Chapter 7

Question 1

What are the two methods of testing function?

Answer 1

Nerve conduction study (NCS)

Somatosensory evoked potentials (SEP)

Question 2

What does NCS measure?

Answer 2

peripheral nerve function

Question 3

What does SEP measure?

Answer 3

peripheral nerves and central nervous system pathways

Question 4

What is compared to determine if NCS is normal?

Answer 4

distal latency
amplitude of the evoked potential
conduction velocity

Question 5

What are SEPs used to determine?

Answer 5

verify subtle signs and locate lesions of the dorsal roots, posterior columns, and brainstem.

Question 6

What is ataxia?

Answer 6

incoordination that is not due to weakness

Question 7

What are three types of ataxia?

Answer 7

sensory
vestibular
cerebellar

Question 8

What is the Romberg test used for?

Answer 8

to distinguish between cerebellar ataxia and sensory ataxia

Question 9

What is neuropathy?

Answer 9

general term for dysfunction or the pathologic condition of one or more peripheral nerves

Question 10

What is the sensory loss in peripheral nerve lesions?

Answer 10

1. conscious proprioception and discriminative touch
2. Cold
3. Fast pain
4. Heat
5. Slow pain

Question 11

What are the common causes of dysfunction of the spinal region?

Answer 11

trauma
disease
virus

Question 12

What happens with complete transection of cord?

Answer 12

All sensation is prevented at one or two levels below the lesion
Voluntary motor control below the lesion is also lost

Question 13

What happens with hemisection of the spinal cord?

Answer 13

• complete loss of sensation in contralateral side 2-3 levels below lesion
• discriminative touch and conscious proprioception lost ipsilateral to lesion

Question 14

Lesion in posterior column:

Answer 14

conscious proprioception, 2 point discrimination and vibration lost below level of lesion
-ataxic movements

Question 15

Brainstem region lesion:

Answer 15

mix of ipsilateral and contralateral signs

-sensory loss can be contralateral in upper midbrain after discriminative sensation have crossed midline

Question 16

Somatosensory Cortex Lesion:

Answer 16

Conscious proprioception
Two-point discrimination
Stereognosis
Localization of touch and pinprick (nociceptive) stimuli
-contralateral and decrease of above sensations

Question 17

Fast and slow pain can occur with musculoskeletal injuried via what fibers?

Answer 17

A-delta and C fibers

Question 18

What parts of the brain are included in processing and regulating pain information?

Answer 18

brainstem, amygdala, hypothalamus, thalamus, and areas of the cerebral cortex

Question 19

What does understanding of pain matrix require?

Answer 19

understanding of:

1. discriminative
2. motivational affective
3. congitive-evaluative component

Question 20

Discriminative aspect of pain matrix refers to what?

Answer 20

the ability to localize the site, timing, and intensity of tissue damage or potential tissue damage

Question 21

Motivational affective aspect of pain matrix refers to what?

Answer 21

the effects of the pain experience on emotions and behavior, including increased arousal and avoidance behavior.

Question 22

Cognitive-evaluative aspect of pain matrix refers to what?

Answer 22

meaning that the person interprets /ascribes to the pain (punishment, burden

Question 23

How is pain controlled?

Answer 23

1. gate theory
2. counterirritant theory
3. dorsal horn processing of nociceptive information
4. antinociceptive systems

Question 24

What is the gate theory of pain?

Answer 24

Typical response to hitting one’s thumb with a hammer is to withdraw the thumb, yell, and apply pressure
- TENS

Question 25

What is the counterirritant theory?

Answer 25

explains the inhibition of nociceptive signals by stimulation of non-nociceptive receptors occurs in the dorsal horn of the spinal cord

Question 26

What is the dorsal horn processing of nociceptive information?

Answer 26

Processing of somatosensory information in the dorsal horn can be altered by abnormal neural activity or by tissue injury

Question 27

What are the states of dorsal horn processing?

Answer 27

normal suppressed sensitized reorganized

Question 28

Normal state of dorsal horn processing:

Answer 28

normal physiologic activity

Question 29

Suppressed state of dorsal horn processing:

Answer 29

segmental and descending inhibition

Question 30

Sensitized state of dorsal horn processing:

Answer 30

changes in neurotransmitters and receptors

Question 31

Reorganized state of dorsal horn processing:

Answer 31

cell death, degeneration of C fiber and sprouting that synapses with neurons in the nociceptive pathways

Question 32

Neuropathic pain is produced by what?

Answer 32

neuroplasticity not by stimulation of nociceptors

Question 33

Antinociception:

Answer 33

the suppression of pain in response to stimulation that would normally be painful.

Question 34

What activates antinociceptive mechanisms?

Answer 34

endorphins and endogenous substances

Question 35

Level I of antiociceptive site:

Answer 35

peipheral

Question 36

Level II of antiociceptive site:

Answer 36

dorsal horn

Question 37

Level III of antiociceptive site:

Answer 37

fast acting neuronal pathway from brainstem

Question 38

Level IV of antiociceptive site:

Answer 38

hormonal

Question 39

Level V of antiociceptive site;

Answer 39

descending cortical inhibition

Question 40

What is primary hyperalgesia?

Answer 40

refers to excessive sensitivity to stimuli in injured tissue