Week 6: Physiology and Classification of Pain Flashcards

1
Q

Define

Pathophysiology

A

The study of the functional changes in the body that result from a disease or injury.

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2
Q

Define

Nociceptive Pain

A

Pain caused by tissue damage, typically from injury or inflammation, involving the activation of nociceptors.

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3
Q

Define

Somatic Pain

A

A type of nociceptive pain originating from the skin, muscles, bones, and joints, often well-localized and sharp.

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4
Q

Define

Visceral Pain

A

A type of nociceptive pain arising from internal organs, often diffuse and hard to pinpoint.

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5
Q

Define

Neuropathic Pain

A

Pain caused by damage or disease affecting the nervous system, often leading to chronic pain and abnormal pain processing.

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6
Q

Define

Psychogenic (Somatoform) Pain

A

Pain that is real and persistent but has no identifiable physical cause, often related to psychological factors.

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7
Q

Define

Afferent Pathway

A

The nerve pathway that transmits sensory information, such as pain signals, from the body to the central nervous system.

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8
Q

Define

Efferent Pathways

A

Nerve pathways that carry signals away from the central nervous system to muscles, triggering a response.

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9
Q

Define

Nociceptors

A

Sensory receptors that respond to potentially harmful stimuli by sending pain signals to the brain.

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10
Q

Define

Transduction

A

The process of converting energy from a harmful stimulus into electrical signals in the nervous system.

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11
Q

Define

Transmission

A

The process of pain signals traveling from the site of injury through the nervous system to the brain.

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12
Q

Define

Perception

A

The conscious awareness of pain, involving various brain structures such as the somatosensory system and limbic system.

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13
Q

Define

Modulation

A

The process by which pain signals are amplified or dampened as they travel through the nervous system.

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14
Q

Define

Endogenous Opioids

A

Natural pain-relieving chemicals in the body, such as endorphins and enkephalins, that modulate pain.

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15
Q

Define

Gate Theory

A

A theory that suggests pain signals can be modulated by a “gate” mechanism in the spinal cord, which can either amplify or inhibit pain perception.

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16
Q

Define

A-delta Fibres

A

Fast-conducting nerve fibers responsible for transmitting sharp, well-localized pain.

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17
Q

Define

C Fibres

A

Slow-conducting nerve fibers responsible for transmitting dull, diffuse, and aching pain.

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18
Q

Define

A-beta Fibres

A

Large, myelinated nerve fibers that transmit non-painful stimuli and are involved in the inhibition of pain through the gate theory.

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19
Q

Define

Neuropathic Pain Mechanisms

A

The processes by which damage to the peripheral or central nervous system leads to abnormal pain perception.

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20
Q

Define

Peripheral Sensitisation

A

A mechanism in which damaged tissues release substances that increase the sensitivity of nociceptors, leading to heightened pain responses.

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21
Q

Define

Acute Pain

A

Pain with a sudden onset, typically associated with injury or illness, lasting for a short period and generally subsiding as healing occurs.

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22
Q

Define

Persistent Pain

A

Also known as chronic pain, it persists beyond the normal healing time, lasting for more than 3-6 months, and often lacks a clear cause.

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23
Q

Define

Superficial Somatic Pain

A

Pain that originates from the skin, mucous membranes, or subcutaneous tissues, typically described as sharp or throbbing.

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24
Q

Define

Deep Somatic Pain

A

Pain arising from muscles, bones, joints, tendons, or blood vessels, usually described as dull or aching.

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25
Q

Define

Referred Pain

A

Pain perceived at a location other than the site of the painful stimulus, often due to the convergence of nerve signals.

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26
Q

Define

Cancer Pain

A

Pain associated with cancer, which can be due to tumor progression, treatments, or physical limitations, often persistent but sometimes acute.

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27
Q

Define

Breakthrough Pain

A

A sudden, intense flare-up of pain that occurs despite ongoing pain management, commonly seen in individuals with chronic conditions like cancer.

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28
Q

Define

Intractable Pain

A

Severe, persistent pain that is resistant to standard medical treatment, often leading to significant physical and psychological distress.

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29
Q

Define

Phantom Pain

A

Pain felt in a part of the body that has been amputated, thought to be related to the ongoing transmission of nerve impulses in the area.

