Test #1 Flashcards
(179 cards)
0
Q
A lesion to which one of the following regions would result in crossed analgesia? A. Dorsal horn of the spinal cord B. Peripheral nerves C. Medulla or lower pons D. Thalamus E. Cortex
A
C. Medulla or lower pons
1
Q
Pseudounipolar cells:
A
E. Have two axon extensions.
2
Q
Which of the following is the structural part of a neuron that releases a neurotransmitter? A. Dendrite B. Axon hillock C. Soma D. Presynaptic terminal E. Postsynaptic terminal
A
D. Presynaptic terminal
3
Q
Which one of the following neuron structures is specialized for receiving synaptic input from other neurons? A. Cell body B. Dendrite C. Axon D. Axon hillock E. Presynaptic terminal
A
B. Dendrite
4
Q
Retrograde transport:
A
A. Recycles substances from the axon back to the soma.
5
Q
The resting membrane potential is:
A
C. Maintained by active transport of sodium ions (Na+) and potassium ions (K+) and passive diffusion of Na+, K+, and chloride ion (Cl–) through leak channels in the cell membrane
6
Q
Depolarization occurs when:
A
A. The membrane potential becomes less negative than the resting membrane potential.
7
Q
Local potentials:
A
E. A, B, and C
A. Are either receptor or synaptic potentials.
B. Spread passively only a short distance along the cell membrane.
C. Result from stimulation of sensory receptors or from the binding of a neurotransmitter with chemical receptor sites on a postsynaptic membrane.
8
Q
Which of the following change the electrical potential across the cell membrane?
A. Activation and opening of ligand-gated K+ channels
B. Activation and opening of modality-gated Na+ channels
C. Activation and opening of voltage-gated Cl– channels
D. Leak channels, which allow continuous diffusion of small ions
E. All of the above
A
E. All of the above
9
Q
Propagation of an action potential along an axon is dependent on a(n):
A
B. Anterograde diffusion of the electric potential with active generation of new potentials
10
Q
Which one of the following is a feature of the nodes of Ranvier?
A. Are distributed approximately every 1 to 2 millimeters (mm) along the membrane of the cell axon.
B. Contain a high density of modality-gated K+ channels for rapid depolarization of the membrane.
C. Contain a high density of voltage-gated Na+ channels for rapid repolarization of the membrane.
D. Have low membrane capacitance, preventing the accumulation of electrical charge.
E. Are heavily myelinated, which allows for rapid diffusion of an electrical potential.
A
A. Are distributed approximately every 1 to 2 millimeters (mm) along the membrane of the cell axon.
11
Q
Demyelination of an axon:
A
E. A, B, and C
A. Results in decreased membrane resistance, allowing a leakage of electrical current.
B. Results in slowed propagation of action potentials.
C. May prevent propagation of action potentials.
12
Q
Peripheral demyelination:
A
D. Typically affects the Schwann cells of large, well-myelinated axons.
13
Q
Guillain-Barré syndrome:
A
E. A, B, and C
A. Involves demyelination of peripheral axons.
B. Results from an autoimmune attack on Schwann cells.
C. May affect cranial nerves controlling the muscles involved in swallowing, breathing, and facial expression.
14
Q
Multiple sclerosis:
A
E. A, B, and C
A. Results from an autoimmune attack on oligodendrocytes.
B. Involves demyelination of axons in the CNS.
C. Has signs and symptoms associated with both motor and sensory impairment.
15
Q
Which one of the following is not one of the primary components of a neuron? A. Axon B. Soma C. Postsynaptic membrane D. Dendrite
A
C. Postsynaptic membrane
16
Q
The strength of local electrical potentials is modulated and integrated via:
A
C. Both A and B
A. Spatial summation, the combined effect of potentials generated in other parts of the neuron
B. Temporal summation, the combined effect of small potential changes occurring over several milliseconds
17
Q
Which one of the following is an example of divergence?
A. Contraction of the hip flexor muscles when a painful stimulus is applied to the toe
B. Integration of taste and smell information in the temporal lobe
C. Multiple different cells synapsing with a single neuron in the spinal cord
D. All of the above
A
A. Contraction of the hip flexor muscles when a painful stimulus is applied to the toe
18
Q
Glial cells contribute which one of the following?
A. Communication between neurons and blood vessels
B. Neural cell death
C. Action potential propagation
D. Both A and B
E. All of the above
A
D. Both A and B
A. Communication between neurons and blood vessels
B. Neural cell death
19
Q
The second messenger in a second messenger system is a(n):
A
D. A, B, and C
A. Opening of membrane ion channels
B. Activation of genes, causing increased synthesis of specific cellular products
C. Modulation of Ca+2 levels inside the cell
20
Q
Which one of the following can serve as the postsynaptic cell of a synapse? A. Smooth muscle cell in an artery B. Hepatocyte in the liver C. Neuron in the thalamus D. Muscle cell in the triceps E. All of the above
A
E. All of the above
21
Q
ACh receptor subtypes include:
A
B. Nicotinic and muscarinic
22
Q
How does onabotulinumtoxinA (BOTOX) therapeutically produce paresis in overactive muscles?
