Regional - Quiz 1
Review of material for test one going over pain pathways and pain management.
- 1.
Which of the ascending pathways innervates the peripheral tissue and sends stimuli to the dorsal horn?
- A.
First Order neurons
- B.
Second Order Neurons
- C.
Third Order Neurons
- D.
All The Above
Correct Answer
A. First Order neuronsExplanation
First order neurons are responsible for carrying sensory information from the peripheral tissue to the dorsal horn of the spinal cord. They transmit stimuli such as pain, temperature, and touch from the sensory receptors in the periphery to the central nervous system. Second order neurons then relay this information from the spinal cord to the brain, while third order neurons carry the information from the thalamus to the appropriate sensory cortex in the brain. Therefore, the ascending pathway that innervates the peripheral tissue and sends stimuli to the dorsal horn is the first order neurons.Rate this question:
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- 2.
Which of the ascending pathways cross the spinal cord and ascend on the contralateral tract?
- A.
First Order Neurons
- B.
Second Order Neurons
- C.
Third Order Neurons
- D.
All The Above
Correct Answer
B. Second Order NeuronsExplanation
Second order neurons are the ones that cross the spinal cord and ascend on the contralateral tract. This is because these neurons receive input from the first order neurons, which enter the spinal cord on the same side, and then cross over to the opposite side of the spinal cord before ascending to the brain. Therefore, the correct answer is Second Order Neurons.Rate this question:
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- 3.
Which of the ascending pathways sends stimuli from the thalamus to the postcentral gyrus?
- A.
First order Neurons
- B.
Second order Neurons
- C.
Third order Neurons
- D.
All the Above
Correct Answer
C. Third order NeuronsExplanation
The ascending pathways are responsible for transmitting sensory information from the body to the brain. The postcentral gyrus is the primary somatosensory cortex, where sensory information is processed. The thalamus acts as a relay station for sensory information, receiving signals from the peripheral nerves and sending them to the appropriate areas of the cerebral cortex. The third order neurons in the ascending pathways carry the sensory information from the thalamus to the postcentral gyrus, where it is further processed and interpreted. Therefore, the correct answer is "Third order Neurons."Rate this question:
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- 4.
Which of the following ascending pathways transmits noxious stimuli?
- A.
First Order Neurons
- B.
Second order neurons
- C.
Third order Neurons
- D.
All the Above
Correct Answer
D. All the AboveExplanation
All the above options are correct because all three types of neurons in the ascending pathway - first order, second order, and third order neurons - are involved in transmitting noxious stimuli. First order neurons receive the sensory input from the peripheral nerves and carry it to the spinal cord or brainstem. Second order neurons relay the signals from the first order neurons to higher brain centers. Third order neurons transmit the signals from the second order neurons to the cerebral cortex for perception and interpretation of pain. Therefore, all three types of neurons play a role in transmitting noxious stimuli.Rate this question:
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- 5.
Which area of the parietal cortex received noxious stimuli from third order neurons?
- A.
PostCentral Gyrus
- B.
Limbic System
- C.
Amygdala
- D.
Medulla
Correct Answer
A. PostCentral Gyrus -
- 6.
Which of the ascending pathways releases Substance P?
- A.
None, released by glands.
- B.
First Order Neurons
- C.
Second Order Neurons
- D.
Third order neurons
Correct Answer
B. First Order NeuronsExplanation
Substance P is released by first order neurons in the ascending pathways. First order neurons are responsible for transmitting sensory information from the peripheral nervous system to the central nervous system. These neurons play a crucial role in the transmission of pain signals and are involved in the release of Substance P, which is a neuropeptide involved in pain perception and inflammation.Rate this question:
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- 7.
Substance P works on what receptors to facilitate transmission of pain?
- A.
Mu receptors
- B.
Lamina 2 receptors
- C.
NK-1 receptors
- D.
P45 receptors
Correct Answer
C. NK-1 receptors -
- 8.
You are the SRNA today Mr. Payne. You have just given him a dose of opioids post op when your preceptor asks what the major site of action for opioids is. What is your response?
- A.
Lamina I
- B.
Lamina V
- C.
Lamina IV
- D.
Lamina II
Correct Answer
D. Lamina II -
- 9.