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30
Q

Define

Hyperalgesia

A

An increased sensitivity to pain, often occurring in the tissue surrounding an affected organ, making normally non-painful stimuli painful.

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31
Q

Define

Opioid-Responsive Pain

A

Pain that can be effectively managed with opioid medications, commonly used for moderate to severe nociceptive pain.

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32
Q

Define

Polyneuropathy

A

A condition involving damage to multiple peripheral nerves, which can lead to neuropathic pain and other neurological symptoms.

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33
Q

Define

NMDA Receptors

A

A type of receptor in the central nervous system involved in pain transmission and modulation, particularly in persistent pain states.

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34
Q

Define

Diaphoresis

A

Excessive sweating, often a symptom of acute pain or sympathetic nervous system activation.

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35
Q

What is

The study of the functional changes in the body that result from a disease or injury.

A

Pathophysiology

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36
Q

What is

Pain caused by tissue damage, typically from injury or inflammation, involving the activation of nociceptors.

A

Nociceptive Pain

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37
Q

What is

A type of nociceptive pain originating from the skin, muscles, bones, and joints, often well-localized and sharp.

A

Somatic Pain

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38
Q

What is

A type of nociceptive pain arising from internal organs, often diffuse and hard to pinpoint.

A

Visceral Pain

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39
Q

What is

Pain caused by damage or disease affecting the nervous system, often leading to chronic pain and abnormal pain processing.

A

Neuropathic Pain

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40
Q

What is

Pain that is real and persistent but has no identifiable physical cause, often related to psychological factors.

A

Psychogenic (Somatoform) Pain

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41
Q

What is

The nerve pathway that transmits sensory information, such as pain signals, from the body to the central nervous system.

A

Afferent Pathway

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42
Q

What is

Nerve pathways that carry signals away from the central nervous system to muscles, triggering a response.

A

Efferent Pathways

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43
Q

What is

Sensory receptors that respond to potentially harmful stimuli by sending pain signals to the brain.

A

Nociceptors

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44
Q

What is

The process of converting energy from a harmful stimulus into electrical signals in the nervous system.

A

Transduction

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45
Q

What is

The process of pain signals traveling from the site of injury through the nervous system to the brain.

A

Transmission

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46
Q

What is

The conscious awareness of pain, involving various brain structures such as the somatosensory system and limbic system.

A

Perception

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47
Q

What is

The process by which pain signals are amplified or dampened as they travel through the nervous system.

A

Modulation

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48
Q

What is

Natural pain-relieving chemicals in the body, such as endorphins and enkephalins, that modulate pain.

A

Endogenous Opioids

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49
Q

What is

A theory that suggests pain signals can be modulated by a “gate” mechanism in the spinal cord, which can either amplify or inhibit pain perception.

A

Gate Theory

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50
Q

What is

Fast-conducting nerve fibers responsible for transmitting sharp, well-localized pain.

A

A-delta Fibres

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51
Q

What is

Slow-conducting nerve fibers responsible for transmitting dull, diffuse, and aching pain.

A

C Fibres

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52
Q

What is

Large, myelinated nerve fibers that transmit non-painful stimuli and are involved in the inhibition of pain through the gate theory.

A

A-beta Fibres

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53
Q

What is

The processes by which damage to the peripheral or central nervous system leads to abnormal pain perception.

A

Neuropathic Pain Mechanisms

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54
Q

What is

A mechanism in which damaged tissues release substances that increase the sensitivity of nociceptors, leading to heightened pain responses.

A

Peripheral Sensitisation

How well did you know this?
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55
Q

What is

Pain with a sudden onset, typically associated with injury or illness, lasting for a short period and generally subsiding as healing occurs.

A

Acute Pain

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56
Q

What is

Also known as chronic pain, it persists beyond the normal healing time, lasting for more than 3-6 months, and often lacks a clear cause.

A

Persistent Pain

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57
Q

What is

Pain that originates from the skin, mucous membranes, or subcutaneous tissues, typically described as sharp or throbbing.

A

Superficial Somatic Pain

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58
Q

What is

Pain arising from muscles, bones, joints, tendons, or blood vessels, usually described as dull or aching.

