• Home
  • Textbooks
  • McGraw-Hill Specialty Board Review Pain Medicine
  • Pain Physiology

McGraw-Hill Specialty Board Review Pain Medicine

Salahadin Abdi, Pradeep Chopra, Howard Smith

Chapter 2

Pain Physiology - all with Video Answers

Educators

Chapter Questions

Problem 7

Neurotransmitters in the central nervous system (CNS) are classified into which of the following?
(1) Excitatory
(2) Inhibitory
(3) Neuropeptides
(4) Regulatory

Check back soon!
03:10

Problem 46

Which of the following nerves conduct nociceptive stimuli?
(A) A- $\delta$ fibers and $C$ fibers
(B) A- $\delta$ fibers and $A-\beta$ fibers
(C) $A-\beta$ fibers and $C$ fibers
(D) $B$ fibers and $C$ fibers
(E) A- $\alpha$ fibers and $A-\beta$ fibers

Asma Venkitta
Asma Venkitta
Numerade Educator
02:28

Problem 47

Arrange A- $\delta, A-\beta, B, C$, and $A-\alpha$ nerves according to their conduction velocity (fastest to slowest):
(A) A- $\alpha, \mathrm{A}-\beta, \mathrm{A}-\delta, \mathrm{B}, \mathrm{C}$
(B) $\mathrm{A}-\delta, \mathrm{C}, \mathrm{B}, \mathrm{A}-\beta, \mathrm{A}-\alpha$
(C) $\mathrm{C}, \mathrm{B}, \mathrm{A}-\delta, \mathrm{A}-\beta, \mathrm{A}-\alpha$
(D) $\mathrm{A}-\beta, \mathrm{A}-\delta, \mathrm{C}, \mathrm{B}, \mathrm{A}-\alpha$
(E) $\mathrm{B}, \mathrm{C}, \mathrm{A}-\beta, \mathrm{A}-\alpha, \mathrm{A}-\hat{\mathrm{A}}$

Saurabh Chandra
Saurabh Chandra
Numerade Educator
02:45

Problem 48

The impulse traveling through the $\mathrm{C}$ fiber terminates in the Rexed laminae:
(A) Laminae 1 and 5
(B) Laminae 1 and 2
(C) Laminae 1,2 , and 5
(D) Laminae 2 and 5
(E) Laminae 3 and 5

Asma Venkitta
Asma Venkitta
Numerade Educator
04:49

Problem 49

Some of the naturally occurring chemicals involved in nociceptive input are hydrogen ions, serotonin $(5-\mathrm{HT})$, and bradykinin. What effect do these have on the nocioptors?
(A) Sensitize the nociceptors
(B) Activate the nociceptors
(C) Activate and sensitize the nociceptors
(D) Block the nociceptors
(E) Modify the nociceptors

Ali Crampton
Ali Crampton
Numerade Educator
02:22

Problem 50

Substance $P$ release from the dorsal hom neuronal elements is blocked by
(A) endogenous opioids
(B) exogenous opioids
(C) both type of opioids
(D) anticonvulsant medications
(E) local anesthetics

Sarah Howell
Sarah Howell
Numerade Educator
04:28

Problem 51

Arrange the visoeral structures - hollow visoera, solid viscera, serosal membranes - in the order of increasing sensitivity to noxious stimuli:
(A) Serosal membranes, hollow viscera, solid viscera
(B) Hollow viscera, solid viscera, serosal membranes
(C) Solid viscera, hollow viscera, serosal membranes
(D) Hollow viscera, serosal membranes, solid viscera
(E) Serosal membranes, solid viscera, hollow viscera

Anas Venkitta
Anas Venkitta
Numerade Educator
02:56

Problem 52

Visceral pain is typically felt as
(A) dull
(B) sharp
(C) vague
(D) all of the above
(E) A and C only

Cody Delk
Cody Delk
Numerade Educator
00:45

Problem 53

Hollow viscera can be painful during which type of contractions?
(A) Isotonic
(B) Isometric
(C) Sustained
(D) Isotonic and isometric
(E) None of the above

Joanna Quigley
Joanna Quigley
Numerade Educator
01:07

Problem 54

Certain nociceptors are termed "silent nociceptors." These can be activated ("awakened") by a prolonged noxious stimulus, such as inflammation. These types of receptors were initially identified in which structures?
(A) Bones
(B) Brain
(C) Nails
(D) Joints
(E) Nerves

Rikhil Makwana
Rikhil Makwana
Numerade Educator
01:08

Problem 55

Visceral referred pain with hyperalgesia can be explained by which of the following?
(A) Viscerovisceral convergence
(B) Viscerosomatic convergence
(C) Nociceptive perception
(D) Sympathetic stimulation.
(E) Sympathetic transmission

