Deck 7: Understanding and Managing Pain

Question 1

Sensory input information passes through what brain structure?

A) the parietal lobe of the cerebral cortex
B) the pons
C) the cerebellum
D) the thalamus

Answer 1

the thalamus

Question 2

The substantia gelatinosa is

A) in the dorsal horns of the spinal cord.
B) in the midbrain region, adjacent to the thalamus.
C) composed of a gelatin-like material that surrounds the lower portion of the brain.
D) a hypothetical structure that has not yet been confirmed.

Answer 2

in the dorsal horns of the spinal cord.

Question 3

Stimulation of the A-delta fibers,since they are myelinated,leads to a _______,whereas the unmyelinated C fibers often result in _____________.

A) "slow pain" response; "fast pain" response
B) "no pain" response; "slow pain" response
C) "fast pain" response; "slow pain" response
D) "no pain" response; "fast pain" response

Answer 3

"fast pain" response; "slow pain" response

Question 4

Myelinated afferent neurons are called

A) A fibers.
B) beta afferents.
C) C fibers.
D) delta afferents.

Question 5

When pain is experienced in some other location than the site where the pain was inflicted,this is called

A) phantom limb pain.
B) referred pain.
C) prechronic pain.
D) chronic recurrent pain.

Question 6

Participants who are socially excluded show more activity in the anterior cingulate cortex,similar to people who are experiencing _____________.

A) physical pain
B) depression
C) anxiety
D) all of the above

Question 7

This system conveys sensory information from the body to the brain.

A) endocrine system
B) digestive system
C) somatosensory system
D) immune system

Question 8

Sherman stubbed his toe on the sidewalk.His sensation of pain traveled first to the

A) muscles in the foot.
B) brain.
C) spinal cord.
D) cranial nerves.

Question 9

More than half of all sensory afferents are

A) A-beta fibers.
B) A-delta fibers.
C) C fibers.
D) myelinated.

Question 10

Nociception refers to the process of perceiving ________.

A) stress
B) pain
C) anger
D) oxygen

Question 11

Afferent fibers group together after leaving the skin,forming a _____.

A) nerve
B) cell
C) cell body
D) ganglion cell

Question 12

Primary afferents convey sensory impulses to the

A) spinal cord.
B) peripheral nervous system.
C) brain.
D) motor neurons.

Question 13

_________ neurons carry nerve impulses away from the brain and toward the muscles.

A) Efferent
B) Afferent
C) Beta afferents
D) Delta afferents

Question 14

The ______ system allows us to interpret certain sensory information as pain.

A) somatosensory
B) endocrine
C) skeletal
D) muscular

Question 15

These proteins produced by the immune system increase pain sensitivity,along with increasing fatigue and sickness:

A) proinflammatory cytokines
B) endorphins
C) opiates
D) both a and b

Question 16

_______ are neurochemicals that help modulate,or lessen,the experience of pain.

A) Endorphins
B) Interneurons
C) Glutamates
D) Proinflammatory cytokines

Question 17

Which structure is most capable of modulating sensory input?

A) primary afferents
B) secondary afferents
C) substantia gelatinosa
D) spinothalamic tract

Question 18

Recent research gave participants __________ to reduce people's feelings of social pain.

A) a shock
B) a hug
C) Tylenol
D) Morphine

Question 19

The dorsal horns are located in the

A) brain stem.
B) kidneys.
C) midbrain.
D) spinal cord.

Question 20

_____ are chemicals that carry information between nerves.

A) Afferent neurons
B) Efferent neurons
C) Neurotransmitters
D) Interneurons

Question 21

Which of these is NOT a distinction between chronic and acute pain?

A) Acute pain is usually adaptive; chronic pain is not.
B) Acute pain is physical; chronic pain is psychological.
C) Chronic pain is frequently perpetuated by environmental reinforcers; acute pain needs no such reinforcement.
D) Chronic pain has no biological benefit; acute warns the person to avoid further injury.

Question 22

According to the gate control theory,emotions such as ______ could increase pain by affecting the gate to open,whereas emotions such as _____ could decrease pain by affecting the gate to close.