A

Deep Somatic Pain

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59
Q

What is

Pain perceived at a location other than the site of the painful stimulus, often due to the convergence of nerve signals.

A

Referred Pain

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60
Q

What is

Pain associated with cancer, which can be due to tumor progression, treatments, or physical limitations, often persistent but sometimes acute.

A

Cancer Pain

61
Q

What is

A sudden, intense flare-up of pain that occurs despite ongoing pain management, commonly seen in individuals with chronic conditions like cancer.

A

Breakthrough Pain

62
Q

What is

Severe, persistent pain that is resistant to standard medical treatment, often leading to significant physical and psychological distress.

A

Intractable Pain

63
Q

What is

Pain felt in a part of the body that has been amputated, thought to be related to the ongoing transmission of nerve impulses in the area.

A

Phantom Pain

64
Q

What is

An increased sensitivity to pain, often occurring in the tissue surrounding an affected organ, making normally non-painful stimuli painful.

A

Hyperalgesia

65
Q

What is

Pain that can be effectively managed with opioid medications, commonly used for moderate to severe nociceptive pain.

A

Opioid-Responsive Pain

66
Q

What is

A condition involving damage to multiple peripheral nerves, which can lead to neuropathic pain and other neurological symptoms.

A

Polyneuropathy

67
Q

What is

A type of receptor in the central nervous system involved in pain transmission and modulation, particularly in persistent pain states.

A

NMDA Receptors

68
Q

What is

Excessive sweating, often a symptom of acute pain or sympathetic nervous system activation.

A

Diaphoresis

69
Q

What is the IASP’s revised definition of pain?

A

An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.

70
Q

What are the three main classifications of pain based on etiology/pathways?

A

Nociceptive, neuropathic, and psychogenic (somatoform) pain.

71
Q

What are the four processes involved in the transmission of nociceptive pain?

A

Transduction, transmission, perception, and modulation.

72
Q

What are A-delta fibers responsible for transmitting?

A

Well-localized, sharp pain that is sensitive to mechanical and thermal stimuli.

73
Q

What is the Gate Theory of pain?

A

A theory proposing that there is a “gate” in the spinal cord that can facilitate or inhibit transmission of pain signals.

74
Q

What is the difference between acute and persistent pain in terms of duration?

A

Acute pain lasts less than three months, while persistent pain lasts longer than three months.

75
Q

What are some examples of chemical mediators released during the transduction phase of nociceptive pain?

A

Prostaglandins, substance P, histamine, bradykinins, serotonin, and potassium.

76
Q

What is allodynia?

A

Pain due to a stimulus that does not normally provoke pain, such as touch.

77
Q

What is hyperalgesia?

A

An increased pain response to noxious stimuli.

78
Q

What are the two types of nociceptive pain?

A

Somatic and visceral pain.

79
Q

What is referred pain?

A

Pain that is felt at a site other than the injured/diseased organ or body part.

80
Q

What is phantom pain?

A

Pain felt in a body part that is missing.

81
Q

What are some psychological factors that can influence pain perception?

A

Anxiety, sense of helplessness, depressive mood, and cognitive deficits.

82
Q

What is the persistent pain cycle?

A

A cycle where pain leads to various psychosocial issues (e.g., depression, sleep disorders, isolation) which in turn can exacerbate the pain experience.

83
Q

What is the difference between pain threshold and pain tolerance?

A

Pain threshold is the point at which a stimulus is felt as painful, while pain tolerance is the duration or intensity of pain a person is willing to endure.

84
Q

What are C fibers responsible for transmitting?

A

Poorly localized, dull and aching pain that is sensitive to mechanical, thermal, and chemical stimuli.

85
Q

What is the function of A-beta fibers in pain transmission?

A

They respond to light touch and transmit non-noxious stimuli. They are involved in the gate theory of pain inhibition.

86
Q

What are the three main areas of the brain involved in pain perception?

A

The reticular formation, thalamus, and cortex.

87
Q

What is central sensitization?

A

Hyperexcitability of central neurons initiated by prolonged binding of neurotransmitters like glutamate and substance P.

88
Q

What is the difference between somatic and visceral nociceptive pain?

A

Somatic pain is well-localized and originates from skin, muscles, and joints, while visceral pain is poorly localized and originates from organs and body cavities.