You were doing some exercise today and decided to ride your bike. While out riding you hit a rock, went flying over the handle bars, and landed on your back. Now you are all sore as you walk home. When you get home you decided to take some Tylenol to relieve your pain. Being a good student you reflect back to pharmacology and ponder how Tylenol is able to relieve you pain. You are happy and feel so smart because you know that Tylenol….
- A.
Is a COX inhibitor, so it prevents arachidonic acid from converting to Prostaglandins which causes pain.
- B.
Blocks activation of phospholipase A to inhibit prostanglandin production.
- C.
Is a leukotriene inhibitor and breaks down bradykinin.
- D.
Inhibits transmission of Substance P by blocking NK-1 receptors.
Correct Answer
A. Is a COX inhibitor, so it prevents arachidonic acid from converting to Prostaglandins which causes pain. -
- 10.
You have just made a horrible mistake. You bought yourself a nice cold milkshake and slurped half of it down as fast as you could. Suddenly, as the cold shake cools your throat you feel the most horrendous brain freeze you have ever felt. As you attempt to relieve yourself from the excruciating brain freeze you realize this is an example of ‘referred pain’… and then begin to curse which lamina of the second order neurons for being responsible for this?
- A.
Lamina I
- B.
Lamina V
- C.
Lamina VII
- D.
Lamina II
Correct Answer
B. Lamina V -
- 11.
Which type of nerve fiber would most likely be used to transmit pain associated with an IV stick?
- A.
A alpha fibers
- B.
C Fibers
- C.
A delta fibers
- D.
D fiber
Correct Answer
C. A delta fibers -
- 12.
Which form of nerve fiber is responsible for post-op pain after a colectomy?
- A.
A Alpha fibers
- B.
D fibers
- C.
A delta fibers
- D.
C fibers
Correct Answer
D. C fibers -
- 13.
Which form of nociceptor would respond to the pain associated a pinch or pinprick?
- A.
Mechanonociceptor
- B.
Silent Nociceptor
- C.
Polymodal mechoheat nociceptors
- D.
Somatic Nociceptors
Correct Answer
A. Mechanonociceptor -
- 14.
Which form of nociceptor would transmit the pain associated an inflamed gallbladder?
- A.
Mechanonociceptor
- B.
Silent Nociceptor
- C.
Polymodal mechoheat nociceptors
- D.
Somatic Nociceptors
Correct Answer
B. Silent Nociceptor -
- 15.
Which form of nociceptor would be involved in feeling heat when holding your hand over a candle?
- A.
Mechanonociceptor
- B.
Silent Nociceptor
- C.
Polymodal mechoheat nociceptors
- D.
Somatic Nociceptors
Correct Answer
C. Polymodal mechoheat nociceptors -
- 16.
Which of the following does not enhance pain transmission?
- A.
Histamine
- B.
Serotonin
- C.
Prostaglandins
- D.
Norepinephrine
Correct Answer
D. Norepinephrine -
- 17.
Mrs. Terren broke her elbow last week when she tripped over her son’s toys in the middle of the night. She is still having dull and aching pain in that elbow, even after it was set and put into a cast. How would you classify this type of pain?
- A.
Acute Deep Somatic Pain
- B.
Acute Visceral Pain
- C.
Chronic Pain
- D.
Acute Superficial Somatic Pain
Correct Answer
A. Acute Deep Somatic Pain -
- 18.
Mrs. Terren is still having pain in her elbow. She broke it 6 months ago and the cast has been off for 4 months. The X-rays all say it is healed but it still hurts her on a regular basis. How would you classify this type of pain?
- A.
Acute Somatic Pain
- B.
Chronic Pain
- C.
Acute Visceral
- D.
None of above
Correct Answer
B. Chronic Pain -
- 19.
Which lamina are involved in the immediate transmission of pain resulting shutting a car door on your finger?
- A.
Lamina II, III, V
- B.
Lamina V only
- C.
Lamina I, V
- D.
Lamina I, II, III
Correct Answer
C. Lamina I, V -
- 20.
Which lamina would be involved in transmitting the pain associated with multiple sclerosis?
- A.
Lamina I, II, III
- B.
Lamina V only
- C.
Lamina I, V
- D.
Lamina I, II, V
Correct Answer
D. Lamina I, II, VExplanation
C fibers transmit this painRate this question:
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- 21.
Which of the following is the major neurotransmitter released from A delta fibers?
- A.
Glutamate
- B.
Substance P
- C.
Dynorphin
- D.
