Deck 8: Pain

Question 1

Kevin,who was intensely involved in a play-off hockey game,did not notice the intense pain of a fractured rib until after the game was over.The absence of pain during the game can be explained by Melzack and Wall as

A)a closed gate in the gate control theory
B)an open gate in the gate control theory
C)phantom pain in the gate control theory
D)nociception in the neuromatrix theory
E)nociception in the neurochemical pain theory

Answer 1

a closed gate in the gate control theory

Question 2

The part of the pain pathway where sensory input information is thought to be modulated is the

A)afferent neurons
B)substantia gelatinosa
C)A-delta fibres
D)C- fibres
E)Nociceptors

Answer 2

substantia gelatinosa

Question 3

______________________ pain occurs in response to tissue damage whereas _____________ pain is reinforced by the person's environment.

A)acute;chronic
B)chronic;acute
C)respondent;operant
D)operant;respondent
E)chronic intractable;chronic recurrent

Answer 3

respondent;operant

Question 4

All of the following are considered benefits to experiencing pain except

A)it serves as a warning to prevent serious injury
B)it serves as a basis of learning to avoid injurious objects
C)it sets limits on activities essential for the body's natural recuperation
D)it serves as a marker for amputated limbs
E)it has survival value

Question 5

The afferent nerve endings that respond to pain stimuli are called

A)nociceptors
B)A-delta fibres
C)C-fibres
D)substantia gelatinosa
E)sensory neurons

Question 6

In the classic study by David Reynolds (1969)rats stimulated in the ______________________ area of the brain did not exhibit pain.

A)substantia nigra
B)substantia gelatinosa
C)dorsal horn
D)periaqueductal gray
E)somatosensory cortex

Question 7

A specialized system of large-diameter,rapidly conducting fibres that,according to Melzack and Wall,initiate the opening and closing of the gate in their gate control theory are called

A)lock-out interval
B)afferent peripheral fibres
C)C-fibres
D)nociceptors
E)the central control trigger

Question 8

Which of the following is true of C-fibres?

A)associated with afferent peripheral fibres that transmit pain impulses
B)associated with sharp,distinct pain
C)small,myelinated fibres
D)large,myelinated fibres
E)transmit impulses very quickly

Question 9

There is evidence that intense physical exercise can trigger the release of ___________ resulting in natural,short-term pain suppression.

A)beta-endorphin
B)proenkephalin
C)prodynorphin
D)periaqueductal gray
E)exogenous opioids

Question 10

Sensory aspects of pain are influenced by the _____________ which send messages to the thalamus while motivational elements of pain are determined by ___________.

A)nociceptors;afferent nerve fibres
B)C-fibres;A-delta fibres
C)A-delta fibres;C-fibres
D)Sensory neurons;motivational neurons
E)Sensory neurons;motor neurons

Question 11

Michelle's cancer has metastasized and in spite of pain killers (analgesics)her pain is increasing.Michelle is experiencing

A)acute pain
B)chronic recurrent pain
C)chronic progressive pain
D)chronic intractable pain
E)operant pain

Question 12

Which of the following is characteristic of chronic intractable benign pain?

A)intense episodes of acute pain followed by relief
B)pain lasting 3-6 months without resolution
C)pain all the time with varying intensity
D)continuous discomfort that gradually intensifies
E)pain most of the time of constant intensity

Question 13

All of the following are true about phantom limbs except

A)a phantom limb usually hangs straight down at the side when the person sits or stands
B)a phantom limb can experience warmth,cold and pressure as well as pain
C)there is considerable evidence of phantoms in people born without limbs
D)phantom limbs have been found in limb amputations that occur in early childhood
E)the phantom limb has an unreal quality to it

Question 14

According to Melzack and Wall,relaxation or positive experiences can ____________ the pain experience by causing the gate to _______________

A)eliminate;open
B)eliminate;close
C)mute;open
D)mute;close
E)increase;close

Question 15

The gate control theory of pain has been the leading theory of pain for over 25 years.Unfortunately,the theory does not account for

A)the effects of depression associated with an injury
B)speed of pain transmission
C)phantom limb pain
D)the influence of distraction on the experience of pain
E)excitatory influence on the transmission cells

Question 16

Janet has recently moved to Alberta.She finds that her migraine headaches are more frequent because of the many abrupt weather changes.Her headaches are an example of

A)acute pain
B)chronic recurrent pain
C)chronic intractable benign pain
D)chronic progressive pain
E)respondent pain

Question 17

The theory which proposes a network of brain neurons which generate patterns called neurosignature patterns is the ________________ theory of pain.

A)specificity
B)pattern
C)gate control
D)neuromatrix
E)neurochemical

Question 18

Currently,Melzack (2001)has proposed an update to his pain theory which he calls the _____________ theory of pain.

A)specificity
B)pattern
C)neuromatrix
D)neurochemical
E)neurospecificity pattern

Question 19

The experience of pain can be influenced by past experience,attention and other cognitive activities through the ____________________

A)nociceptors
B)central control trigger
C)afferent neurons
D)C-fibres
E)A-delta fibres

Question 20

Researchers have discovered that chronic pain sufferers who report ________ levels of satisfaction with social support,exhibit ___________ levels of pain related behaviours.