A) happiness; depression
B) joy; anxiety
C) anxiety; happiness
D) depression; anxiety

Question 23

Which of the body's own neurochemicals does NOT have opiate-like effects?

A) serotonin
B) dynorphin
C) endorphin
D) enkephalin

Question 24

What is the relationship between the experience of pain and some types of psychopathology?

A) People with personality disorders have heightened pain perception.
B) People with pain-prone personalities tend to have borderline personality disorder.
C) People with pain-resistant personalities tend to have bipolar disorder.
D) It is not clear whether psychopathology makes one vulnerable to pain or whether being in pain produces psychopathology.

Question 25

People in pain frequently receive attention and sympathy,which may provide ____________ for these pain behaviors.

A) reinforcement
B) negative scheduling
C) punishment
D) generalization

Question 26

This personality trait has been associated with a "pain-resistant" personality.

A) Conscientiousness
B) Extraversion
C) Neuroticism
D) There is no "pain-resistant" personality.

Question 27

The theory of pain proposed by Melzack and Wall has been called the _____ theory.

A) gate control
B) sensory decision
C) cognitive-emotional
D) tension-reduction

Question 28

Kyle is experiencing headaches and his partner has taken over the household chores.Research by Pence et al.(2008)would suggest that Kyle's headaches are likely to

A) increase in intensity.
B) decrease in intensity.
C) completely disappear.
D) disappear until his partner makes him do the chores again.

Question 29

What brain structure contains a representation of the skin's surface?

A) somatosensory cortex
B) parietosensory area
C) sensorimotor cortex
D) occipital cortex

Question 30

Specificity theory hypothesizes that

A) a person's interpretation of pain is more important that tissue damage in determining the intensity of pain.
B) acute pains intensify over time.
C) the experience of pain is approximately equal to the amount of tissue damage or injury.
D) chronic pain can become acute pain over time.

Question 31

Pain is usually defined as

A) a sensory experience only.
B) an emotional experience only.
C) neither a sensory nor an emotional experience.
D) both a sensory and an emotional experience.

Question 32

Neurotransmitters like _____ decrease pain,but those like ________ increase the experience of pain.

A) serotonin . . . dynorphin
B) endorphin . . . glutamate
C) substance P . . . serotonin
D) endorphin . . . enkephalin

Question 33

In some cultures,people undergo initiation rituals that call for them to have their body pierced,cut,tattooed,burned,or beaten.These individuals

A) feel no pain.
B) show little or no pain from an accidental injury.
C) feel pain, but their culture trains them to exhibit no pain during these initiation rituals.
D) offer proof that pain is totally psychological.

Question 34

With regard to gender,

A) women sense pain more quickly than men.
B) women are more likely to hide their pain.
C) men are more likely to be aware of their pain.
D) men are less likely to report pain.

Question 35

Henry Beecher reported that soldiers wounded at the Anzio beachhead during World War II experienced ______ pain.

A) chronic intractable
B) stress-related
C) severe, excruciating
D) very little

Question 36

During the birth process,women in some cultures exhibit many more signs of pain than women in other cultures.This observation shows that

A) the experience of pain varies from culture to culture.
B) cultural practices can influence the expression of pain.
C) natural childbirth produces less pain than opiate drugs.
D) women who express little pain during childbirth are undergoing self-hypnosis.

Question 37

Physicians are likely to underestimate the pain of

A) Asian Americans.
B) African Americans.
C) European Americans.
D) no ethnic group; doctors treat all patients equally.

Question 38

Matthew is running a marathon and trips over a pile of acorns,but finishes the race.Afterwards,he finds out his ankle is sprained.What theory best accounts for the fact that Matthew did not immediately stop running after tripping?

A) specificity theory of pain
B) gate control theory of pain
C) delay of gratification theory of pain
D) none of the above

Question 39

Victoria has just cut her hand with a sharp knife.The pain she feels can best be described as

A) acute.
B) prechronic.
C) chronic intractable.
D) chronic.