Capsaicin
Correct Answer
A. Glutamate -
- 22.
Which of the following is the major neurotransmitter released from C fibers?
- A.
Glutamate
- B.
Substance P
- C.
Dynorphin
- D.
Capsaicin
Correct Answer
B. Substance P -
- 23.
Which of the following is responsible for modulating pain?
- A.
Dorsal Horn
- B.
Posterior Thalamus
- C.
Dorsolateral Funiculus
- D.
Substantia gelatinosa
Correct Answer
C. Dorsolateral Funiculus -
- 24.
You are caring for Mr. Dorsey today is having a sharp in the right lower quadrant of his abdomen. He has been diagnosed with acute appendicitis. You realize this is an acute pain, but what type?
- A.
True Parietal Acute Visceral
- B.
True Visceral Acute Visceral
- C.
Acute Deep Somatic
- D.
Acute Referred visceral
Correct Answer
A. True Parietal Acute Visceral -
- 25.
You are taking care of Ms. Batiste today. She is asleep in bed and all tangled up. You decide to fluff out her sheets to straighten them. As the soft, fluffy sheets touch her skin she yelps out in pain. Fluffy sheets are ordinarily a non-noxious stimulus, yet she is feeling pain. What is this an example of?
- A.
Parasthesia
- B.
Allodynia
- C.
Hyperalgesia
- D.
Neuralgia
Correct Answer
B. Allodynia -
- 26.
The absence of all sensation is known as:
- A.
Hypoalgesia
- B.
Analgesia
- C.
Parasthesia
- D.
Anesthesia
Correct Answer
D. Anesthesia -
- 27.
During surgery your patient suffered a complication when their trigeminal nerve was accidentally damaged during the procedure. After the surgery is over, the patient experiences numbness in their face, but says they have pain within the area of numbness. This would be an example of:
- A.
Anesthesia Dolorosa
- B.
Allodynia
- C.
Hypesthesia
- D.
Parasthesia
Correct Answer
A. Anesthesia Dolorosa -
- 28.
Unpleasant or abnormal sensation with or without a stimulus, as commonly seen in diabetics is known as:
- A.
Hyperalgesia
- B.
Dysesthesia
- C.
Anesthesia Dolorosa
- D.
Radiculopathy
Correct Answer
B. DysesthesiaExplanation
Dysesthesia refers to an unpleasant or abnormal sensation that can occur with or without a stimulus. It is commonly observed in individuals with diabetes. This condition is characterized by sensations such as burning, tingling, or numbness, which can be quite uncomfortable for the affected individual. Hyperalgesia refers to an increased sensitivity to pain, anesthesia dolorosa refers to painful numbness, and radiculopathy refers to nerve root damage. However, neither of these terms specifically captures the broader range of abnormal sensations experienced in dysesthesia.Rate this question:
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- 29.
Dimiished response to a noxious stimulus is known as:
- A.
Radiculopathy
- B.
Dysesthesia
- C.
Hypalgesia
- D.
Parasthesia
Correct Answer
C. HypalgesiaExplanation
Hypalgesia refers to a diminished response to a noxious stimulus. It is a condition where the individual experiences reduced sensitivity to painful stimuli. This can be caused by various factors such as nerve damage, certain medications, or neurological disorders. Unlike radiculopathy, which involves compression or irritation of the nerve roots, hypalgesia specifically relates to a decreased perception of pain. Dysesthesia refers to abnormal sensations, and paresthesia refers to abnormal tingling or prickling sensations.Rate this question:
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- 30.
You are doing a glucose check on a patient. After you prick his finger he falls to the ground writhing in pain. He calls you a bastard and claims this is the worst pain of his entire life, he mutters something about the Geneva convention but it is muffled by the tears. Sure, it was a noxious stimuli but this response is highly exaggerated. What is this an example of?
- A.
Radiculopathy
- B.
Anesthesia Dolorosa
- C.
Allodynia
- D.
Hyperalgesia
Correct Answer
D. HyperalgesiaExplanation
Hyperalgesia refers to an increased sensitivity to pain, resulting in a heightened response to a painful stimulus. In this scenario, the patient's reaction to a simple finger prick is excessive and disproportionate, indicating hyperalgesia. The term "noxious stimuli" mentioned in the question further supports this explanation, as hyperalgesia specifically involves an amplified response to painful stimuli. The other options (radiculopathy, anesthesia dolorosa, and allodynia) do not accurately describe the exaggerated pain response exhibited by the patient.Rate this question:
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- 31.
