Regional - Quiz 1 - Quiz & Trivia

1. 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?

Acute Somatic Pain

Chronic Pain

Acute Visceral

None of above

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Explanation

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2. A and B fibers are __________ while C fibers are _________.

Unmyelinated, myelinated

Slow, Fast

Myelinated, unmyelinated

Thin, thick

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.

Explanation

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.

3. Which of the ascending pathways innervates the peripheral tissue and sends stimuli to the dorsal horn?

First Order neurons

Second Order Neurons

Third Order Neurons

All The Above

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.

Explanation

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.

4. Which of the following is not an alogen?

Bradykinin

Serotonin

Histamine

Epinephrine

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Explanation

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5. Which of the ascending pathways sends stimuli from the thalamus to the postcentral gyrus?

First order Neurons

Second order Neurons

Third order Neurons

All the Above

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."

Explanation

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."

6. Which area of the parietal cortex received noxious stimuli from third order neurons?

PostCentral Gyrus

Limbic System

Amygdala

Medulla

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Explanation

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7. Which of the following has the incorrect pairing of neuron and its location?

First order neurons - from peripheral tissue to dorsal horn

Second order neurons - from dorsal horn to thalamus

Third order neurons - from thalamus to post central gyrus

All of the above are correct

This question is asking about the pairing of neurons and their locations. The correct answer is "All of the above are correct." This means that all of the pairings mentioned in the question are incorrect. According to the question, first order neurons should transmit signals from peripheral tissue to the dorsal horn, second order neurons should transmit signals from the dorsal horn to the thalamus, and third order neurons should transmit signals from the thalamus to the postcentral gyrus. However, all of these pairings are incorrect.

Explanation

This question is asking about the pairing of neurons and their locations. The correct answer is "All of the above are correct." This means that all of the pairings mentioned in the question are incorrect. According to the question, first order neurons should transmit signals from peripheral tissue to the dorsal horn, second order neurons should transmit signals from the dorsal horn to the thalamus, and third order neurons should transmit signals from the thalamus to the postcentral gyrus. However, all of these pairings are incorrect.

8. Which of the following is incorrect regarding pain fibers?

A delta fibers are fast, sharp, myelinated, and well-localized

All A fibers (alpha, beta, gamma, and delta) are myelinated

C fibers are non-myelinated, slow, and poorly localized.

A fibers are responsible for throbbing, aching postop pain

A fibers are not responsible for throbbing, aching postop pain. This is incorrect because A fibers are fast, sharp, myelinated, and well-localized, and they are not associated with throbbing, aching pain. Throbbing, aching pain is typically associated with C fibers, which are slow, non-myelinated, and poorly localized.

Explanation

A fibers are not responsible for throbbing, aching postop pain. This is incorrect because A fibers are fast, sharp, myelinated, and well-localized, and they are not associated with throbbing, aching pain. Throbbing, aching pain is typically associated with C fibers, which are slow, non-myelinated, and poorly localized.

9. Which of the ascending pathways cross the spinal cord and ascend on the contralateral tract?

First Order Neurons

Second Order Neurons

Third Order Neurons

All The Above

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.

Explanation

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.

10. 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?

Radiculopathy

Anesthesia Dolorosa

Allodynia

Hyperalgesia

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.

Explanation

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.

11. Nociceptive nerve ending will respond to all of the following except….

Heat damage

Mechanical damage

Disease damage

Chemical damage

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Explanation

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12. You have blister on your heel from trying to break in a new pair of shoes. You feel a very well localized, sharp and burning pain when anything touches the blister. What type of pain is this?

Acute Deep Somatic

Acute True Visceral pain

Acute true Parietal pain

Acute Superficial somatic pain

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Explanation

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13. How are facial first order neurons different from other first order neurons?

Are carried by facial nerves to the brain stem where they synapse with second order neurons.

Synapse with second order neurons in the dorsal horn

Are much thicker and transmit non painful stimuli

None of above

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Explanation

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14. Which of the following would be most painful?

Surgical incision into the kidney

A surgical incision into the skin

Both are equally painful

A surgical incision into the skin would be more painful than a surgical incision into the kidney. The skin has a higher concentration of nerve endings compared to the kidney, making it more sensitive to pain. Additionally, the skin is directly exposed to the external environment, which can lead to increased pain sensation due to factors such as pressure, temperature, and touch. On the other hand, the kidney is located deep inside the body and is protected by layers of tissue, which can help to dampen the pain sensation.

Explanation

A surgical incision into the skin would be more painful than a surgical incision into the kidney. The skin has a higher concentration of nerve endings compared to the kidney, making it more sensitive to pain. Additionally, the skin is directly exposed to the external environment, which can lead to increased pain sensation due to factors such as pressure, temperature, and touch. On the other hand, the kidney is located deep inside the body and is protected by layers of tissue, which can help to dampen the pain sensation.