A
E. Inhibits the release of ACh from the presynaptic terminal at the neuromuscular junction
23
Q
N-methyl-D-aspartate (NMDA) receptors:
A
D. A, B, and C
A. Are involved in long-term potentiation.
B. Bind glutamate.
C. Have been implicated in pathologic changes in the nervous system.
24
Myasthenia gravis:
C. Is an autoimmune disease that destroys ACh receptors on the postsynaptic membrane of muscles, thus interferes with ACh binding for repetitive muscle contractions.
25
Neurons that are deprived of oxygen for a prolonged period:
C. Release glutamate, which causes overexcitation of the surrounding neurons.
26
Excitotoxicity begins with:
D. Persistent binding of glutamate to N-methyl-D-aspartate (NMDA)–type receptors in the postsynaptic cell membrane
27
Cellular effects of excitotoxicity include:
A. Excessive production of lactic acid
B. Destruction of cellular proteins
C. Cellular edema
D. Interference of mitochondria functions
E. All of the above
All of the above
28
```
Which one of the following types of memory is affected by an injury to the hippocampus?
A. Memory of how to ride a bicycle
B. Memory of names and events
C. Memory of how to tie shoe laces
D. Both A and B
E. A, B, and C
```
B. Memory of names and events
29
```
In the mature central nervous system (CNS), axonal regeneration is impeded by which of the following?
A. Glial scar formation
B. Absence of neural growth factor
C. Release of growth inhibiting factors
D. Both A and B
E. A, B, and C
```
E. A, B, and C
30
Constraint-induced movement after a stroke requires which one of the following?
A. Immobilization of the affected upper extremity (UE) to control spasticity
B. Repetitive closed-chain resistance training
C. Aggressive range of motion and exercise within 12 hours after a stroke
D. Repetitive, task-specific functional movements of only the affected UE
E. Weight bearing and prolonged stretching of the affected UE
D. Repetitive, task-specific functional movements of only the affected UE
31
Learning an individual’s name requires:
B. LTP-long term potentiation
32
```
Spinal axons conveying a signal for conscious somatosensation from the upper limb ascend in which of the following?
A. Ventral horn
B. Fasciculus gracilis
C. Fasciculus cuneatus
D. Internal arcuate fibers
E. Medial lemniscus
```
C. Fasciculus cuneatus
33
```
Cell bodies of second-order neurons conveying a signal for conscious proprioceptive information from the lower limb are located in which of the following?
A. Dorsal root ganglion
B. Fasciculus cuneatus
C. Somatosensory cerebral cortex
D. Nucleus gracilis
E. Medial lemniscus
```
D. Nucleus gracilis
34
The ventral posterolateral (VPL) nucleus of the thalamus is the site of synapse for:
B. Second-order neurons with their cell bodies in the nucleus cuneatus and/or nucleus gracilis
35
```
Rapidly turning the eyes and head toward a painful stimulus is a function of which one of the following tracts?
A. Trigeminoreticulolimbic
B. Spinoreticular
C. Spinomesencephalic
D. Trigeminospinothalamic
```
C. Spinomesencephalic
36
Which of the following statements is true about the homunculus for the somatosensory cortex?
A. The homunculus was developed by experimentally recording electrical potentials from cells in the somatosensory cortex during stimulation of various parts of the body.
B. The area of the homunculus that represents the foot is adjacent to the area for the hand.
C. The proportions of the homunculus are the same as the proportions of the physical body.
D. Somatotopic organization is only found in cellular organization of the somatosensory cortex.
E. The area of the homunculus that represents the torso is adjacent to the area for the face.
A. The homunculus was developed by experimentally recording electrical potentials from cells in the somatosensory cortex during stimulation of various parts of the body.
37
Which of the following is a function of the primary somatosensory cortex?
A. Discrimination of the texture of an object
B. Discrimination of the shape of an object
C. Stereognosis
D. Both A and B
E. A, B, and C
D. Both A and B
38
Sensory extinction is the:
D. Awareness of stimuli on only one side of the body when both sides of the body are simultaneously stimulated
39
The role of enkephalins in the spinal cord is:
D. A and B
A. To decrease release of substance P from the primary afferent
B. To hyperpolarize spinal interneurons in the pain pathway
40
Afferent neurons convey information:
C. From peripheral receptors to the CNS
42
When the raphespinal tract is active, which neurotransmitter is released at the axon terminal in the dorsal horn of the spinal cord?
E. Serotonin
43
```
Which of the following is(are) part of the fast-descending neuronal system for pain inhibition?
A. Rostral ventromedial medulla
B. Periaqueductal gray
C. Locus coeruleus
D. A, B, and C
E. None of the above
```
D. A, B, and C
44
```
The locus coeruleus is located in which one of the following?
A. Spinal cord dorsal horn
B. Medulla
C. Pons
D. Midbrain
E. Cerebral cortex
```
C. Pons
45
```
The periaqueductal gray is located in which one of the following?