A)lower;lower
B)lower;higher
C)higher;lower
D)higher;higher
E)moderate;lower

Question 21

Pain rating scales are primarily used to measure

A)pain behaviour
B)pain tolerance
C)pain threshold
D)emotional adjustment to pain
E)pain intensity

Question 22

Clinical research has documented that in reporting pain women are more likely to indicate ___________________________ than men.

A)less severe levels but more frequent pain
B)more severe levels but less frequent pain
C)less severe levels and less frequent pain
D)more severe levels and more frequent pain
E)more severe levels but shorter duration

Question 23

According to the McGill Pain Questionnaire,sensory qualities of pain include all of the following except

A)temporal properties of pain
B)spatial properties
C)pressure
D)fear
E)thermal properties

Question 24

When a persons' sensory system detects a stimulus,such as pressure on one's heel,the signal to the brain produces an increase in

A)muscle tension
B)high blood pressure
C)evoked potentials
D)increased heart rate
E)nausea

Question 25

The simplest and most direct measure of pain is the

A)EEG
B)EMG
C)interview
D)rating scale
E)respiratory rate

Question 26

The most commonly used pain questionnaire in clinical settings and laboratory research is the

A)McGill Pain Questionnaire
B)West Haven-Yale Multidimensional Pain Inventory
C)Pain Anxiety symptoms Scale
D)Dalhousie Everyday Pain Scale
E)Chronic Pain Coping Inventory

Question 27

In the cold-pressor task detecting the experience of pain is called _______________ whereas the duration of time a person is willing to endure the cold water is referred to as __________

A)pain threshold;pain tolerance
B)pain tolerance;pain threshold
C)acute pain;chronic pain
D)respondent pain;operant pain
E)operant pain;respondent pain

Question 28

By comparing cancer pain across cultures it is obvious that

A)cultural differences in pain perception no longer exist
B)cultural differences in pain perception still exist
C)American's over report cancer pain
D)Asian's over report cancer pain
E)European countries demonstrate the most stoicism

Question 29

During an electroencephalogram the peaks on the graph ______________ when people take analgesics and correlate ______________ with subjective reports of pain.

A)decrease,negatively
B)increase;positively
C)decrease;positively
D)increase;negatively
E)are unchanged;positively

Question 30

All of the following are key issues surrounding gender differences and pain except

A)the manner in which women perceive pain
B)biological factors
C)psychosocial factors such as role expectations
D)the response of the health care system
E)susceptibility to effects of litigation and compensation

Question 31

The McGill Pain Questionnaire offers patients the opportunity to describe their pain on three broad dimensions,_______________________

A)physiological,behavioural,social
B)sensory,affective,evaluative
C)intensity,verbal and nonverbal
D)lifestyle,intensity;sensory
E)psychological,physiological,social

Question 32

All of the following are examples of pain behaviours except

A)grimacing
B)limping
C)avoidance of activity
D)evoked potentials
E)frequency of pain related complaints

Question 33

The psychophysiological measure of the pain experience which assesses electrical activity in muscles is called a(n)

A)electroencephalograph
B)electromyography
C)thermograph
D)electrocardiograph
E)sphygmomanometer

Question 34

Alaa bought a new pair of golf shoes and decided that he should wear them even though he would be walking the full eighteen holes.After ten holes he realized that the heel of the shoe had been rubbing his heel and it was painful.Alaa is demonstrating

A)pain threshold
B)pain tolerance
C)respondent pain
D)operant pain
E)chronic progressive pain

Question 35

A pain rating scale where a line is anchored on the left by the phrase "no pain" and on the right by a phrase like "worst pain imaginable" and where people rate their pain by marking a point on the line is an example of a

A)visual analog scale
B)box scale
C)verbal rating scale
D)pain questionnaire
E)pain behaviour scale

Question 36

Amal was raking leaves in her backyard.She has arthritis and her shoulder became painful soon after she started.She continued working for twenty minutes.The time from when she noticed the pain until she stopped is known as

A)pain threshold
B)pain tolerance
C)operant pain
D)respondent pain
E)chronic recurrent pain

Question 37

The most frequently used portion of the McGill Pain Questionnaire is the

A)front and back drawings of the human body
B)pain-rating index
C)verbal rating scales
D)present pain intensity score
E)part 3 indicating how patients' pain has changed with time

Question 38

In the measurement of pain behaviour during day to day activities,the best assessment is one completed by

A)the family physician
B)the person experiencing the pain
C)a family member or significant other
D)a neighbour or unbiased family friend
E)a physiotherapist

Question 39

Interviews about pain can provide valuable information regarding all of the following except

A)history of the problem
B)techniques used for controlling the pain
C)patient's emotional adjustment
D)factors seeming to trigger the pain
E)psychophysiological changes

Question 40

Health professionals should be attentive to possible biases in expectation about pain responses and behaviour in men and women because typically,they assume men are