15. 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?

Lamina I

Lamina V

Lamina IV

Lamina II

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Explanation

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16. Which of the following acts on arachidonic acid to convert it to prostacyclins and PGE?

Lipoxygenase

Factor XII

Phospholipase A

Cyclooxygenase

Cyclooxygenase is the correct answer because it is an enzyme that acts on arachidonic acid to convert it to prostacyclins and PGE. Cyclooxygenase is involved in the synthesis of prostaglandins, which are important mediators of inflammation, pain, and fever. It catalyzes the conversion of arachidonic acid into prostaglandin H2, which is then further metabolized into various prostaglandins including prostacyclins and PGE.

Explanation

Cyclooxygenase is the correct answer because it is an enzyme that acts on arachidonic acid to convert it to prostacyclins and PGE. Cyclooxygenase is involved in the synthesis of prostaglandins, which are important mediators of inflammation, pain, and fever. It catalyzes the conversion of arachidonic acid into prostaglandin H2, which is then further metabolized into various prostaglandins including prostacyclins and PGE.

17. Which form of nociceptor would respond to the pain associated a pinch or pinprick?

Mechanonociceptor

Silent Nociceptor

Polymodal mechoheat nociceptors

Somatic Nociceptors

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Explanation

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18. COMIC RELIEF: Brought to you by the Bulgarian version of american idol!

https://www.youtube.com/watch?v=BNQLmHKlmiE&NR=1

Wow, she actually though that was english?

Ken Leeeeeeeee!!!!!

Stupid pixar removed their cartoons from you tube.....

All the above

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Explanation

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19. Substance P works on what receptors to facilitate transmission of pain?

Mu receptors

Lamina 2 receptors

NK-1 receptors

P45 receptors

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Explanation

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20. Which type of nerve fiber would most likely be used to transmit pain associated with an IV stick?

A alpha fibers

C Fibers

A delta fibers

D fiber

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Explanation

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21. The absence of all sensation is known as:

Hypoalgesia

Analgesia

Parasthesia

Anesthesia

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Explanation

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22. Which of the following does not enhance pain transmission?

Histamine

Serotonin

Prostaglandins

Norepinephrine

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Explanation

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23. 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?

Acute Deep Somatic Pain

Acute Visceral Pain

Chronic Pain

Acute Superficial Somatic Pain

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Explanation

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24. Which enzyme acts on phospholipids to turn them into arachidonic acid?

Prostaglandin E

Cyclo-oxygenase

Phospholipase A

Lipoxygenase

Phospholipase A is the enzyme that acts on phospholipids to convert them into arachidonic acid. This enzyme specifically cleaves the fatty acid chain from the sn-2 position of the phospholipid molecule, releasing arachidonic acid. Arachidonic acid is a precursor for the synthesis of various bioactive molecules, including prostaglandins and leukotrienes, which play important roles in inflammation and other physiological processes.

Explanation

Phospholipase A is the enzyme that acts on phospholipids to convert them into arachidonic acid. This enzyme specifically cleaves the fatty acid chain from the sn-2 position of the phospholipid molecule, releasing arachidonic acid. Arachidonic acid is a precursor for the synthesis of various bioactive molecules, including prostaglandins and leukotrienes, which play important roles in inflammation and other physiological processes.

25. The lipoxygenase pathway acts on arachidonic acid to convert it into what?

Leukotrienes

Prostacyclins

Prostaglandin E

Bradykinin

The lipoxygenase pathway is responsible for converting arachidonic acid into leukotrienes. Leukotrienes are inflammatory mediators that play a role in various physiological processes, including allergic reactions and asthma. They are involved in the contraction of smooth muscle, increased vascular permeability, and recruitment of immune cells to the site of inflammation. Therefore, the conversion of arachidonic acid into leukotrienes is an important step in the inflammatory response.

Explanation

The lipoxygenase pathway is responsible for converting arachidonic acid into leukotrienes. Leukotrienes are inflammatory mediators that play a role in various physiological processes, including allergic reactions and asthma. They are involved in the contraction of smooth muscle, increased vascular permeability, and recruitment of immune cells to the site of inflammation. Therefore, the conversion of arachidonic acid into leukotrienes is an important step in the inflammatory response.

26. Which form of nociceptor would be involved in feeling heat when holding your hand over a candle?

Mechanonociceptor

Silent Nociceptor

Polymodal mechoheat nociceptors

Somatic Nociceptors

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Explanation

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27. What is parasthesia?

