Regional - Quiz 1

60 Questions | Total Attempts: 88

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Regional - Quiz 1

Review of material for test one going over pain pathways and pain management.


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Questions and Answers
  • 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

  • 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

  • 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

  • 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

  • 5. 
    Which area of the parietal cortex received noxious stimuli from third order neurons?
    • A. 

      PostCentral Gyrus

    • B. 

      Limbic System

    • C. 

      Amygdala

    • D. 

      Medulla

  • 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

  • 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

  • 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

  • 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.

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 16. 
    Which of the following does not enhance pain transmission?
    • A. 

      Histamine

    • B. 

      Serotonin

    • C. 

      Prostaglandins

    • D. 

      Norepinephrine

  • 17. 
    Which of the following systemic effects would you not expect to see with acute pain?
    • A. 

      Increased insulin secretion and hypoglycemia

    • B. 

      Increased HR and cardiac Output

    • C. 

      Decreased ability to cough and deep breathe

    • D. 

      Immunosuppression

  • 18. 
    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

  • 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

  • 20. 
    Which of the following is the major neurotransmitter released from A delta fibers?
    • A. 

      Glutamate

    • B. 

      Substance P

    • C. 

      Dynorphin

    • D. 

      Capsaicin

  • 21. 
    Which of the following is the major neurotransmitter released from C fibers?
    • A. 

      Glutamate

    • B. 

      Substance P

    • C. 

      Dynorphin

    • D. 

      Capsaicin

  • 22. 
    Which of the following is responsible for modulating pain?
    • A. 

      Dorsal Horn

    • B. 

      Posterior Thalamus

    • C. 

      Dorsolateral Funiculus

    • D. 

      Substantia gelatinosa

  • 23. 
    IV opioids act primarily on ______ receptors, while spinal analgesia opioids primarily act upon _____ receptors.
    • A. 

      Mu-2, Mu-1

    • B. 

      Kappa, Mu-2

    • C. 

      Mu-1, Delta

    • D. 

      Mu-1, Mu-2

  • 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

  • 25. 
    Moderate pain may effect all organ systems and may adversely effect post-op morbidity and mortality.
    • A. 

      True

    • B. 

      False

  • 26. 
    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

  • 27. 
    The absence of pain perception is known as:
    • A. 

      Anesthesia

    • B. 

      Hypoalgesia

    • C. 

      Analgesia

    • D. 

      Parasthesia

  • 28. 
    The absence of all sensation is known as:
    • A. 

      Hypoalgesia

    • B. 

      Analgesia

    • C. 

      Parasthesia

    • D. 

      Anesthesia

  • 29. 
    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

  • 30. 
    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

  • 31. 
    Dimiished response to a noxious stimulus is known as:
    • A. 

      Radiculopathy

    • B. 

      Dysesthesia

    • C. 

      Hypalgesia

    • D. 

      Parasthesia

  • 32. 
    When you combine hyperesthesia, allodynia, and hyperalgesia what do you get?
    • A. 

      Hyperpathia

    • B. 

      Radiculopathy

    • C. 

      Hyperneuralgia

    • D. 

      Acute Polyradiculopathy

  • 33. 
    Reduced cutaneous sensation is known as?
    • A. 

      Hypalgesia

    • B. 

      Hypesthesia

    • C. 

      Parasthesia

    • D. 

      Dysesthesia

  • 34. 
    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.

  • 35. 
    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

  • 36. 
    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

  • 37. 
    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

  • 38. 
    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

  • 39. 
    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

  • 40. 
    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

  • 41. 
    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

  • 42. 
    A and B fibers are __________ while C fibers are _________.
    • A. 

      Unmyelinated, myelinated

    • B. 

      Slow, Fast

    • C. 

      Myelinated, unmyelinated

    • D. 

      Thin, thick

  • 43. 
    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

  • 44. 
    What type of fibers innervate the larynx?
    • A. 

      C fibers

    • B. 

      B fibers

    • C. 

      A fibers

    • D. 

      All the above

  • 45. 
    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

  • 46. 
    Nociceptive nerve ending will respond to all of the following except….
    • A. 

      Heat damage

    • B. 

      Mechanical damage

    • C. 

      Disease damage

    • D. 

      Chemical damage

  • 47. 
    Which of the following is not an alogen?
    • A. 

      Bradykinin

    • B. 

      Serotonin

    • C. 

      Histamine

    • D. 

      Epinephrine

  • 48. 
    Alpha delta fibers primarily synapse in which Lamina? (two answers)
    • A. 

      I

    • B. 

      II

    • C. 

      V

    • D. 

      VII

  • 49. 
    The C fibers primarily synapse in which lamina?
    • A. 

      X

    • B. 

      I

    • C. 

      IV

    • D. 

      II

  • 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

  • 51. 
    The Spinal reticular pain pathway is thought to be responsible for what?
    • A. 

      Location, density and duration of pain.

    • B. 

      Arousal and autonomic responses to pain.

    • C. 

      Unpleasant emotional perception of pain.

    • D. 

      Activates antinociceptive descending pathways.

  • 52. 
    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?
    • A. 

      Acute Deep Somatic

    • B. 

      Acute True Visceral pain

    • C. 

      Acute true Parietal pain

    • D. 

      Acute Superficial somatic pain

  • 53. 
    Which of the following is not a systemic effect associated with acute pain?
    • A. 

      Decreased minute ventilation and CO2 production

    • B. 

      HTN and increased myocardial irritability

    • C. 

      Decreased intestinal and urinary motility

    • D. 

      Hypercoagulability

  • 54. 
    The arachidonic acid is produced from….
    • A. 

      Histamine released from mast cells

    • B. 

      Phospholipids released from damaged cell membranes

    • C. 

      Release of alogens from damaged cells

    • D. 

      Bradykinin released from tissues

  • 55. 
    Which enzyme acts on phospholipids to turn them into arachidonic acid?
    • A. 

      Prostaglandin E

    • B. 

      Cyclo-oxygenase

    • C. 

      Phospholipase A

    • D. 

      Lipoxygenase

  • 56. 
    Which of the following acts on arachidonic acid to convert it to prostacyclins and PGE?
    • A. 

      Lipoxygenase

    • B. 

      Factor XII

    • C. 

      Phospholipase A

    • D. 

      Cyclooxygenase

  • 57. 
    The lipoxygenase pathway acts on arachidonic acid to convert it into what?
    • A. 

      Leukotrienes

    • B. 

      Prostacyclins

    • C. 

      Prostaglandin E

    • D. 

      Bradykinin

  • 58. 
    Which of the following would be most painful?
    • A. 

      Surgical incision into the kidney

    • B. 

      A surgical incision into the skin

    • C. 

      Both are equally painful

  • 59. 
    Which of the following is not a peripheral mechanism for chronic pain?
    • A. 

      Sensitization of receptors to stimuli

    • B. 

      Upregulation of adrenergic receptors

    • C. 

      Spontaneous discharges

    • D. 

      Loss of segmental inhibition

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

      Upregulation of adrenergic receptors

    • B. 

      Wind up WDR neurons

    • C. 

      Reorganization of neural connections

    • D. 

      Loss of segmental inhibition