximal, pain inhibits some muscle activity. Sub maximal, yes,

Question 28

Why is the flexion relaxation response absent in individuals with back pain?

Answer 28

Pain from deep structures causes Es to protect the back. So cannot fully relax and rely on structures to support in full trunk flexion,

Question 29

Hodges theory of movement adaptation suggests what?

Answer 29

That each individual may have different responses to pain because movement adaptation in pain may involve reduced motor activity, increased or combinations of both, depending on variables such as experience, posture, task, context

Question 30

Hodges suggests that movement adaptation in pain has little benefit to the patient in what circumstance, why?

Answer 30

Movement adaptation in short term can be beneficial but in long term may compromise quality of movement through increased tissue loading, reduction in variability etc.

Question 31

Deep somatic structures like muscles produce hard to localise and often referred pain because?

Answer 31

Of convergence, converging afferent worsen quality of information, making it more difficult to specify location.

Question 32

Why might referred pain be more intense?

Answer 32

Because local pain is more intense

Question 33

Are hyperalgesia and referred pain related?

Answer 33

Hyperalgesia can develop in areas of referred pain leading to tenderness,

Question 34

Mechanism of referred pain incorporates, but not dependant on normal afferent information arising from tissues located in the site of referred pain, true false why?

Answer 34

Analgesic injections at site of referred pain reduced intensity.

Question 35

Traumatic damage to viscera does?

Answer 35

Nothing if it is from cutting burning or pressure.

Question 36

How does neuropathic pain arise from visceral pain?

Answer 36

If viscera inflames and causes damage to a nerve.

Question 37

Is somatic and visceral central sensitization similar

Answer 37

No

Question 38

Pain behaviours Are usually ——- actions and reinforced through negative but not positive pain behaviour

Answer 38

Unconscious, reinforced through negative and positive.

Question 39

What does an individual tend to do in stressful situations in regards to stereotypy?

Answer 39

Stereotypy is the way in which muscles react to stress, by tensing up.

Question 40

Hypervigilance can be controlled? True false. Explain

Answer 40

True, but there are consequences , attempts to suppress pain or fear may be futile and or show a paradoxal increase in pain once these attempts stop

Question 41

A negative personality type and pain Catatrophizing are related true or false?

Answer 41

False.

Question 42

Are safety behaviours good or bad or both?

Answer 42

Good in short term bad in long term

Question 43

Why are safety behaviours good or bad or both?

Answer 43

Because hypervigilance may lead to poor task performance and pain avoidance can lead to avoidance of beneficial daily activities.

Question 44

Are people with history of depression and or anxiety at higher risks of chronic pain?

Answer 44

Yes.

Question 45

Does remission of depression equate to decrease in pain intensity?

Answer 45

No, pain intensity does not disappear sometimes. Suggests changes plasticity?

Question 46

What are the properties of c fibres?

Answer 46

Dull, burning, small and unmyelinated.