Question 40

Which of these findings cast doubt on the specificity theory of pain?

A) Researchers have failed to find specific skin receptors devoted to relaying pain.
B) Phantom limb pain occurs in 70% of amputees.
C) Injury can occur without pain, such as that experienced by the soldiers at Anzio beach.
D) all of these

Question 41

According to the gate control theory of pain,the spinal cord

A) mechanically relays sensory input information.
B) modulates the input of sensory information.
C) does not have the physiological capacity to affect pain perception.
D) is less important in pain perception than the cerebellum.

Question 42

According to the gate control theory of pain,the structure that is the likely location of the gate is

A) the substantia gelatinosa.
B) the ventral horns of the spinal cord.
C) the transverse section of the medulla.
D) supraspinal nerve endings.

Question 43

_____ pain is the most common of all syndromes of pain with a lifetime incidence rate of more than 99%.

A) Headache
B) Low back
C) Burn
D) Knee

Question 44

What type of pain has a gradual onset,sensations of tightness around the neck and shoulders,and a steady ache on both sides of the head?

A) low back pain
B) migraine headache
C) cluster headache
D) tension headache

Question 45

Heart rate predicts perceptions of pain,but only for ________.

A) children
B) the elderly
C) men
D) women

Question 46

Wendy suffers from headaches that occur nearly every day for about a month,but then go away for about a year or more.From this description,it appears that Wendy suffers from

A) cluster headaches.
B) migraine headaches.
C) tension headache.
D) none of the above.

Question 47

Which of these methods have been used to measure pain?

A) self-reports
B) behavioral assessment
C) physiological measures
D) all of these

Question 48

The Visual Analog Scale is considered to be

A) a self-report.
B) an evoked potential measure of pain.
C) a behavioral assessment of pain.
D) a pain questionnaire.

Question 49

The two most common types of pain are

A) cancer and headache.
B) arthritis and low back.
C) headache and low back.
D) cancer and low back.

Question 50

A personality inventory sometimes used to assess pain is the

A) California Personality Inventory.
B) Minnesota Multiphasic Personality Inventory.
C) Edwards Personality Schedule.
D) Guilford-Zimmerman Temperament Survey.

Question 51

Which of these techniques measures muscle tension as an index of pain?

A) electromyography
B) thermography
C) blood flow in the temporal artery
D) heart rate

Question 52

Valid and reliable measures of pain are important to health psychologists primarily because

A) such measurements permit accurate evaluation of various pain therapy programs.
B) self-reports are more useful than physiological measures.
C) pain is a product of both physiological and emotional factors.
D) behavioral assessments are more reliable and valid.

Question 53

Which of these conditions may contribute to low back pain?

A) pregnancy
B) improper lifting of heavy objects
C) aging
D) all of these

Question 54

Melzack proposed the _______ theory,which is an extension of the gate control theory.

A) sensory decision
B) specificity
C) neuromatrix
D) cerebellar

Question 55

The gate control theory of pain assumes

A) the physiological reality of pain.
B) the nature of motor output factors in pain perception.
C) that chronic pain is heavily influenced by both spinal cord and brain activity.
D) that sensory input is not the only factor in pain perception.

Question 56

Rosa suffers from recurrent attacks of pain that are accompanied by exaggerated sensitivity to light,loss of appetite,and nausea.From these characteristics you would diagnose Rosa as having

A) migraine headaches.
B) tension headaches.
C) cancer pain.
D) phantom limb pain.

Question 57

Carlos is a 45-year-old civil engineer who has never had a migraine headache.His chances of a first migraine are

A) very high.
B) about 50/50.
C) very low.
D) nonexistent.

Question 58

Low back pain has many causes.About what percent of back pain patients have an identified,physical cause for their pain?

A) 20%
B) 50%
C) 75%
D) about 40% of men and about 60% of women

Question 59

The most widely used pain questionnaire was developed by Ronald Melzack and is known as the

A) Melzack and Wall Pain Questionnaire.
B) Visual Analog Scale.
C) Minnesota Multiphasic Personality Inventory.
D) McGill Pain Questionnaire.