Functional abnormality of one or more nerve roots

Abnormal sensation perceived without an apparent stimulus

Pain in the distribution of a nerve or a group of nerves.

Pain in an area the lacks sensation

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.

Explanation

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.

28. What is neuropathic pain?

Pain that is the result of injury or acquired abnormalities of peripheral or central neural structures.

Pain that results directly from a disease process.

Pain causes by activation or sensitization of peripheral nociceptors, which transmit noxious stimuli.

None of the above

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."

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."

29. The arachidonic acid is produced from….

Histamine released from mast cells

Phospholipids released from damaged cell membranes

Release of alogens from damaged cells

Bradykinin released from tissues

Arachidonic acid is a fatty acid that is produced from phospholipids, which are a major component of cell membranes. When cell membranes are damaged, phospholipids are released and can be converted into arachidonic acid. This conversion is catalyzed by enzymes such as phospholipase A2. Therefore, the correct answer is "Phospholipids released from damaged cell membranes."

Explanation

Arachidonic acid is a fatty acid that is produced from phospholipids, which are a major component of cell membranes. When cell membranes are damaged, phospholipids are released and can be converted into arachidonic acid. This conversion is catalyzed by enzymes such as phospholipase A2. Therefore, the correct answer is "Phospholipids released from damaged cell membranes."

30. Which of the following is the major neurotransmitter released from C fibers?

Glutamate

Substance P

Dynorphin

Capsaicin

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Explanation

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31. What is Radiculopathy?

Functional abnormality of one or more nerve roots

Abnormal sensation perceived without an apparent stimulus

Pain in the distribution of a nerve or a group of nerves.

Pain in an area the lacks sensation

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Explanation

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32. Which of the following is not a systemic effect associated with acute pain?

Decreased minute ventilation and CO2 production

HTN and increased myocardial irritability

Decreased intestinal and urinary motility

Hypercoagulability

Acute pain can cause various systemic effects, such as increased blood pressure (HTN) and myocardial irritability, decreased intestinal and urinary motility, and hypercoagulability. However, it does not typically lead to decreased minute ventilation and CO2 production. Acute pain usually triggers an increase in respiratory rate and depth, resulting in increased minute ventilation and CO2 elimination.

Explanation

Acute pain can cause various systemic effects, such as increased blood pressure (HTN) and myocardial irritability, decreased intestinal and urinary motility, and hypercoagulability. However, it does not typically lead to decreased minute ventilation and CO2 production. Acute pain usually triggers an increase in respiratory rate and depth, resulting in increased minute ventilation and CO2 elimination.

33. Which form of nociceptor would transmit the pain associated an inflamed gallbladder?

Mechanonociceptor

Silent Nociceptor

Polymodal mechoheat nociceptors

Somatic Nociceptors

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Explanation

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34. Which of the following is the major neurotransmitter released from A delta fibers?

Glutamate

Substance P

Dynorphin

Capsaicin

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Explanation

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35. Unpleasant or abnormal sensation with or without a stimulus, as commonly seen in diabetics is known as:

Hyperalgesia

Dysesthesia

Anesthesia Dolorosa

Radiculopathy

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.

Explanation

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.

36. Dimiished response to a noxious stimulus is known as:

Radiculopathy

Dysesthesia

Hypalgesia

Parasthesia

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.

Explanation

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.

37. When you combine hyperesthesia, allodynia, and hyperalgesia what do you get?

Hyperpathia

Radiculopathy

Hyperneuralgia

Acute Polyradiculopathy

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.

Explanation

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.

38. What is neuralgia?

Functional abnormality of one or more nerve roots

Abnormal sensation perceived without an apparent stimulus

Pain in the distribution of a nerve or a group of nerves.

The sensation I am feeling right now having to study all the BS.

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.

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.

39. What is nociceptive pain?

Pain that is the result of injury or acquired abnormalities of peripheral or central neural structures.

Pain that results directly from a disease process.

Pain caused by activation or sensitization of peripheral nociceptors, which transmit noxious stimuli.

None of the above

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Explanation

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40. Which of the following ascending pathways transmits noxious stimuli?

First Order Neurons

Second order neurons

Third order Neurons

All the Above

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.

Explanation

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.

41. 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….

Is a COX inhibitor, so it prevents arachidonic acid from converting to Prostaglandins which causes pain.

Blocks activation of phospholipase A to inhibit prostanglandin production.

Is a leukotriene inhibitor and breaks down bradykinin.

Inhibits transmission of Substance P by blocking NK-1 receptors.

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Explanation

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42. What type of fibers innervate the larynx?

C fibers

B fibers

A fibers

All the above

C fibers innervate the larynx.

Explanation

C fibers innervate the larynx.