A)dramatizing their pain
B)minimizing their pain
C)implementing more coping strategies than women
D)misusing the health care system
E)malingering

Question 41

The method of pain management which involves placing electrodes on the surface of the skin is called

A)electromyography
B)acupuncture
C)transcutaneous electrical nerve stimulation
D)central analgesia
E)subcutaneous biofeedback

Question 42

The type of meditation which has its roots in Buddhist practice is called

A)meditative relaxation
B)hypnosis
C)biofeedback
D)mindfulness meditation
E)guided imagery

Question 43

In the David Reynolds study of rats' brain stems,the area of the midbrain that is involved in pain reception was the

A)thalamus
B)hypothalamus
C)periaqueductal gray area
D)somatosensory area
E)neuromatrix

Question 44

When using acupuncture for pain relief it has been found that the pain relief experience is dependent on the

A)expertise of the person inserting the needles
B)the type of needles used (e.g.steel,gold,or other metals)
C)correct location of acupuncture points
D)intensity of the stimulation
E)social acceptance of the theory underlying its use

Question 45

Which of the following is an example of a centrally acting analgesic?

A)ibuprofen
B)acetaminophen
C)oxycontin
D)aspirin
E)Ritalin

Question 46

Interestingly,one of the components of hypnosis which is useful in pain management is

A)guided imagery
B)distraction
C)biofeedback
D)meditation
E)central analgesia

Question 47

Sara is prone to migraine headaches.To help her treat or control these headaches Sara's doctor has recommended that she learn to increase circulation to her hands.In order to accomplish this Sara uses

A)hypnosis
B)meditation
C)biofeedback
D)distraction
E)guided imagery

Question 48

Goals of different pain management programs typically include all of the following except

A)improving social support
B)improving lifestyle functioning
C)decreasing reliance on medications
D)increasing use of health care services
E)decreasing the patient's experience of pain

Question 49

The slow gentle stroking characteristic of Swedish massage is known as_____________ and has the effect of ________________

A)Shiatsu,stimulation of the circulatory system
B)pettrisage,unblocking energy
C)effleurage,relaxation
D)pettrisage;central analgesia
E)effleurage: deep muscle massage

Question 50

Reynolds provided electrical stimulation to the periaqueductal gray area of the midbrain in rats and produced:

A)analgesia (SPA)
B)relaxation response
C)phantom limb pain
D)the central control trigger
E)acute pain

Question 51

A disadvantage of the McGill Pain Questionnaire is that it is

A)gender biased
B)not useful for assessing pain in young children
C)three dimensional
D)not useful for identifying patterns of pain
E)only available in English

Question 52

One advantage of transcutaneous electrical nerve stimulation is that it can be

A)inexpensive
B)self-administered
C)applied for days at a time
D)invasive when necessary
E)used to increase evoked potentials in the brain

Question 53

The rationale for relaxation as a method of pain management is the assertion that

A)continual muscle contraction causes pain
B)muscle relaxation acts as distraction
C)muscle relaxation unblocks energy
D)relaxation is a form of meditation
E)relaxation is a form of hypnosis

Question 54

Distraction techniques are particularly useful for reducing

A)chronic pain
B)respondent pain
C)operant pain
D)acute pain
E)low back pain

Question 55

Bensonian relaxation is a method of

A)progressive muscle relaxation
B)meditative relaxation
C)hypnosis
D)biofeedback
E)mindfulness meditation

Question 56

An added benefit to the use of hypnosis in treating pain is that patients

A)no longer show the classic physiological reactions to pain
B)report experiencing less anxiety
C)enjoy the hallucinations which are common side effects
D)forget their pain entirely
E)it can be self administered

Question 57

All of the following are methods that can be used in pain management to increase the relaxation response except:

A)progressive muscle relaxation
B)distraction
C)guided imagery
D)mindfulness meditation
E)hypnosis

Question 58

Guided imagery is classified as

A)a form of relaxation and distraction
B)a form of distraction and meditation
C)a form of relaxation and biofeedback
D)a form of distraction and biofeedback
E)a form of meditation and relaxation

Question 59

Multidisciplinary pain management programs provide an excellent example of the successful application of the

A)medical model
B)psychological model
C)biopsychosocial approach
D)physiological approach
E)physical and occupational therapy approach

Question 60

Peripherally acting analgesics decrease pain by

A)binding to opiate receptor sites
B)reducing inflammation at the site of tissue damage
C)distracting the patient with hallucinations
D)imitating the effects of the body's endogenous system
E)stimulating the central control trigger

Question 61

Sally suffers from trigeminal neuralgia,a painful disease of the trigeminal nerve located in the face.She has undergone a surgical procedure whereby the trigeminal nerve was severed so that the pain signal would no longer be sent to the brain.Unfortunately,this worked for only a few months.Why was this not a permanent solution for Sally?

A)much of Sally's pain is psychological so cutting the nerve wouldn't help
B)the nerve can regenerate which enables pain to travel along a variety of pathways
C)it is very difficult to identify the trigeminal nerve during surgery
D)most of pain behaviour is learned and not dependent on the stimulus
E)Sally is still imagining her pain although it is really not there