S3L3: Classification of Pain

Question 1

Three dimensions

Refers to localization, intensity, duration, & the nature of
the pain (burning, sharp, shooting, superficial, etc.)

Answer 1

Sensory-discriminative

Question 2

Three dimensions

Refers to the emotional response a person has to the pain

Answer 2

Motivation-affective

Question 3

Three dimensions

Includes physiological manifestations of that emotional
response, including nausea

Answer 3

Motivation-affective

Question 4

Three dimensions

Relates to how pain is interpreted in the context of past &
present experience, culture, & so forth

Answer 4

Cognitive-affective

Question 5

Physiological Classification

Refers to response to an immediate noxious stimulus signaling
impending tissue damage

Answer 5

Nociceptive

Question 6

Modified T/F

A. Nociceptive pain can be due to mechanical, thermal, or chemical insult to the area
B. It leads to protective withdrawal response & is beneficia

Answer 6

TT

Question 7

Physiological classification

This type of pain ncreases sensory sensitivity after tissue damage thus discouraging use & further damage

Answer 7

Inflammatory pain

Question 8

Modified T/F

A. Inflammatory pain allows for tissue repair
B. It is due to hypersensitivity due to peripheral injury, pathology, or other inflammatory process

Answer 8

TT

Question 9

T/F

Inflammatory pain is generally beneficial as it encourages rest, but becomes counterproductive if severe or ongoing.

Answer 9

True

Question 10

Physiological classification

This type of pain results from an abnormally functioning nervous system relaying pain signals unrelated or disproportionate to
tissue damage

Answer 10

Maladaptive pain

Question 11

Modified T/F

A. Maldaptive pain represents altered neural processing
B. Decreased physical activity resulting from maladaptive
pain contribute to healing an recovery

Answer 11

TF

Decreased physical activity resulting from maladaptive pain does not contribute to healing & may exacerbate pain & lead to secondary problems

Question 12

Which of the following conditions is NOT typically considered an example of maladaptive pain?

A) Tension headache
B) TMJ disorder
C) Fibromyalgia
D) Migraine headache

Answer 12

D) Migraine headache

Question 13

Which condition is commonly regarded as an example of maladaptive pain?

A) Tension headache
B) TMJ disorder
C) Fibromyalgia
D) Inflammatory bowel syndrome (IBS)
E) A & D only
F) All of the above

Answer 13

F) All of the above

Question 14

T/F

Characteristics of muscle pain include dull, deep, aching, cramping, & localized

Answer 14

F

Difficult to localize

Question 15

Modified T/F

A.Muscle trigger points can refer pain to other sites
b. It can cause other Sx such as tinnitus, paresthesias, & blurry
vision

Answer 15

TT

Question 16

Modified T/F

A. Trigger points may be idiopathic or associated with OA, RA, FM, TMJD, or chronic tension headaches
B. Widespread myofascial pain syndrome appears to
involve peripheral sensitization & central nociception

Answer 16

TF

Widespread myofascial pain syndrome appears to
involve** central sensitization & peripheral nociception**

Question 17

Fast vs. Slow Pain

Nerves: A-delta
(myelinated)

Answer 17

Fast

Question 18

Fast vs Slow pain

Nerves: C (unmyelinated)

