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1

Homer has developed post-hepatic neuralgia after the shingles. He cant tolerate his t-shirt. The term that can describe this is:

A) Hyperalgesia

B) Peripheral sensitization

C) Allodynia

D) Cutaneous pain

C) Allodynia

2

The pain ada[tation argues that the activity of a muscle that is painful or produces a painful movement is uniformly inhibited whereas that of the antagonist are

  1. facilitated
  2. inhibited
  3. ischaemic 
  4. down regulated 

facilitated

 

Week 8 lecture slide 6

3

In central nociceptive transmission, thalamic projections to the somatosensory cortex are predominantly involved in the:

a)     Sensory–discriminative component of pain

b)     Emotional arousal from pain

c)     Escape from pain

d)     Sensory-cognitive component of pain

a)     Sensory–discriminative component of pain

4

Peripheral sensitization may occur as a result of an increase in the release of excitatory neurotransmitters, such as:

a)     Serotonin

b)     GABA

c)     Substance P and glutamate

d)     Noradrenaline

c)     Substance P and glutamate

5

• Sluka, pg 38, “Spinal cord” last paragraph

6

C) Increased pain from a stimulus that normally provokes pain

D) Increased sensitivity to pain

Week 2 lecture, slide 28.

Have moderated ALL attempts to ensure that either C or D is marked as correct.

7

Which of the following statements about nociceptive pain is false?

A) Occurs when nociceptors respond to a noxious stimulus

B) caused by lesion of the somatosensory nervous system

C) Usually time limited

D) Resolves when damaged tissue heals

B) caused by lesion of the somatosensory nervous system

8

The headache produced by cervical artery dissection is due to nociceptor activation in the:

Tunica intima 

Tunica media

Tunica adventitia 

All of the above

Tunica Adventitia

9

Which of the following theories states that physical emotional and cognitive factors all contribute to the experience of pain?

A) specificity theory

B) Nociceptive theory

C) self-control theory

D) Gate control theory

E) Neuromatrix theory

E) Neuromatrix theory

10

the phrase "pain memories" is associated with which pain theory?

  1. pain adaptation theory
  2. Classical conditioning
  3. pain spasm theory 
  4. Hodges protection hypothesis 

Classical conditioning

11

 

The sacroiliac joint is a compound joint that is:

Part synovial and part fibrous 

Part synovial and part symphysis

Part symphysis and part fibrous

Part symphysis and part synchrondrosis

Part synovial and part fibrous 

12

• Sluka, pg 56 “POTENTIAL MECHANISMS OF CENTRAL SENSITIZATION”

13

Which of the following statements about acute pain is false?

A) Pain usually resolves upon healing

B) Is accompanied by increased nervous system activity

C) Usually has no protective function

D) There is usually obvious tissue damage

C) Usually has no protective function

14

Regarding nociceptive transmission, the predominant role of the thalamus is to:

a)     Execute movement commands to withdraw from the noxious stimuli

b)     Execute the withdrawal reflex from the noxious stimuli

c)     Integrate information regarding noxious stimuli

d)     Release dopamine to increase the ability of descending inhibition

c)     Integrate information regarding noxious stimuli

15

Describe four clinical features that may be present in a case of C7 radiculopathy (4 marks)

Nerve root inflammation

  1. Sensory deficit 
  2. motor deficit
  3. numbness tingling.
  4. Dermatomal distribution of sensory loss helps to determine segment of root compression
  5. Radicular pain is felt over multiple dermatomes 

16

When you assess the sensation in a patient’s posterior thigh, the first order neuron being stimulated is the:

Sciatic nerve

Inferior gluteal nerve

Posterior femoral cutaneous nerve

Sural nerve

Posterior femoral cutaneous nerve

17

Low back pain is generally understood to become chronic after a period of how long

A) 6 weeks

B) 12 weeks

C) 14 weeks

D) 1 month

B) 12 weeks

18

According to the intact nociceptor hypothesis 

  1. Intact nociceptors that survive injury and innervate the region by the injured nerve or root are desensitized by the local degenerating nerve fibres and wholly denervated target tissue
  2. Intact nociceptors that survive injury and innervate the region by the injured nerve or root are desensitized by the local degenerating nerve fibres and partly denervated target tissue
  3. Intact nociceptors that survive injury and innervate the region by the injured nerve or root are sensitized by the local degenerating nerve fibres and partly denervated target tissue
  4. Intact nociceptors that survive injury and innervate the region by the injured nerve or root are sensitized by the local degenerating nerve fibres and wholly denervated target tissue

Intact nociceptors that survive injury and innervate the region by the injured nerve or root are sensitized by the local degenerating nerve fibres and partly denervated target tissue

19

• Sluka, pg 23 “Neuropeptides”

20

Define the term cervical spondylotic myelopathy?

nerve root compression caused by degeneration 

  • Osteocytes build up in the canal
  • Disc calcification resulting in loss of disc height
  • ligamentous ossification PLL
  • ligamentous buckling LF

21

One of the differentials for your patient is a strain of the scalenes muscle group. Which of the following is the superior attachment of anterior scalenes?

TPs of C1 – C4

SPs of C2 – C7

TPs of C3 – C6 

TPs of C5 – C7

TPs of C3 – C6 

22

regarding motor control and pain theories, what did early scientist propose?

  1. That a simplistic relationship between pain and motor control exists. meaning that would lead to either inhibition of muscle activity and spasm 
  2. That a simplistic relationship between pain and motor control exists. meaning that would lead to either inhibition of muscle activity and ischaemia 
  3. That a simplistic relationship between pain and motor control exists. meaning that would lead to either excitation of muscle activity and ischaemia
  4. That a simplistic relationship between pain and motor control exists. meaning that would lead to either excitation of muscle activity and spasm

That a simplistic relationship between pain and motor control exists. meaning that would lead to either inhibition of muscle activity and spasm 

23

A cervical facet joint is an example of:

  1. A saddle synovial joint 
  2. A plane synovial joint
  3. A pivot synovial joint
  4. A condyloid synovial joint

A plane synovial joint

24

Consider the following clinical features: 

  • Duration of 4 – 72 hours
  • Bears at least two of the following characteristics:
  • Unilateral location
  • Pulsating quality 
  • Moderate or severe intensity
  • Aggravation by routine physical activity
  • AND associated with at least one of nausea, vomiting, photophobia and phobia 

The headache most consistent with this clinical description is:

  1. Cervicogenic headache
  2. Cluster headache
  3. Migraine
  4. Tension type headache

Migraine

25

During nociceptive transmission, the primary function of high threshold neurons is to respond to:

a)     Both innocuous stimulation and nociceptive stimulation 

b)     Noxious stimulation

c)     Innocuous mechanical stimulation

d)     Both noxious stimulation and innocuous mechanical stimulation

b)     Noxious stimulation

26

Sluka, pg 19 “Muscle and joint nociceptors”

27

D) Painful response to a non nociceptive stim

• Figure 1.1 and table 1.1 Sluka

“Allodynia is a term used to describe pain from a nonnociceptivestimulus”

28

• Sluka, pg 37 “Central nociceptive pathways”

29

D) Pain arising as a direct consequence of a lesion or disease affecting the somatosensory system

Week 2 Lecture – slide 10

30

Discuss three common injury mechanisms associated with a hamstring strain – please provide examples within your answer

  1.  Occurs in activities where the hamstrings can be stretched eccentrically at high speed. 
  2. Occurs with acute overstretching
  3. Occurs with repetitive strain causing disruption of mm fibres

examples: sprinters, soccer, football, dancers, hurdlers