89
Q

What are endogenous opioids and how do they affect pain?

A

They are naturally occurring pain-inhibiting substances in the body, such as endorphins and enkephalins, that help modulate pain signals.

90
Q

What is the role of the NMDA receptor in persistent pain?

A

NMDA receptor activation is involved in central sensitization and the development of persistent pain states.

91
Q

What is breakthrough pain?

A

Sudden onset, short-duration pain that occurs despite ongoing pain management, common in cancer patients.

92
Q

How does persistent pain differ from acute pain in terms of treatment goals?

A

Acute pain treatment aims for pain control and eventual elimination, while persistent pain treatment focuses on pain control to the extent possible and enhancing function and quality of life.

93
Q

What is catastrophizing in the context of pain?

A

Negative thinking patterns where patients believe their pain will never improve or that it’s the worst possible scenario.

94
Q

How can cultural factors influence pain perception?

A

Cultural beliefs and practices can affect how pain is expressed, perceived, and managed.

95
Q

What is the role of the limbic system in pain perception?

A

The limbic system is involved in the emotional and affective aspects of pain perception.

96
Q

What is intractable pain?

A

Pain that is not relieved by ordinary medical, surgical, or nursing measures and is usually persistent and excruciating.

97
Q

How does sleep disturbance relate to persistent pain?

A

Sleep disturbances can exacerbate pain, and persistent pain can lead to sleep problems, creating a cyclical relationship.

98
Q

What is the difference between primary and secondary hyperalgesia?

A

Primary hyperalgesia occurs at the site of injury, while secondary hyperalgesia occurs in surrounding uninjured tissue.

99
Q

How does the sympathetic nervous system respond to acute pain?

A

It can cause increased heart rate, blood pressure, respiratory rate, and other physiological changes.

100
Q

What is the role of substance P in pain transmission?

A

Substance P is a neurotransmitter that helps transmit pain signals and contributes to neurogenic inflammation.

101
Q

How does cognitive-behavioral therapy (CBT) help in managing persistent pain?

A

CBT can help patients develop coping strategies, change negative thought patterns, and improve pain management skills.

102
Q

What is the biopsychosocial model of pain?

A

A model that considers biological, psychological, and social factors in understanding and managing pain.

103
Q

How can genetics influence pain perception?

A

Genetic factors can affect pain sensitivity, analgesic response, and susceptibility to certain pain conditions.

104
Q

What is nociception and how does it differ from pain?

A

Nociception is the neural process of encoding noxious stimuli, while pain is the subjective perception and experience of these signals.

105
Q

What is the role of the thalamus in pain processing?

A

The thalamus acts as a relay and processing center for sensory information, including pain signals, before they reach the cortex.

106
Q

How does the gate control theory explain the effectiveness of rubbing a painful area?

A

Rubbing activates large-diameter A-beta fibers, which can “close the gate” on pain signals carried by smaller nerve fibers.

107
Q

What is wind-up in the context of pain?

A

Wind-up refers to the progressive increase in pain perception due to repeated stimulation of C-fibers, leading to increased excitability of spinal cord neurons.

108
Q

How does chronic pain affect the brain over time?

A

Chronic pain can lead to changes in brain structure and function, including alterations in gray matter density and connectivity patterns.

109
Q

What is the role of descending pain modulation?

A

Descending pain modulation involves pathways from the brain that can either inhibit or facilitate pain signals at the spinal cord level.

110
Q

How does anticipation of pain affect pain perception?

A

Anticipation of pain can increase anxiety and activate pain-related brain areas, potentially intensifying the pain experience.

111
Q

What is the difference between tolerance and dependence in pain management?

A

Tolerance is the need for increasing doses of medication to achieve the same effect, while dependence is a physiological adaptation to the medication.

112
Q

How does neuroplasticity contribute to chronic pain conditions?

A

Neuroplasticity can lead to maladaptive changes in the nervous system that perpetuate pain even after the initial injury has healed.

113
Q

What is the role of glial cells in chronic pain?

A

Glial cells, once thought to be merely supportive, are now known to play a crucial role in pain modulation and the development of chronic pain states.

114
Q

How does the placebo effect influence pain perception?

