Advanced Pathophysiology
What is a protective and complex phenomenon composed of sensory experiences
(time, space, intensity), emotion, cognition, and motivation? - ANSWER: Pain
Portion of the nervous system responsible for sensation and perception of pain can be
divided into 3 areas: - ANSWER: A: Afferent pathways B interpretive centers in the
brainstem, midbrain & diencephalon C: descending pathways from the brain to the
dorsal horn of spinal cord.
Nociceptors are pain receptors that detect a wide range of stimuli and respond to: -
ANSWER: Chemical, mechanical, and thermal stimulation
The afferent system is: - ANSWER: Composed of nociceptors the dorsal horn of the
spinal column (second-order neurons) and afferent neurons in the Aδ and C fibers (first-
order neurons);spinothalamic tract (third-order neurons).
Myelinated Aδ receptor transmission is - ANSWER: Fast and conveys mechanical and
thermal localized pain.
Unmyelinated polymodal C fiber transmission is: - ANSWER: Slower and conveys
sharp, diffuse burning and aching sensations
These primary-order neurons terminate on second-order neurons. - ANSWER:
Three classes of second-order neurons modulate pain transmission: - ANSWER:
projection cells, excitatory interneurons and inhibitory interneurons.
The second-order neurons are located: - ANSWER: in the spinal cord laminae
The second-order neurons function as - ANSWER: a pain gate to regulate pain
transmission.
Second-order neurons cross over the cord and ascend primarily in - ANSWER: the
lateral the spinothalamic tract to projection centers including the thalamus reticular
formation, and PAG matter.
Third-order neurons carry information to the - ANSWER: sensory cortex and reticular
and limbic systems for pain processing and interpretation.
Efferent pathways from the PAG are responsible for modulation or inhibition of afferent
pain signals. - ANSWER:
, The thalamus cortex, and postcentral gyrus perceive, describe, and localize: -
ANSWER: Pain
The reticular formation and limbic system control the - ANSWER: emotional and
affective response to pain.
Pain threshold is the point at which pain is perceived. Pain threshold does not vary
significantly among people or within the same person over time. - ANSWER:
Pain tolerance is the duration of time or the intensity of pain that an individual will
ensure before initiating overt pain response. - ANSWER:
Tolerance varies widely among individuals and in the same individual over time and in
the same individual over time. - ANSWER:
Descending inhibitory or facilitatory pathways facilitate pain. - ANSWER:
Segmental inhibition is the peripheral stimulation of nociceptors by touch nuclei, and
neurotransmitter inhibit or vibration or pressure resulting in closure of the spinal cord
pain gate. - ANSWER:
The higher brain centers also can - ANSWER: influence painful stimuli
(heterosegmental control of nociception) as well as inhibition from the caudal medulla
(diffuse noxious inhibitory controls).
Thus pain can be modulated with: - ANSWER: Stimulation from the periphery or by
descending impulses from the brain
Cognitive expectation can attenuate or intensify pain and this is known as the: -
ANSWER: Placebo and nocebo effects.
Pain neurotransmitters can be classified as inflammatory excitatory, and inhibitory
modulators of pain. - ANSWER:
Inflammatory neurotransmitters are usually excitatory. Gammaaminobutyric acid
(GABA) and glycine are inhibitors of pain. - ANSWER:
Endogenous opioids are a family of morphine-like neuropeptides that inhibit
transmission of pain by acting on: - ANSWER: specific opiod receptors (mu [μ] kappa
[κ], and delta [δ]).
Classifications of pain include - ANSWER: A: nociceptive pain (with a known physiologic
cause)
B: nonnociceptive pain (neuropathic pain)
What is a protective and complex phenomenon composed of sensory experiences
(time, space, intensity), emotion, cognition, and motivation? - ANSWER: Pain
Portion of the nervous system responsible for sensation and perception of pain can be
divided into 3 areas: - ANSWER: A: Afferent pathways B interpretive centers in the
brainstem, midbrain & diencephalon C: descending pathways from the brain to the
dorsal horn of spinal cord.
Nociceptors are pain receptors that detect a wide range of stimuli and respond to: -
ANSWER: Chemical, mechanical, and thermal stimulation
The afferent system is: - ANSWER: Composed of nociceptors the dorsal horn of the
spinal column (second-order neurons) and afferent neurons in the Aδ and C fibers (first-
order neurons);spinothalamic tract (third-order neurons).
Myelinated Aδ receptor transmission is - ANSWER: Fast and conveys mechanical and
thermal localized pain.
Unmyelinated polymodal C fiber transmission is: - ANSWER: Slower and conveys
sharp, diffuse burning and aching sensations
These primary-order neurons terminate on second-order neurons. - ANSWER:
Three classes of second-order neurons modulate pain transmission: - ANSWER:
projection cells, excitatory interneurons and inhibitory interneurons.
The second-order neurons are located: - ANSWER: in the spinal cord laminae
The second-order neurons function as - ANSWER: a pain gate to regulate pain
transmission.
Second-order neurons cross over the cord and ascend primarily in - ANSWER: the
lateral the spinothalamic tract to projection centers including the thalamus reticular
formation, and PAG matter.
Third-order neurons carry information to the - ANSWER: sensory cortex and reticular
and limbic systems for pain processing and interpretation.
Efferent pathways from the PAG are responsible for modulation or inhibition of afferent
pain signals. - ANSWER:
, The thalamus cortex, and postcentral gyrus perceive, describe, and localize: -
ANSWER: Pain
The reticular formation and limbic system control the - ANSWER: emotional and
affective response to pain.
Pain threshold is the point at which pain is perceived. Pain threshold does not vary
significantly among people or within the same person over time. - ANSWER:
Pain tolerance is the duration of time or the intensity of pain that an individual will
ensure before initiating overt pain response. - ANSWER:
Tolerance varies widely among individuals and in the same individual over time and in
the same individual over time. - ANSWER:
Descending inhibitory or facilitatory pathways facilitate pain. - ANSWER:
Segmental inhibition is the peripheral stimulation of nociceptors by touch nuclei, and
neurotransmitter inhibit or vibration or pressure resulting in closure of the spinal cord
pain gate. - ANSWER:
The higher brain centers also can - ANSWER: influence painful stimuli
(heterosegmental control of nociception) as well as inhibition from the caudal medulla
(diffuse noxious inhibitory controls).
Thus pain can be modulated with: - ANSWER: Stimulation from the periphery or by
descending impulses from the brain
Cognitive expectation can attenuate or intensify pain and this is known as the: -
ANSWER: Placebo and nocebo effects.
Pain neurotransmitters can be classified as inflammatory excitatory, and inhibitory
modulators of pain. - ANSWER:
Inflammatory neurotransmitters are usually excitatory. Gammaaminobutyric acid
(GABA) and glycine are inhibitors of pain. - ANSWER:
Endogenous opioids are a family of morphine-like neuropeptides that inhibit
transmission of pain by acting on: - ANSWER: specific opiod receptors (mu [μ] kappa
[κ], and delta [δ]).
Classifications of pain include - ANSWER: A: nociceptive pain (with a known physiologic
cause)
B: nonnociceptive pain (neuropathic pain)