When you combine hyperesthesia, allodynia, and hyperalgesia what do you get?
- A.
Hyperpathia
- B.
Radiculopathy
- C.
Hyperneuralgia
- D.
Acute Polyradiculopathy
Correct Answer
A. HyperpathiaExplanation
When you combine hyperesthesia (increased sensitivity to touch), allodynia (pain response to non-painful stimuli), and hyperalgesia (increased sensitivity to pain), you get hyperpathia. Hyperpathia refers to an abnormal and exaggerated response to painful stimuli. It is characterized by an increased perception of pain, prolonged pain after the stimulus is removed, and a reduced pain threshold.Rate this question:
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- 32.
Reduced cutaneous sensation is known as?
- A.
Hypalgesia
- B.
Hypesthesia
- C.
Parasthesia
- D.
Dysesthesia
Correct Answer
B. HypesthesiaExplanation
Hypesthesia refers to a reduced sensitivity or diminished sensation in the skin. This can occur due to various reasons such as nerve damage, injury, or certain medical conditions. Hypesthesia can affect different areas of the body and may result in a decreased ability to feel touch, pressure, temperature, or pain.Rate this question:
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- 33.
What is neuralgia?
- A.
Functional abnormality of one or more nerve roots
- B.
Abnormal sensation perceived without an apparent stimulus
- C.
Pain in the distribution of a nerve or a group of nerves.
- D.
The sensation I am feeling right now having to study all the BS.
Correct Answer
C. Pain in the distribution of a nerve or a group of nerves.Explanation
Neuralgia refers to pain that occurs in the distribution of a nerve or a group of nerves. It is characterized by sharp, shooting, or burning pain that can be intermittent or constant. This pain is typically caused by irritation or damage to the nerves, which can be due to various factors such as inflammation, compression, or injury. Neuralgia can affect any part of the body and is often described as a stabbing or electric shock-like sensation. Treatment options for neuralgia may include medications, nerve blocks, physical therapy, or in some cases, surgery.Rate this question:
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- 34.
What is parasthesia?
- A.
Functional abnormality of one or more nerve roots
- B.
Abnormal sensation perceived without an apparent stimulus
- C.
Pain in the distribution of a nerve or a group of nerves.
- D.
Pain in an area the lacks sensation
Correct Answer
B. Abnormal sensation perceived without an apparent stimulusExplanation
Parasthesia refers to an abnormal sensation that is perceived without any apparent stimulus. This means that individuals experience sensations such as tingling, numbness, or a "pins and needles" feeling without any external cause. It is important to note that parasthesia can occur due to various underlying causes, including nerve damage or compression, certain medical conditions, or side effects of medication.Rate this question:
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- 35.
What is Radiculopathy?
- A.
Functional abnormality of one or more nerve roots
- B.
Abnormal sensation perceived without an apparent stimulus
- C.
Pain in the distribution of a nerve or a group of nerves.
- D.
Pain in an area the lacks sensation
Correct Answer
A. Functional abnormality of one or more nerve roots -
- 36.
What would be an appropriate four hour limit of Morphine for a patient on a PCA pump? This pt weighs 60 kg.
- A.
3.6 mg
- B.
180 mg
- C.
60 mg
- D.
18 mg
Correct Answer
D. 18 mg -
- 37.
What is an appropriate four hour limit of Fentanyl for a patient on a PCA pump? This patient weighs 45 kg.
- A.
135 mcg
- B.
13.5 mcg
- C.
2.7 mcg
- D.
45 mcg
Correct Answer
A. 135 mcg -
- 38.
What is an appropriate four hour limit of Dilaudid for a patient on a PCA pump? This patient weighs 50 kg.
- A.
150 mcg
- B.
3 mg
- C.
15 mg
- D.
50 mg
Correct Answer
B. 3 mg -
- 39.
What is nociceptive pain?
- A.
Pain that is the result of injury or acquired abnormalities of peripheral or central neural structures.
- B.
Pain that results directly from a disease process.
- C.
Pain caused by activation or sensitization of peripheral nociceptors, which transmit noxious stimuli.
- D.
None of the above
Correct Answer
C. Pain caused by activation or sensitization of peripheral nociceptors, which transmit noxious stimuli. -
- 40.