A

The placebo effect can activate endogenous pain modulation systems, leading to real pain relief even without active medication.

115
Q

What is central pain syndrome?

A

Central pain syndrome is pain initiated by a primary lesion or dysfunction in the central nervous system.

116
Q

How does stress affect pain perception?

A

Stress can exacerbate pain by increasing muscle tension, altering hormone levels, and affecting pain modulation systems.

117
Q

What is the role of neuroimaging in pain research?

A

Neuroimaging techniques like fMRI and PET scans help researchers understand how the brain processes pain and how various factors influence this processing.

118
Q

How does catastrophizing affect pain management outcomes?

A

Catastrophizing can lead to increased pain intensity, disability, and poorer treatment outcomes in chronic pain patients.

119
Q

What is the IASP’s definition of pain?
a) A physical sensation caused by tissue damage
b) An unpleasant sensory and emotional experience associated with actual or potential tissue damage
c) A response to noxious stimuli in the body
d) A subjective experience of discomfort

A

b) An unpleasant sensory and emotional experience associated with actual or potential tissue damage

120
Q

Which of the following is NOT a main classification of pain based on etiology?
a) Nociceptive
b) Neuropathic
c) Psychogenic
d) Idiopathic

A

d) Idiopathic

121
Q

What are the four processes involved in nociceptive pain transmission?
a) Sensation, perception, modulation, reaction
b) Transduction, transmission, perception, modulation
c) Reception, conduction, interpretation, response
d) Stimulation, conduction, perception, action

A

b) Transduction, transmission, perception, modulation

122
Q

Which type of nerve fibers are responsible for transmitting sharp, well-localized pain?
a) A-beta fibers
b) A-delta fibers
c) C fibers
d) B fibers

A

b) A-delta fibers

123
Q

What is the primary function of nociceptors?
a) To transmit touch sensations
b) To detect harmful stimuli
c) To modulate pain signals
d) To produce endorphins

A

b) To detect harmful stimuli

124
Q

Which of the following best describes somatic pain?
a) Poorly localized pain from internal organs
b) Well-localized pain from skin, muscles, or joints
c) Burning or shooting pain from nerve damage
d) Psychologically induced pain with no physical cause

A

b) Well-localized pain from skin, muscles, or joints

125
Q

Visceral pain is characterized by:
a) Sharp, well-localized sensations
b) Burning or electric-like sensations
c) Dull, poorly localized, and often referred pain
d) Itching and tingling sensations

A

c) Dull, poorly localized, and often referred pain

126
Q

What is the primary cause of neuropathic pain?
a) Tissue damage
b) Psychological factors
c) Nerve damage or dysfunction
d) Inflammation

A

c) Nerve damage or dysfunction

127
Q

Which of the following is a key difference between acute and persistent pain?
a) Acute pain lasts longer than persistent pain
b) Persistent pain serves a biological purpose, while acute pain does not
c) Acute pain decreases over time, while persistent pain continues beyond normal healing time
d) Persistent pain is always more severe than acute pain

A

c) Acute pain decreases over time, while persistent pain continues beyond normal healing time

128
Q

What is allodynia?
a) An increased response to painful stimuli
b) Pain caused by a stimulus that doesn’t normally provoke pain
c) The absence of pain in response to stimulation
d) A decreased pain threshold

A

b) Pain caused by a stimulus that doesn’t normally provoke pain

129
Q

Which of the following is a physiological change associated with acute pain?
a) Decreased heart rate
b) Lowered blood pressure
c) Increased respiratory rate
d) Decreased muscle tension

A

c) Increased respiratory rate

130
Q

In persistent pain, which of the following physiological changes is commonly observed?
a) Consistently elevated heart rate and blood pressure
b) Increased immune system function
c) Altered sleep patterns
d) Improved appetite and digestion

A

c) Altered sleep patterns

131
Q

Which condition is most likely to cause nociceptive somatic pain?
a) Diabetic neuropathy
b) Appendicitis
c) Osteoarthritis
d) Multiple sclerosis

A

c) Osteoarthritis

132
Q

Neuropathic pain is commonly associated with which of the following conditions?
a) Fractures
b) Muscle strains
c) Shingles (herpes zoster)
d) Kidney stones

A

c) Shingles (herpes zoster)

