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Pain and Temperature

Total questions: 15

Worksheet time: 9mins

Name
Class
Date
1.

Which pathway represents a route that pain information could take in the nervous system?

a)

Free nerve ending nociceptor, unmyelinated C fiber axon, spinal cord

b)

Free nerve ending nociceptor, myelinated C fiber axon, spinal cord

c)

Unspecialized, unmyelinated Ad axon, spinal cord

d)

Specialized pain receptor, partially myelinated C fiber axon, brainstem

e)

Mechanoreceptor, myelinated axons, cranial nerve, spinal cord

2.

A 40-year-old woman presented to the pain clinic with complaints of severe pain in response to non-painful stimuli, such as light touch or clothing brushing against her skin. The patient described the sensation as excruciating and debilitating, significantly impacting her quality of life. Clinical examination revealed no visible signs of injury or inflammation, suggesting a neuropathic origin of the pain. What is the underlying mechanism of this patient's condition?

a)

upper and lower motor neuron disease due to autoimmune destruction

b)

inadvertent stimulation of 2nd –order neurons in the dorsal horn

c)

autoimmune destruction of nicotinic receptors at the motor end-plate

d)

increased sensitization to mu receptor activation

3.

A 60-year-old male presented to the pain management clinic with complaints of chronic pain following a traumatic injury to his lower back. Despite various treatments, including medications and physical therapy, the patient reported worsening pain intensity and sensitivity over time. Clinical examination revealed signs of hyperalgesia and allodynia, suggesting the presence of Windup Phenomenon. What is the cellular mechanism involved in this patient's condition?

a)

Removal of Mg2+ block of NMDA receptor, decreasing sensitization to glutamate

b)

Piezo receptor activation allowing for excessive influx of Na+ and Ca2+ ions

c)

Reduced mu receptor expression increasing pain sensation

d)

Removal of Mg2+ block of NMDA receptor, increasing sensitization to glutamate

e)

TRPV1 receptor activation resulting in excessive burning sensations

4.

What do nociceptor neurons and non-nociceptor somatosensory neurons have in common?

a)

Unspecialized nerve endings

b)

Specialized nerve endings

c)

Conduction velocity

d)

Highly myelinated axons

e)

Cell body located in the dorsal root ganglia

5.

Which conclusion about the neuronal basis of pain is consistent with the graph?

a)

Stimuli of certain temperatures can activate nociceptors but not thermoreceptors.

b)

These nociceptors respond only to stimuli that are sufficiently warm (approximately 43°C or above).

c)

There is a linear relationship between thermoreceptor response and temperature of the stimulus.

d)

The nociceptors and thermoreceptors respond to a thermal stimulus by decreasing the frequency of action potentials

e)

Any thermal stimulus can activate both the nociceptors and the thermoreceptors.

6.

Which fibers conduct the sensation of first pain?

a)

Unmyelinated C

b)

Myelinated Aδ

c)

Myelinated Ia

d)

Unmyelinated II

e)

Myelinated Aβ

7.

Which sensation would an individual with anesthetized C fibers report when exposed to intense heat?

a)

Sharp pain followed by a dull burning

b)

Sharp pain only

c)

Dull burning only

d)

Tingling

e)

No sensation

8.

ASIC channels are involved in generating the sensation of pain associated with heart attack because, during heart attack

a)

pH of the tissue increases, which activates the channels.

b)

pH of the tissue decreases, which activates the channels.

c)

heart tissue undergoes necrosis, the products of which activate the channels.

d)

heart muscle contracts, and this mechanical force activates the channels.

e)

capsaicin produced in the heart muscle activates the channels.

9.

Which deficit would a lesion restricted to the right side of the spinal cord produce?

a)

Mechanosensory deficit on the right side of the body only

b)

Mechanosensory deficit on the left side of the body only

c)

Pain deficit on the right side of the body only

d)

Pain deficit on the left side and mechanosensory deficit on the right side of the body

e)

Pain deficit on the right side and mechanosensory deficit on the left side of the body

10.

Colon cancer pain has been shown to be relieved by disruption of the visceral pain pathway at the level of the

a)

spinal cord near the midline at the sacral level.

b)

spinal cord near the midline at the thoracic level.

c)

ventral horn ipsilateral to the site of pain at the thoracic level.

d)

dorsal horn contralateral to the site of pain at the thoracic level.

e)

insular cortex ipsilateral to the site of pain.

11.

A man gets punched in the face (see Pantera's album cover). Where are the bodies of first-order neurons located?

a)

Pars interpolaris

b)

Ventral posterior medial nucleus

c)

Dorsal root ganglia of C1

d)

Thalamus

e)

Trigeminal ganglia

12.

Which statement about placebos is most accurate?

a)

Studies of the placebo effect prove that some people are imagining they feel pain.

b)

The use of placebos is a relatively new strategy for treating pain.

c)

Placebos relieve pain in some people by stimulating endogenous opioid receptors.

d)

In a study of patients with postoperative wounds, the placebo effect was shown to be ineffective in 75% of subjects given sterile saline as the placebo.

13.

Which center has the highest order within the system that modulates the transmission of ascending pain signals?

a)

Raphe nuclei

b)

Locus coeruleus

c)

Parabrachial nucleus

d)

Medullary reticular formation

e)

Midbrain periaqueductal gray

14.

Which statement correctly summarizes the gate theory of pain?

a)

Flow of ascending pain information is modified by stimulation of low-threshold mechanoreceptors

b)

Flow of ascending pain information is modified by stimuli from cortical centers

c)

Flow of ascending pain information is modified by stimuli from brainstem centers

d)

Descending inputs from pain centers directly modify the activity of dorsal horn projection neurons

e)

Descending inputs from pain centers indirectly modify the activity of dorsal horn projection neurons by acting on local circuit neurons

15.

In which region of the brain can all three endogenous opioid peptides be found?

a)

Rostral ventral medulla

b)

Dorsal horns of the spinal cord

c)

Periaqueductal gray matter

d)

Amygdala

e)

Insula