Cody Delk
Cody Delk
Numerade Educator
00:31

Problem 56

Enkephalins and somatostatin - are these types of neurotransmitters:
(A) Excitatory
(B) Inhibitory
(C) Gastrotransmitters
(D) Excitatory and inhibitory
(E) None of the above

Shazia Naz
Shazia Naz
Numerade Educator

Problem 56

Substance $\mathrm{P}$ is released by the activation of nociceptors and has the following eifect(s):
(1) Vasodilatation
(2) Vasoconstriction
(3) Mast cell activation
(4) Decrease vascular permeability

Check back soon!
02:04

Problem 57

There are several subtypes of $\mathrm{N}$-methyl-Daspartate (NMDA) receptors. They are
(A) NR1, NR2 (A, B, and C)
(B) NR1, NR2 (A, B, C, and D)
(C) NR1, NR2 (A, B, and C), and NR3 (A and B)
(D) NR1, NR2 (A, B, C, and D), and NR3 (A and B)
(E) NR1, NR2 (A, B, C, and D), NR3 ( $\mathrm{A}$ and $\mathrm{B})$ and $\mathrm{NRA}(\mathrm{A}$ and $\mathrm{B})$

Jessica Wooten
Jessica Wooten
Numerade Educator
01:24

Problem 58

Sodium channels are also important in neurotransmission through the dorsal root ganglion (DRG). How many different types of sodium channels have been identified?
(A) Four
(B) Eight
(C) Seven
(D) Five
(E) Nine

Leah Lampen
Leah Lampen
Numerade Educator
00:47

Problem 59

Ziconotide, found in snail venom, acts primarily on which type of calcium channel?
(A) N-type
(B) T-type
(C) L-type
(D) P-type
(E) Q-type

Jorge Villanueva
Jorge Villanueva
Numerade Educator
02:18

Problem 60

Pretreatment with an NMDA antagonist prior to inflammation has been shown to
(A) enhance central sensitization
(B) attenuate central sensitization
(C) have no effect on central sensitization
(D) enhance peripheral sensitization
(E) attenuate peripheral sensitization

Alexa Moschella
Alexa Moschella
Numerade Educator
00:36

Problem 61

NMDA receptor channels are usually inactive and blocked by zinc and magnesium ions. A depolarization of the cell membrane removes these ions and allows influx of which ions?
(A) Sodium
(B) Calcium
(C) Chloride
(D) Sodium and calcium
(E) Sodium and chloride

Hunza Gilgit
Hunza Gilgit
Numerade Educator
00:32

Problem 62

Nociceptive stimuli cause increased activity in the cerebral cortex in
(A) a focal area around the central gyrus
(B) widespread areas in the temporal cortex
(C) a focal area around the posterior cortical areas
(D) widespread areas in the frontal cortex
(E) a focal area in the thalamus

Joanna Quigley
Joanna Quigley
Numerade Educator
04:53

Problem 63

$\gamma$-Aminobutyric acid (GABA) receptors (a type of cellular channel), are these types of ion channels:
(A) Calcium
(B) Sodium
(C) Chloride
(D) Magnesium
(E) Potassium

Prashant Bana
Prashant Bana
Numerade Educator
00:31

Problem 64

Nociceptors are present in
(1) skin
(2) subcutaneous tissue
(3) joints
(4) visceral tissue

Sam Limsuwannarot
Sam Limsuwannarot
Numerade Educator

Problem 66

Visceral pain input terminates in the following Rexed lamina(e):
(1) Lamina 1
(2) Lamina 2
(3) Lamina 5
(4) Lamina 10

Check back soon!

Problem 67

The visceral pain may be felt as pain in
(1) the midline
(2) the unilateral
(3) the bilateral
(4) multiple patterns

Check back soon!

Problem 68

Which of the following induce pain in hollow viscera?
(1) Cutting
(2) Ischemia
(3) Burning
(4) Distension

Check back soon!
04:49

Problem 69

Viscera are supplied by sympathetic nerves which contribute to pain generation and transmission. They release several chemical substances including the following:
(1) Norepinephrine
(2) Histamine
(3) Serotonin
(4) Epinephrine

Ali Crampton
Ali Crampton
Numerade Educator
02:47

Problem 71

These are some of the excitatory neurotransmitters:
(1) Glutamate
(2) Glycine
(3) Aspartate
(4) GABA

Cody Delk
Cody Delk
Numerade Educator
03:04

Problem 72

NMDA receptor blockade in the spinal cord causes
(1) inhibition of pain transmission
(2) modulation of pain transmission
(3) reduction in pain transmission
(4) does not have a role in pain transmission

