Topic 2 - Pain Theories & Clinical Reasoning Models

Question 1

T/F - If tissues are not a source of pain, they can then be a source of nociception.

Answer 1

False - If tissues are not a source of pain, they can NOT TECHNICALLY be a source of nociception.

Question 2

___________ are the source of nociception and _______ stimuli are what they detect.

Answer 2

Nociceptors
Noxious

Question 3

Tissue damage leads to ____ damage.

Answer 3

Cell

Question 4

Cell damage neurochemicals initiate an ____________ (noxious) and immune response. __________ nociceptors are sensitized and there is _______ hyperalgesia in the immediate area of injury.

Answer 4

Inflammatory
Peripheral
Primary

Question 5

Neurochemicals from cell damage reach the spinal cord in _____ and lymph. _______ nociceptors are sensitized and there is _________ hyperalgesia and/or allodynia in areas surrounding or distant from the area of injury.

Answer 5

Blood
Central
Secondary

Question 6

What are the 2 types of hyperalgesia associated with different mechanisms?

Answer 6

1) Primary Hyperalgesia
2) Secondary Hyperalgesia

Question 7

Area of increased excitability of nociceptors at the site of the insult or injury. Common after skin injury, but may also develop following insults to joints, muscle or viscera.

Answer 7

Primary Hyperalgesia

Question 8

T/F - Secondary hyperalgesia is largely attributed to an increase in the excitability of peripheral nociceptors.

Answer 8

False - PRIMARY hyperalgesia is largely attributed to an increase in the excitability of peripheral nociceptors.

Question 9

Area of increased sensitivity surrounding the site of injury, and often at sites distant from the injury (particularly when joints and especially the viscera are involved).

Answer 9

Secondary Hyperalgesia

Question 10

T/F - With visceral insult, sensations are referred or perceived to arise from overlying structures, most notably skin.

Answer 10

True

Question 11

Myocardial oxygen deficiency (aka. angina) involves pain being referred to the ________, down the ____ arm, and occasionally up to the jaw.

Answer 11

Shoulder
Left Arm

Question 12

T/F - Primary hyperalgesia is associated with changes in the excitability of neurons in the CNS, including the spinal cord and supra-spinal sites in the brain.

Answer 12

False - SECONDARY hyperalgesia is associated with changes in the excitability of neurons in the CNS, including the spinal cord and supra-spinal sites in the brain.

Question 13

If one’s ankle gets broken, the entire limb may show increased ___________ to touch, heat, cold, and the person will feel malaise, fatigued, and overall agitated… the entire limb from the above example has now turned into a huge ___________ “source”.

Answer 13

Sensitivity
Nociceptive

Question 14

T/F - One definite and exclusive source of nociception without other systemic effects is theoretically possible.

Answer 14

True

Question 15

There are now good grounds to believe that in some cases of __________ pain states, central nociceptive sensitization in the spinal cord has become __________.

Answer 15

Persistent (x2)

Question 16

A physical feeling from contact with the body. The ability to feel something physically.

Answer 16

Sensation

Question 17

T/F - Perception is a mental process (e.g. seeing, hearing, smelling) resulting from immediate external stimulation of a sense organ.

Answer 17

False - SENSATION is a mental process (e.g. seeing, hearing, smelling) resulting from immediate external stimulation of a sense organ.

Question 18

Relating to sensation or to the senses. Conveying nerve impulses from the sense organs.

Answer 18

Sensory

Question 19

The state of being or process of becoming aware of something through the senses. Awareness of the elements of the environment through physical sensation.

Answer 19

Perception

Question 20

_________ can be described as:
- Physiological process
- Information about the physical world via our sensory receptors
- Involves specialized neurons that respond to specific types of stimuli
- Sensory information is detected by a sensory receptor
- Transduction is a characteristic

Answer 20

Sensation

Question 21

__________ can be described as:
- Psychological process
- Process by which sensations are organized and interpreted
- Differ from person to person based on the individual’s memory, emotions, expectations and learning

Answer 21

Perception

Question 22

Conversion from sensory stimulus energy to action potential.

Answer 22

Transduction

Question 23

T/F - Sensation cannot occur without perception.

Answer 23

False - Sensation CAN occur without perception.

Question 24

Perceptions built from sensory input. There is no context to the experience

Answer 24

Bottom-Up

Question 25

Interpretation of sensations influenced by what we know, have experienced, and are what we think. There is context to the experience.

Answer 25

Top-Down

Question 26

What type of perception is being described below?
“Someone jabbed you with a needle, but you don’t know they did it. You feel pain in your arm.”

Answer 26

Bottom-Up

Question 27

What type of perception is being described below?
“Someone jabbed you with a blood filled needle in a dark alley, and you know they did it. You feel no pain in your arm because you are freaked out and scared for your life.”

Answer 27

Top-Down

Question 28

Features of __________ that may be present with a pain experience include:
- Belief
- Memory
- Fear
- Hope
- Imagination

Answer 28

Perception