43. 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?

Parasthesia

Allodynia

Hyperalgesia

Neuralgia

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Explanation

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44. 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:

Anesthesia Dolorosa

Allodynia

Hypesthesia

Parasthesia

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Explanation

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45. How do corticosteroids help to produce analgesia?

Through inhibition of the COX pathway, which turns arachidonic acid into PGE.

Through inhibition of phospholipase A which acts on phospolipds to make arachidonic acid

Through inhibition of bradykinin which relieves inflammation

All the above

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Explanation

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46. The Spinal reticular pain pathway is thought to be responsible for what?

Location, density and duration of pain.

Arousal and autonomic responses to pain.

Unpleasant emotional perception of pain.

Activates antinociceptive descending pathways.

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Explanation

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47. Which lamina are involved in the immediate transmission of pain resulting shutting a car door on your finger?

Lamina II, III, V

Lamina V only

Lamina I, V

Lamina I, II, III

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Explanation

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48. Which of the following is not one of mechanisms responsible for central sensitization in the spinal cord?

Wind up and sensitization of second order neurons

Receptor field expansion

Up regulation of adrenergic receptors

Hyperexcitability of flexion reflexes

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Explanation

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49. Pain is conducted along the first, second, and third order neurons that transmit noxious stimuli to periphery from cerebral cortex.

True

False

The statement is false because pain is actually conducted along the first, second, and third order neurons that transmit noxious stimuli from the periphery to the cerebral cortex, not the other way around. The cerebral cortex is where the brain processes and interprets the pain signals, but the transmission of the signals starts from the periphery and moves towards the brain.

Explanation

The statement is false because pain is actually conducted along the first, second, and third order neurons that transmit noxious stimuli from the periphery to the cerebral cortex, not the other way around. The cerebral cortex is where the brain processes and interprets the pain signals, but the transmission of the signals starts from the periphery and moves towards the brain.

50. Which of the following is not true regarding the substantia gelatinosa?

Synthesizes and releases Substance P

Also known as Lamina II

Is believed to be the main site of action for opioids

Plays a major role in processing and modulating nociceptive input from cutaneous receptors

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Explanation

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51. Which of the ascending pathways releases Substance P?

None, released by glands.

First Order Neurons

Second Order Neurons

Third order neurons

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.

Explanation

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.

52. 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?

Lamina I

Lamina V

Lamina VII

Lamina II

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Explanation

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53. Which form of nerve fiber is responsible for post-op pain after a colectomy?

A Alpha fibers

D fibers

A delta fibers

C fibers

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Explanation

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54. The C fibers primarily synapse in which lamina? (two answers)

X

I

IV

II

MM 365 (I know linda's notes say II & III.... but I am going with the book)

Explanation

MM 365 (I know linda's notes say II & III.... but I am going with the book)

Submit

55. Primary afferent neurons are located in the _______, and then birfurcate to send their ends elsewhere.

Dorsal horn

Peripheral tissues

Dorsal Root Ganglion

Dorsolateral Funiculus

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Explanation

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56. Which of the following nerve fibers has the fastest velocity of conduction?

A delta fibers

B fibers

C fibers

A alpha fibers

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.

Explanation

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.

57. Which of the following is responsible for modulating pain?

Dorsal Horn

Posterior Thalamus

Dorsolateral Funiculus

Substantia gelatinosa

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58. What is an appropriate four hour limit of Fentanyl for a patient on a PCA pump? This patient weighs 45 kg.

135 mcg

13.5 mcg

2.7 mcg

45 mcg

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59. Alpha delta fibers primarily synapse in which Lamina? (two answers)

I

II

V

VII

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60. Which of the following is not a central mechanism of chronic pain?

Upregulation of adrenergic receptors

Wind up WDR neurons

Reorganization of neural connections

Loss of segmental inhibition

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61. What would be an appropriate four hour limit of Morphine for a patient on a PCA pump? This pt weighs 60 kg.

3.6 mg

180 mg

60 mg

18 mg

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62. What is an appropriate four hour limit of Dilaudid for a patient on a PCA pump? This patient weighs 50 kg.

150 mcg

3 mg

15 mg

50 mg

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63. Which lamina would be involved in transmitting the pain associated with multiple sclerosis?

Lamina I, II, III

Lamina V only

Lamina I, V

Lamina I, II, V

C fibers transmit this pain

Explanation

C fibers transmit this pain

64. Reduced cutaneous sensation is known as?

Hypalgesia

Hypesthesia

Parasthesia

Dysesthesia

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.

Explanation

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.

65. 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?

True Parietal Acute Visceral

True Visceral Acute Visceral

Acute Deep Somatic

Acute Referred visceral

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Explanation

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