What is neuropathic pain?
- A.
Pain that is the result of injury or acquired abnormalities of peripheral or central neural structures.
- B.
Pain that results directly from a disease process.
- C.
Pain causes by activation or sensitization of peripheral nociceptors, which transmit noxious stimuli.
- D.
None of the above
Correct Answer
A. Pain that is the result of injury or acquired abnormalities of peripheral or central neural structures.Explanation
Neuropathic pain refers to pain that is caused by damage or abnormalities in the nerves of the peripheral or central nervous system. This type of pain can occur as a result of injury, trauma, or certain medical conditions. It is different from pain that directly arises from a disease process or from the activation of peripheral nociceptors. Therefore, the correct answer is "Pain that is the result of injury or acquired abnormalities of peripheral or central neural structures."Rate this question:
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- 41.
A and B fibers are __________ while C fibers are _________.
- A.
Unmyelinated, myelinated
- B.
Slow, Fast
- C.
Myelinated, unmyelinated
- D.
Thin, thick
Correct Answer
C. Myelinated, unmyelinatedExplanation
A fibers and B fibers are myelinated, meaning they are surrounded by a protective layer called myelin. This allows for faster transmission of signals along these nerve fibers. On the other hand, C fibers are unmyelinated, meaning they lack this protective layer. This results in slower transmission of signals along C fibers compared to A and B fibers.Rate this question:
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- 42.
Which of the following nerve fibers has the fastest velocity of conduction?
- A.
A delta fibers
- B.
B fibers
- C.
C fibers
- D.
A alpha fibers
Correct Answer
D. A alpha fibersExplanation
Alpha fibers are large myelinated nerve fibers that have the fastest velocity of conduction compared to other types of nerve fibers. They are responsible for transmitting sensory information related to proprioception (awareness of body position) and motor commands for muscle contraction. The myelin sheath surrounding alpha fibers allows for faster transmission of electrical impulses, resulting in quicker conduction velocity. This enables rapid and precise communication between the brain and the rest of the body, facilitating efficient motor control and sensory perception.Rate this question:
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- 43.
What type of fibers innervate the larynx?
- A.
C fibers
- B.
B fibers
- C.
A fibers
- D.
All the above
Correct Answer
A. C fibersExplanation
C fibers innervate the larynx.Rate this question:
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- 44.
How do corticosteroids help to produce analgesia?
- A.
Through inhibition of the COX pathway, which turns arachidonic acid into PGE.
- B.
Through inhibition of phospholipase A which acts on phospolipds to make arachidonic acid
- C.
Through inhibition of bradykinin which relieves inflammation
- D.
All the above
Correct Answer
B. Through inhibition of phospholipase A which acts on phospolipds to make arachidonic acid -
- 45.
Nociceptive nerve ending will respond to all of the following except….
- A.
Heat damage
- B.
Mechanical damage
- C.
Disease damage
- D.
Chemical damage
Correct Answer
C. Disease damage -
- 46.
Which of the following is not an alogen?
- A.
Bradykinin
- B.
Serotonin
- C.
Histamine
- D.
Epinephrine
Correct Answer
D. Epinephrine -
- 47.
Which of the following is not true regarding the substantia gelatinosa?
- A.
Synthesizes and releases Substance P
- B.
Also known as Lamina II
- C.
Is believed to be the main site of action for opioids
- D.
Plays a major role in processing and modulating nociceptive input from cutaneous receptors
Correct Answer
A. Synthesizes and releases Substance P -
- 48.
Alpha delta fibers primarily synapse in which Lamina? (two answers)
- A.
I
- B.
II
- C.
V
- D.
VII
Correct Answer(s)
A. I
C. V -
- 49.
The C fibers primarily synapse in which lamina? (two answers)
- A.
X
- B.
I
- C.
IV
- D.
II
Correct Answer(s)
B. I
D. IIExplanation
MM 365 (I know linda's notes say II & III.... but I am going with the book)Rate this question:
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- 50.
How are facial first order neurons different from other first order neurons?
- A.
Are carried by facial nerves to the brain stem where they synapse with second order neurons.
- B.
Synapse with second order neurons in the dorsal horn
- C.
Are much thicker and transmit non painful stimuli
- D.
None of above
Correct Answer
A. Are carried by facial nerves to the brain stem where they synapse with second order neurons. -
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