133
Q

Which of the following is an example of visceral pain?
a) Toothache
b) Migraine
c) Pancreatitis
d) Carpal tunnel syndrome

A

c) Pancreatitis

134
Q

What is catastrophizing in the context of pain?
a) A coping strategy to minimize pain
b) Exaggerated negative thinking about pain experiences
c) A medical treatment for chronic pain
d) Physical therapy exercises for pain management

A

b) Exaggerated negative thinking about pain experiences

135
Q

How can cultural factors influence pain perception?
a) They have no impact on pain perception
b) They only affect acute pain, not chronic pain
c) They can influence how pain is expressed and managed
d) They determine the physical intensity of pain

A

c) They can influence how pain is expressed and managed

136
Q

Which of the following is NOT typically part of the persistent pain cycle?
a) Depression
b) Sleep disorders
c) Increased social engagement
d) Lowered self-esteem

A

c) Increased social engagement

137
Q

What role does the Gate Control Theory play in understanding pain?
a) It explains how certain neurons can “close the gate” on pain signals
b) It describes how pain medications work in the body
c) It outlines the stages of chronic pain development
d) It defines the different types of pain receptors

A

a) It explains how certain neurons can “close the gate” on pain signals

138
Q

Which fact about pain in the elderly is true?

a. Pain is part of the ageing process.

b. Elderly persons often do not report pain because they consider it a normal part of the ageing process.

c. Opioid medications are inappropriate for the elderly

d. The elderly have a greater tolerance to pain than younger adults.

A

b. Elderly persons often do not report pain because they consider it a normal part of the ageing process.

138
Q

How does stress typically affect pain perception?
a) It always reduces pain sensitivity
b) It has no effect on pain perception
c) It can exacerbate pain by increasing muscle tension and affecting pain modulation systems
d) It only affects psychogenic pain, not physical pain

A

c) It can exacerbate pain by increasing muscle tension and affecting pain modulation systems

139
Q

An example of a behavioural indicator of acute pain is:

Question 2Answer

a. Moaning/groaning

b. Rapid shallow breathing

c. All options are correct

d. Restlessness

A

c. All options are correct

140
Q

If pain is not assessed or treated, it can cause:

a. Decreased recovery time

b. A decreased chance of addiction

c. Decreased tolerance to opioids

d. Unnecessary suffering

A

d. Unnecessary suffering

141
Q

Patients who experience pain always demonstrate an elevated pulse rate and blood pressure.

True or False

A

False

142
Q

Allodynia is defined as:

a. Pain due to a lack of nociceptors in the body

b. A failure to feel pain when a stimulus would normally provoke pain

c. Pain caused by a stimulus that does not normally provoke pain

d. A fear of experiencing pain

A

c. Pain caused by a stimulus that does not normally provoke pain

143
Q

Analgesia is defined as:

a. Abnormal physiological response to pain

b. Increased sensitivity to pain

c. Absence of sensitivity to pain

d. Absence of emotional reaction to pain

A

c. Absence of sensitivity to pain

144
Q

Hyperalgesia is defined as:

a. Decreased physiological response to pain

b. Perception of a painful stimulus as more painful than normal

c. Increased vocalisation in reaction to pain

d. Perception of a painful stimulus as less painful than normal

A

b. Perception of a painful stimulus as more painful than normal

145
Q

Paraesthesia is defined as:

a. Abnormal burning, tingling or numbing sensation typically associated with neuropathic pain

b. Abnormal burning, tingling or numbing sensation typically associated with acute pain

c. Abnormal burning, tingling or numbing sensation typically associated with persistent pain

d. Abnormal burning, tingling or numbing sensation typically associated with visceral pain

A

a. Abnormal burning, tingling or numbing sensation typically associated with neuropathic pain

146
Q

The pain threshold is:

a. the point at which a person feels numbness

b. the point at which the body temperature increases

c. the point at which a person feels pain

d. the point at which a person is paralysed by pain

A

c. the point at which a person feels pain

147
Q

Pain tolerance is:

a. the point at which a person is paralysed by pain

b. the level of pain at which a person cries

c. the level of pain at which a person is conscious of the sensation

d. the level of pain that a person can endure

A

d. the level of pain that a person can endure