Question 60

With regard to migraine headaches,

A) men are somewhat more likely than women to have migraines.
B) women are much more likely than men to have migraines.
C) women are slightly more likely than men to have migraines.
D) women and men are about equally susceptible to migraines.

Question 61

Systems of self-paced administration of analgesic drugs

A) overcome the problem of undermedication.
B) increase the probability of addiction.
C) lead to a situation in which about 45% of patients overmedicate themselves.
D) all of these.

Question 62

Cognitive behavioral therapy has been shown to be effective in relieving pain for

A) headache patients
B) fibromyalgia patients
C) patients with AIDS pain
D) all of the above

Question 63

_______ occurs when the body needs more and more of the drug to reach the same effect and _______ occurs when removal of the drug causes withdrawal symptoms.

A) Withdrawal; dependence
B) Dependence; withdrawal
C) Tolerance; dependence
D) Dependence; tolerance

Question 64

The three primary kinds of headaches are:

A) migraine, cluster, chronic
B) chronic, tension, cluster
C) migraine, cluster, tension
D) tension, migraine, chronic

Question 65

One variation of cognitive behavioral therapy,encourages participants to _____ their pain and focus their attention on valued activities.

A) deny
B) accept
C) enjoy
D) commit to

Question 66

The tendency to catastrophize is associated with ________.

A) magnification of pain.
B) lessening of pain.
C) no differences in perception of pain.
D) magnification of pain, but only when other people are present.

Question 67

Jesse's leg was amputated when he was 20.10 years later,he still occasionally feels pain in that missing limb.This pain is called

A) missing limb pain.
B) phantom limb pain.
C) amputation pain.
D) neuroses.

Question 68

Approximately _____ % of all terminal cancer cases experience pain.

A) 15-20
B) 25-40
C) 45-65
D) 98 to 99

Question 69

Unlike rheumatoid arthritis,osteoarthritis

A) frequently occurs in younger as well as older people.
B) affects mostly men.
C) is an autoimmune disorder.
D) affects mostly older people.

Question 70

Opiate drugs

A) are effective analgesics.
B) produce dependence.
C) produce tolerance.
D) all of these.

Question 71

Medical procedures used in pain management have traditionally included

A) cognitive therapy.
B) drugs.
C) surgery.
D) both drugs and surgery.

Question 72

About what percentage of people who receive opiates during a hospital stay becomes addicted?

A) less than 1%
B) more than 5% but less than 25%
C) about 50%
D) almost 100%

Question 73

What types of headaches are more common in men than in women?

A) chronic
B) cluster
C) migraine
D) tension

Question 74

Bailey has tried many treatments for chronic back pain.His treatment of last resort would probably be

A) surgery.
B) TENS.
C) opium-based drugs.
D) hypnosis.

Question 75

Analgesic drugs are effective for pain control,but

A) most people misuse these drugs, using dangerous amounts.
B) NSAIDS are more effective than opiates.
C) anesthetic drugs are preferable for controlling chronic pain.
D) antidepressant drugs may also be useful in treating some types of pain.

Question 76

For phantom limb pain,the pain is more likely in the missing limb when:

A) there was much pain before the amputation.
B) there was no pain before the amputation.
C) the amputated limb is a leg.
D) all phantom pain is the same pain intensity.

Question 77

Aspirin-type analgesic drugs are most effective in

A) treating gastric disorders.
B) relieving cancer pain.
C) treating injuries that are accompanied by inflammation.
D) treating patients who are candidates for surgery.

Question 78

Almost ____ of all cancer patients' pain was untreated.

A) 10%
B) 20%
C) 50%
D) 90%

Question 79

Chronic pain affects approximately ____ of the population in the United States.

A) 50%
B) 10%
C) 75%
D) 30%

Question 80

Researchers have found that transcutaneous electrical nerve stimulation (TENS)

A) is effective for acute but not chronic pain.
B) increases pain during stimulation, but patients report less pain after stimulation.
C) is not very effective in relieving pain.
D) has no advantage over other medical methods.