PainNMSControl and Biofeedback

Question 1

stages of the death and dying model

Answer 1

Denial, anger, bargaining, depression, acceptance

Question 2

How applicable is death and dying model for athletic injury?

Answer 2

not good

Question 3

Cognitive Appraisal Models of pain state that response to injury depends on?

Answer 3

understanding of the injury

Question 4

What is the purpose of pain?

Answer 4

• warns of impending injury
• essential for survival
• protects body
• signifies something is wrong
• limits further injury

Question 5

Which superficial mechanoreceptors are associated with pressure and touch?

Answer 5

meissners corpuscles, pacinian corpuscles

Question 6

Which superficial mechanoreceptors are associated with skin stretch/pressure?

Answer 6

Merkle cells, Ruffini endings

Question 7

What deep sensory/proprioceptors are associated with change in muscle length and spindle tension?

Answer 7

Golgi Tendon organs

Question 8

Which deep sensory/proprioceptors are associated with change in joint position and vibration?

Answer 8

pacinian corpuscles

Question 9

Which proprioceptors are associated with joint end range and possible heat?

Answer 9

Ruffini endings

Question 10

Pain can occur at the

Answer 10

• periphery
• spinal level
• ascending pathway
• supraspinal level
• descending pathway

Question 11

sight, taste, smell, hearing and balance are examples of what type of receptors

Answer 11

Special sensory receptors

Question 12

Hunger, nausea, distension are examples of what

Answer 12

visceral receptors

Question 13

Process of changing energy of nociception

into electrical action potential in the neuron

Answer 13

transduction

Question 14

First order afferents are typed according to structural and functional
characteristics such as:

Answer 14

• Diameter of nerve (velocity of transmission)
• Degree of myelination (velocity of transmission)
• Function of nerve (determines type of info carried
by nerve)
– Light touch, pressure, pain or temperature

Question 15

Examples of A-beta first order afferents

Answer 15

Hair follicles, Meissners corpuslces, Pacinian
corpuscles, Merkle cell endings, Ruffini
endings

Question 16

• Touch, vibration, and hair deflection
• Large diameter (6-12 micrometer um)
• Myelinated

Answer 16

A-beta fibers

Question 17

Myelinated 1st order afferent
– Fast conduction velocity 36-72 microseconds
– Low threshold

Answer 17

A-beta fibers

Question 18

Warm and cold receptors, hair follicles, free nerve endings
• Touch, pressure, temp and pain
• Free nerve endings respond to noxious stimuli such as pricking, pinching and crushing

Answer 18

A-delta fibers

Question 19

Myelinated first order afferents
– Smaller diameter (1-6 um)
» Slower conduction velocity (6-36 usecs)

Answer 19

A-delta fibers

Question 20

Pain, touch, pressure, temperature (skin)
– Pain (receptors of muscle)
• Include efferent postganglionic fibers of SNS, mechanoreceptors, nociceptors and thermoreceptors
• Smallest peripheral nerves associated with pain

Answer 20

C fibers

Question 21

Unmeylinated first order afferent

– Small diameter

Answer 21

C fiber

Question 22

First order neuron synapses in ___

Answer 22

spinal cord dorsal

horn

Question 23

Cell body of second order neuron (T cell) is in ___

Answer 23

the dorsal horn

Question 24

Multiple tracts carry information through the SC to the brain • cell bodies of third order neurons are located in

Answer 24

VPL (ventral posterior lateral) and VPM (ventral posterior

medial) of the thalamus

Question 25

Ascending pain fibers from body synapse in this part of the thalamus

Answer 25

VPL

Question 26

Fibers from the head and face synapse in this part of the thalamus

Answer 26

VPM

Question 27

Thalamus modulates input and transmits to ___ where localization and discrimination occur in the ___.

Answer 27

somatosensory cortex, post central gyrus

Question 28

Regulates emotional, autonomic and endocrine | responses to pain (affective motivational component

Answer 28

limbic system

Question 29

Phase where any activity after the cortex has received input

Answer 29

modulation phase

Question 30

When these areas are not inhibited can lead to | affective emotional response similar to shock

Answer 30

Hypothalamus, pituitary, reticular formation, | Raphe nucleus

Question 31

Network of messages and activation of brain centers may exacerbate the painful event and lead to

Answer 31

“windup”

Question 32

Increases threshold • More difficult to stimulate • Fewer pain impulses transmitted to SC • May try to decrease effects of chemical mediators in inflammatory process

Answer 32

Pain modulation targeted at desensitizing of | peripheral nociceptors

Question 33

– Decrease effects of chemical mediators | – Decrease speed of pain transmission

Answer 33

ice

Question 34

Non-painful stimulus can block the transmission of noxious stimulus

Answer 34

Gate Theory

Question 35

in dorsal horn of spinal cord acts as a “switch operator”

Answer 35

Substantia gelatinosa

Question 36

Interneuron that utilizes ___is present in substantia gelatinosa – Inhibits pain transmission w/in dorsal horn

Answer 36

enkephalin

Question 37

Shaking your hand gives ___stimulation. This can cause inhibitory interneurons to be stimulated – Blocks pain transmission – TENS gives sensory feedback at a non painful level to stimulate A-beta fibers

Answer 37

A-beta

Question 38

– Low frequency, high intensity stimulation of peripheral nerves (Motor TENS) – Causes activation of Reticular Formation and pituitary gland – Descending Endogenous Opiate System (DEOS) • Endogenous opioid (endorphin) release – Inhibitory effect on lower pain pathways – Descending pain modulation (analgesia)

Answer 38

Motor Pain Modulation

Question 39

– Electrical stimulation of C fibers in the injury area (Noxious TENS) – Activates Periaqueductal Gray (PAG) and Raphe nucleus – Serotonin neurons in dorsal horn inhibit second order neuron directly or through an interneuron – Also ice stimulation of C fibers during burning and aching sensation

Answer 39

Noxious Pain Modulation

Question 40

When stimulation encroaches on the refractory period of the sensory nerve and causes inhibition by continual stimulation • Russian stimulation, Interferential current

Answer 40

Nerve Block/ Wedenskis Pain Modulation

Question 41

decreased pain sensation during physical activity | Increased endogenous opioids (endorphins) and catecholamines (epinephrine/norepinephrine) during exercise

Answer 41

Exercise Induced Hypoalgesia