Final Exam

Question 1

Definition of hypoalgesia

Answer 1

Diminished pain in response to a normally painfull stimulus

Question 2

Définition of hyperalgesia

Answer 2

I creased pain from a stimulus that normally provokes pain

Question 3

Définition of allodynia

Answer 3

Pain due to a stimulus that does not normally provoke pain

Question 4

Pain threshold definition

Answer 4

The minimum intensity of stimulus that is perceived as painful

Question 5

Pain tolerance

Answer 5

The maximum intensity of a pain producing stimulus that a subject os willing to accept in a given situation

Question 6

Pain behaviour

Answer 6

What a person does in resction to pain or to express pain
Ex: avoidance, withdrawal, crying, grimacing

Question 7

Stress response systems

Answer 7

Hpa axis
Autonomic ns
Endocrine system
Cardiovascular system

Question 8

Nociceptive pain

Answer 8

Pain that arises from actual or threatened damage to non-neural tissue and is due to the activation of nociceptors

Question 9

Neuropathic pain

Answer 9

Pain caused by a lesion or disease of the somathosensory nervous system

Question 10

Nociplastic pain

Answer 10

Pain that arises from altered nociception despite no clear evidence of actuà or threatened tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain

Question 11

Purpose of pain

Answer 11

Detect threat
Motivate protective behaviour

Question 12

Why bot use pain carastrophizing with pt

Answer 12

• dismiss the medical basis of pain
• question authenticity of pain complaints
• blame indv for their pain

Question 13

Def of pain catastrophizing

Answer 13

Is an exaggerated threat apprasial of pain (understanding)

Question 14

Advatages of patient reported outcome measures

Answer 14

• standardized
• psychometric properties (reliability, validity)
• limit biais
• documentation quality

Question 15

Purpose of patient reported outcome measure, such as questionaire

Answer 15

• screen
• evaluate
• prioritize
• inform
• to re-assess
• to motivate

Question 16

Pain experience

Answer 16

Unpleasant sensory and emotional experience, and is understood to be a function of the whole person

Question 17

Pain expression

Answer 17

Broad collection of qualitative words and behaviours that communicate pain
- pain narrative (words)
- pain behaviour (non-verbal and praverbal behaviour)

Question 18

Pain measures

Answer 18

Quantitative tools used to assess pain
- self reported measures (questionaires)
- non self report ( imaging)

Question 19

Definition of pain

Answer 19

An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage

Question 20

Imp to listen and validate why

Answer 20

Therapeutic alliance
Person feels heard they stop wasting energy on trying to prove to you that their pain is real, more engaged in disclosure of relevant info

Question 21

Principles of pain management

Answer 21

Patient autonomy
Therapeutic àalliance
Layers of clinical considerations for pain

Question 22

Therapeutic alliance

Answer 22

A trusting connection and rapport established between therapist and client through collaboration, communication, therapist empathy and mutual understanding and respect

Question 23

Mechanism based approach to pain management: nociceptive

Answer 23

Exercise
Massage
Tens

Question 24

Mechanism based approach to pain management: nociplastic

Answer 24

Education
Exercise
Massage
Manipulation
TENS

Question 25

Mechanism based approach to pain management: neuropathic

Answer 25

Exercise

Question 26

Mechanism based approach to pain management: psychosocial

Answer 26

Education Exercise Massage

Question 27

Mechanism based approach to pain management: motor

Answer 27

Education Exercise Manipulation

Question 28

Principles of trauma informed care

Answer 28

Safety Trustworthiness and transparency Peer support Collaboration and mutuality Enpowerment, voice, and choice Cultural,historical and gender

Question 29

clarification of definition of pain

Answer 29

- personal experience - pain does not equal nociception - affected by life exp - pt report respected - affects psychosocial aswell - many behaviours to pain (verbal to non-vebal)

Question 30

central sensitization what happens in body

Answer 30

- increased responsiveness of nociceptive neurons in the CNS to their normal or sub threshold afferent input - increased size of receptive fields for nociceptive spinal dorsal horn neurons - reduced threshold of nociceptive spinal dorsal horn neurons to stimulation of their receptive fields - temporal summation of pain = prig increase of pain to the same stim administered repetitively or over long period

Question 31

peripheral sensitization what happens in body

Answer 31

- increased respnsiveness of nociceptors to stimulation of their receptive fields - increased size of nociceptors receptive fields - reduced threshold of nociceptors to stimulation of their receptive fields - activation of silent nociceptors

Question 32

pain related fear definition

Answer 32

refers to fear of the pain itself or fear of doing physical mvt/activity that could worsen the pain, injury, or cause re-injury

Question 33

explain guided disclosure

Answer 33

gradually cross levels of intimacy

Question 34

explain OARS

Answer 34

Open ended questoins A: affirming (validate feelings not not bad behaviour) R: reflecting (empathy) S: summarize (main problems and needs)

Question 35

explain motivational interviewing

Answer 35

R: resist (not telling them what to do) U: understand (what motivates them) L: Listen (empathy) E: empower (support autonomy)

Question 36

explain forward pacing

Answer 36

increase pace of disclosure skip necessary dialogue reflect what the patient says and follow with an open ended question to direct convo to imp part

Question 37

why is it imp to educate pt

Answer 37

- pain neuroscience education addressing unhelpful misconception or lack of knowledge about pain/injury/recovery - setting expectations - modifying maladaptive coping habits - modifying training - daily life/ lifestyle habits for recovery, prevention and overall health

Question 38

benefits of active tx

Answer 38

- empower patient autonomy - internal locus of control - building self-efficacy - motivation for long-term adherence to improved lifestyle habits - better, faster recovery + prevention of recurrence

Question 39

how to apply pain neuroscience education

Answer 39

- leverages the communication strategies (oars, rule, etc) - consider which bps factors are relevant to talk about - gauge the extent/depth to which the patient cares to talk about it (pt centered) - evidence-based, collaborative & empathetic

Question 40

two components of sleep physiology

Answer 40

homeostatic process circadian rhythm

Question 41

explain homeostatic process

Answer 41

sleep pressure build up through time awake feel more sleepy and get better sleep rebound if high pressure lowers with naps

Question 42

explain circadian rhythm

Answer 42

internal clock dictates when to sleep and when to be awake affected by light (natural and blue from screens) dark increases melatonin

Question 43

components of cognitive behavioural therapy for insomnia CBT-I

Answer 43

- sleep diary - sleep hygiene - restricted time in bed - stimulus control - relaxation - cognitive restructuration

Question 44

responding to an overwhelmed/distress pt

Answer 44

- listen and validate - explore what is the source of the distress - evaluate how they are coping with the distress - when appropriate, get back to focusing on managing the pain/injury, or refer out for additional support