Part 12 Flashcards
Pain arising as a direct consequence of damage or disease of the somatosensory system is called:
A. neuropathic
B. acute
C. nociceptive
D. chronic
A. neuropathic
There are two main types of pain: nociceptive, which is pain arising from injury or pathology in somatic or visceral structures where it activates nociceptors in the affected tissues; and neuropathic, which is pain arising as a direct consequence of damage or disease affecting the somatosensory system.
Pain that has lasted for less than three months is also called:
A. neuropathic
B. acute
C. nociceptive
D. chronic
B. acute
Pain can be divided into acute pain (less than three months) and chronic pain (three months or more).
The inability to feel pain in certain situations, such as when trying to survive in a battlefield, is called:
A. neuropathic pain
B. episodic analgesia
C. phantom limb pain
D. congenital analgesia
B. episodic analgesia
Episodic analgesia is the inability to feel pain in certain situations such as when trying to survive on the battlefield.
A part of the brain that is involved in pain as a major relay station in the transmission of noxious signals is the:
A. cingulate cortex
B. hippocampus
C. cerebellum
D. thalamus
D. thalamus
From the spinal cord, noxious signals reach the brain via a number of ascending tracts, which terminate in many structures throughout the brainstem, thalamus and cortex (Woolf 2011). The thalamus acts as a major relay station in the transmission of noxious signals.
______________ has added significantly to our knowledge of where and how pain is processed in the brain.
A. Blood testing
B. Functional imaging
C. Trephination
D. Cognitive behavioural therapy
B. Functional imaging
Functional neuroimaging techniques such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) detect changes in regional blood flow or changes in local blood oxygen levels, which coincide with changes in local functional brain activity in pain versus non-pain states. In recent years, functional imaging has added significantly to our knowledge of where and how pain is processed in the brain.
_________ pain is thought to have a protective biological function, for example, the pain from touching a hot stove will result in withdrawing the hand from the stove.
A. Acute
B. Chronic
C. Neuropathic
D. Phantom limb
A. Acute
Acute pain is generally thought to have a protective biological function; for example, when a person touches a hot stove, pain alerts them to immediately withdraw their hand. Likewise, following a fracture, pain imposes significant limitation of function that is useful in preventing further damage.
Chronic pain can result in:
A. sleep disturbance
B. irritability and helplessness
C. distress and depression
D. all the above
D. all the above
Persistent or chronic pain can have a strong impact on psychological function and can have significant functional consequences. People report mood and sleep disturbance, irritability, distress, helplessness and depression. They may lose confidence in their ability to perform tasks and become fear avoidant. There may be other consequences, such as loss of status, relationship breakdown and loss of employment.
In order to manage acute pain, you should:
A. identify and treat the cause or provide pain relief such as medication
B. talk to the person about the pain experience to help them understand it
C. administer cognitive behavioural therapy
D. all the above
A. identify and treat the cause or provide pain relief such as medication
The emphasis in managing acute pain is to identify and treat the cause or to provide pain relief until healing occurs. Acute musculoskeletal pain can respond well to a variety of medications.
Management of chronic pain has been found to be more effective from what sort of framework or perspective?
A. Biomedical
B. Physiological
C. Biopsychosocial
D. Spiritual
C. Biopsychosocial
Despite its neurobiological basis, the presentation of pain can only be usefully explained and understood when all relevant psychological and environmental factors are taken into account. This is particularly important in the case of chronic pain where biomedical interventions have only limited effectiveness and the emphasis shifts from pain relief to pain management, and specifically to more adaptive management of relevant psychosocial factors, as per the biopsychosocial model of pain.
An approach that has been found effective in reducing time lost from work and disability associated with chronic back pain is:
A. physical conditioning or exercise programs that include cognitive behavioural therapy
B. aromatherapy
C. high-dose narcotic medication
D. all the above
A. physical conditioning or exercise programs that include cognitive behavioural therapy
A recent systematic review of physical conditioning programs with a stated relationship to the workplace and a focus on job demands by Schaafsma and colleagues (2010) concluded that intensive physical conditioning programs improved long-term return-to-work outcomes for patients with chronic low back pain compared with routine clinical care.
Psychological risk factors for developing chronic pain and a high level of disability are known as:
A. red flags
B. yellow flags
C. warning signs
D. compensation issues
B. yellow flags
It would be very useful to be able to predict who might be at risk of developing chronic pain and a high level of disability, and provide appropriate interventions at an early stage. There has been extensive research into which factors might be relevant in the development of chronic pain and a range of psychological, social and environmental risk factors have been identified.
Yellow flags or psychological risk factors include: high levels of distress or anxiety; beliefs about pain (e.g. increased pain = further damage); an expectation of the need for pain resolution; over-reliance on passive treatments; and avoidance of activity due to fear of pain and/or damage.
If groaning and grimacing result in being encouraged to rest and take medication and this results in more groaning and grimacing in the future, this is an example of:
A. cognitive behavioural therapy
B. neuropathic pain
C. episodic analgesia
D. operant learning
D. operant learning
Fordyce (1976) proposed that operant learning plays an important role in the development and maintenance of pain behaviour. Operant learning refers to the reinforcement or rewarding of a behaviour, such that it is more likely to occur in the future. In the case of pain, for example, reinforcement of behaviours like groaning and grimacing by encouraging the person to rest and take medication, is likely to lead to increased groaning and grimacing in the future, especially if it allows the person to avoid aversive tasks.
People who get compensation for their pain exaggerate their pain or disability.
A. True
B. False
B. False
People with compensation claims are often regarded as having a motive for exaggerating their pain or disability, but in fact research in the area suggests there are no important differences between compensated and non-compensated patients and the vast majority of workers do recover and get back to work (Robinson & Loeser 2012).
Pain is almost always explained by linking it to a noxious stimulus.
A. True
B. False
B. False
Pain is an unpleasant sensory and emotional experience that is not adequately explained by simply linking it to a noxious stimulus.
NSAIDs and opioids are effective pain relief for all pain.
A. True
B. False
B. False
Neuropathic pain generally does not respond well to NSAIDs and opioids should only be considered as second- or third-line options in noncancer neuropathic pain treatments due to the risks associated with long-term use.