Bryan Valdivia
Bryan Valdivia
Numerade Educator
00:41

Problem 73

The subunit most relevant in nociception is
(1) NR2A
(2) NR2B
(3) NR3A
(4) NR1

Mishal Gul
Mishal Gul
Numerade Educator

Problem 74

Ketamine and Memantine are NMDA receptor
(1) allosteric negulators
(2) agonists
(3) stimulators
(4) blockers

Check back soon!
00:31

Problem 75

The most important substances found in the descending inhibitory pathways of the CNS include
(1) acetylcholine
(2) serotonin
(3) nitric oxide (NO)
(4) norepinephrine (NE)

Shazia Naz
Shazia Naz
Numerade Educator
01:46

Problem 76

There are several types of calcium channels. Which one is the most relevant to pain impulse transmission in the spinal cord?
(1) L-type
(2) R-type
(3) T-type
(4) N-type

Qudsiya Anis
Qudsiya Anis
Numerade Educator
00:36

Problem 77

N-type calcium channels are highly concentrated in which of the following areas?
(1) DRG
(2) Cerebral cortex
(3) Dorsal horn
(4) Postsynaptic terminals

Carlene Jimenez
Carlene Jimenez
Numerade Educator
05:01

Problem 78

Windup is a phenomenon that occurs due to constant input of C-fiber activity to the spinal cord. This phenomenon defines
(1) reduction in excitability of spinal neurons in the DRG
(2) increase in excitability of spinal neurons in the DRG
(3) reduction in excitability of spinal neurons in the dorsal horn
(4) increase in excitability of spinal neurons in the dorsal horn

Rikhil Makwana
Rikhil Makwana
Numerade Educator
02:47

Problem 79

Primary inhibitory neurotransmitters include the following:
(1) Glycine
(2) Glutamate
(3) GABA
(4) Aspartate

Cody Delk
Cody Delk
Numerade Educator
03:04

Problem 80

Excitatory neuropeptides in the CNS include the following:
(1) Substance $P$
(2) Somatostatin
(3) Neurokinin A
(4) Dynorphin

Bryan Valdivia
Bryan Valdivia
Numerade Educator
01:16

Problem 81

Serotonin is released as mediator as a result of tissue injury from which of the following?
(1) Platelets
(2) Muscle cells
(3) Mast cells
(4) White blood cells

Joanna Quigley
Joanna Quigley
Numerade Educator
03:04

Problem 82

Protease-activated receptors (PAR) were detected in which of the following?
(1) Platelets
(2) Endothelial cells
(3) Fibroblasts
(4) Nervous system

Bryan Valdivia
Bryan Valdivia
Numerade Educator
01:51

Problem 83

Increased nerve growth factor (NGF) levels observed after inflammatory stimuli result from increased synthesis and release of NGF from cells in the affected tissue. Large number of stimuli can alter NGF production including:
(1) $2 \mathrm{IL}-1 \beta, \mathrm{IL}-4, \mathrm{IL}-5$
(2) Tumor necrosis factor $\alpha$ (TNF- $\alpha$ ), transforming growth factor $\beta$ (TGF- $\beta$ )
(3) Platelet-derived growth factor
(4) Epidermal growth factor

Mariana Roldan
Mariana Roldan
Numerade Educator
00:34

Problem 84

Endogenous opioid peptides are important in nociceptive perception and modulation. These include which of the following?
(1) Leucine-enkephalin
(2) Dynorphin
(3) Methionine-enkephalin
(4) Nociceptin

Emily Himsel
Emily Himsel
Numerade Educator
00:52

Problem 85

Nociceptors are specific receptors within the superficial layers of the skin.

Mariana Roldan
Mariana Roldan
Numerade Educator
04:40

Problem 86

Conduction velocity of $\mathrm{A}-\delta$ fibers is faster than the $\mathrm{C}$ fibers.

Robert Schnibbe
Robert Schnibbe
Numerade Educator
02:00

Problem 87

Nociceptive impulse terminates in nociceptive-specific as well as wide dynamic range (WDR) neurons.

Michela Jacobson
Michela Jacobson
Numerade Educator
00:38

Problem 88

Hyperalgesia can only occur with somatic nociceptive stimuli and not visceral stimuli.

Joanna Quigley
Joanna Quigley
Numerade Educator
00:13

Problem 89

NMDA receptor in the spinal cord dorsal horn is essential for central sensitization, the central facilitation of pain transmission produced by peripheral injury.

Emily Marty
Emily Marty
Numerade Educator
01:09

Problem 90

Neuropeptides are only excitatory in nature-

Anitha Mary
Anitha Mary
Numerade Educator