Answer 18

Slow

Question 19

Fast vs Slow pain

Stimulus: Pinprick, heat

Answer 19

Fast

Question 20

Fast vs. Slow pain

Stimulus: Tissue damage

Answer 20

Slow

Question 21

Fast vs Slow pain

Sensation: Sharp, pricking,
burning,
dermatomal

Answer 21

Fast

Question 22

Fast vs. Slow pain

Sensation: Slow, dull, crawling,
sclerotomal

Answer 22

Slow

Question 23

Fast vs. Slow pain

Diameter: 1-4 micrometer

Answer 23

Fast

Question 24

Fast vs. Slow pain

Diameter: 0.1-1 micrometer

Answer 24

Slow

Question 25

# Fast vs. Slow pain Conduction Velocity: 5-30 m/sec

Answer 25

Fast

Question 26

# Fast vs. Slow pain Conduction velocity: 0.4-1.4 m/sec

Answer 26

Slow

Question 27

# Fast vs. Slow pain Distribution: Body surface

Answer 27

Fast

Question 28

# Fast vs. Slow pain Distribution: All tissue except CNS

Answer 28

Slow

Question 29

# Fast vs. Slow pain Reflex response: withdrawal

Answer 29

Fast

Question 30

# Fast vs. Slow pain Reflex response: withdrawal: Muscle spasm, increased tone or muscle guarding

Answer 30

Slow

Question 31

# Fast vs. Slow pain Biological Value: Avoidance of tissue damage because we withdraw the area

Answer 31

Fast

Question 32

# Fast vs. Slow pain Biological Value: Enforced rest

Answer 32

Slow

Question 33

# Fast vs. Slow pain Effect Of Morphine: Very little

Answer 33

Fast

Question 34

# Fast vs. Slow pain Effect Of Morphine: Supresses

Answer 34

Slow ## Footnote Morphine is usually given to those patient who suffer from chronic pain because it affectsmthe C fibers

Question 35

# Fast vs. Slow pain CNS Target: Thalamus, cortex

Answer 35

Fast

Question 36

# Fast vs. Slow pain CNS Target: Limbic, hypothalamic

Answer 36

Slow

Question 37

# Fast vs. Slow pain Affective Response: No

Answer 37

Fast

Question 38

# Fast vs. Slow pain Affective Response: Yes

Answer 38

Slow

Question 39

# Fast vs. Slow pain Automatic signs: No

Answer 39

Fast

Question 40

# Fast vs. Slow pain Automatic signs: Yes

Answer 40

Slow

Question 41

# Fast vs. Slow pain Localized Receptive Field: Yes

Answer 41

Fast

Question 42

# Fast vs. Slow pain Localized Receptive Field: No

Answer 42

Slow

Question 43

# Fast vs. Slow pain Dorsal Horn Connection: Laminae I & V

Answer 43

Fast

Question 45

# Fast vs. Slow pain Dorsal Horn Connection: Laminae II & III

Answer 45

Slow

Question 46

# Modified T/F A. Peripheral Neurogenic Pain refers to mechanical or chemical change to the peripheral nerves B. Vasomotor, sudomotor & trophic changes can occur

Answer 46

TT ## Footnote Vasomotor, sudomotor & trophic changes can occur specifically in **CAUSALGIA**

Question 47

# T/F: Usual symptoms of peripheral neurogenic pain are hypoesthesia, anesthesia, weakness, paresthesia, dysesthesia, & pain

Answer 47

True

Question 48

Nerves can be a source of pain d/t [] (sensory innervation of nerve) & [] (sensitive to movement or stretch)

Answer 48

Nerves can be a source of pain d/t **nervi nervorum** (sensory innervation of nerve) & **neural connective tissue** (sensitive to movement or stretch)

Question 49

# T/F Peripheral neurogenic pain can extend beyond the initial nerve injury through processes of peripheral sensitization & glial cells releasing growth factors & other substances acting on the immune system

Answer 49

True

Question 50

True or False: Causalgia, characterized by severe aching pain in a limb resulting from a peripheral nerve injury, is rare, and severe cases can be referred to as Major Causalgia.

Answer 50

False ## Footnote Causalgia, characterized by** severe burning pain in a limb**

Question 51

# Modified T/F A. Central neurogenic pain refers to the injury of CNS such as stroke, TBI, MS or FM B. Pain is burning, aching, lancing, pricking, or pressing

Answer 51

TT

Question 52

# Modified T/F A. Hyperalgesia & allodynia should not coincide in central neurogenic pain B. Central neurogenic pain involves descending facilitation

Answer 52

FT ## Footnote Hyperalgesia & allodynia may coincide

Question 53

# Modified T/F A. In central neurogenic pain, glia and astrocytes play a role in altering synaptic connections forming between General Somatic Afferents (GSA) and pain fibers. B. Central neurogenic pain, often associated with conditions like fibromyalgia (FM), irritable bowel syndrome (IBS), post-traumatic stress disorder (PTSD), and burnout, involves dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) Axis.

Answer 53

TT