A. Spinal cord dorsal horn
B. Medulla
C. Pons
D. Midbrain
E. Cerebral cortex
```
D. Midbrain
46
```
Which of the disorders listed below is/are psychogenic (caused by abnormal psychological factors):
A. Phantom limb pain
B. Pain in diabetic neuropathy
C. Fibromyalgia
D. Complex regional pain syndrome
E. None of the above
```
E. None of the above
47
Which of the following characterize the late stage of complex regional pain syndrome?
A. Trauma
B. Red skin, excessive sweating, edema, skin atrophy
C. Lack of any sympathetic activity
D. Muscle atrophy, osteoporosis, arthritic changes
E. Excessive acetylcholine release by postganglionic neurons
D. Muscle atrophy, osteoporosis, arthritic changes
48
Tinel’s sign is associated with which of the following?
A. Avulsion of dorsal roots as a result of trauma
B. Maladaptive structural reorganization with phantom pain
C. Neuropathic syndrome associated with fibromyalgia
D. Ectopic foci associated with peripheral neuropathy
E. All of the above
D. Ectopic foci associated with peripheral neuropathy
49
Migraine symptoms are thought to be related to amplification of proprioceptive signals in which pathway?
C. Trigeminothalamocortical pathway
50
```
Which of the following contribute to chronic low back pain syndrome?
A. Muscle guarding
B. Abnormal movement
C. Disuse syndrome
D. A and B
E. A, B, and C
```
E. A, B, and C
51
During acute appendicitis, the contribution of the somatosensory nociceptive afferents is which of the following?
A. Regulation of visceral function
B. Production of skeletal muscle guarding to protect the appendix
C. Modulation of respiratory function
D. Signaling visceral distress to the brain
E. Signaling conscious awareness of pain in the umbilical region
E. Signaling conscious awareness of pain in the umbilical region
52
```
Areas of the central nervous system (CNS) that modulate autonomic control include which of the following?
A. Thalamus
B. Hypothalamus
C. Limbic system
D. Both A and B
E. A, B, and C
```
E. A, B, and C
53
Which one of the following is NOT a characteristic of the autonomic efferent system?
A. Innervates blood vessels in skeletal muscle.
B. Hormones regulate effector control.
C. Is usually a two-neuron pathway with a synapse outside the CNS.
D. Activation of effectors is usually voluntary.
E. Neurotransmitters are used for signaling.
D. Activation of effectors is usually voluntary.
54
Sympathetic activation does NOT produce which of the following?
A. Increased blood flow to active muscles
B. Increased blood glucose levels
C. Increased digestive activity
D. Dilation of bronchioles
E. Increased heart rate
C. Increased digestive activity
55
Capacitance vessels include which of the following?
A. Skeletal muscle veins and venules
B. Arterioles in the skin
C. Arterioles in the CNS
D. Skeletal muscle arteries and arterioles
E. Arteries in the abdomen
A. Skeletal muscle veins and venules
56
```
Drugs that block beta-1 (β1) receptors are used to treat which one of the following?
A. Asthma
B. Excess sweating
C. Metabolic disorders
D. Tachycardia
E. Vagus nerve disorders
```
E. Vagus nerve disorders
57
Where are the cell bodies of the sympathetic preganglionic neurons located?
B. Lateral horn of spinal cord T1-L2 levels
58
Autonomic regulation of the heart is dependent on which one of the following?
A. Parasympathetic fibers of the vagus nerve
B. Sympathetic fibers from the thoracic level
C. Periaqueductal gray
D. Both A and B
E. A, B, and C
D. Both A and B
59
Which one of the following signs occurs in Horner's syndrome?
A. Drooping of the upper eyelid
B. Constriction of the pupil of the eye
C. Vasodilation of skin, with an absence of sweating on the ipsilateral side of the face and neck
D. Both A and B
E. A, B, and C
E. A, B, and C
60
```
Which one of the following is NOT a cause of syncope?
A. Insufficient cardiac output
B. Hypoxia
C. Hyperglycemia
D. Strong emotions
E. Hypoglycemia
```
C. Hyperglycemia
61
Positron-emission tomographic (PET) scan
Uses radioisotopes to construct an image based on blood flow, glucose metabolism, or receptor location.
62
Electron microscopy
Allows visualization of microscopic cellular organelles.
63
Magnetic resonance imaging (MRI)
Provides anatomic images and information concerning blood flow.
64
Microelectrode recording
Records the activity of a single cell.
65
Computerized axial tomographic (CAT) scan
Produces an image of the density of areas in the nervous system.
66
Median nerve; Conveys information from sensory receptors into the central nervous system (CNS) and from the CNS to skeletal muscles, smooth muscles, and glands.
Peripheral
67
Ventral roots; Conveys somatosensory information between to the brain and conveys signals from the brain to neurons that directly control movement.
Spinal
68
Medulla; Conveys information between the cerebrum and spinal cord. Is the region of sensory and motor integration and controls vital functions.
Brainstem (cerebellar
69
Diencephalon; Is involved in motor control, sensory processing memory, reasoning, and verbal and/or nonverbal communication.
Cerebral
70
What is a lemiscus?
A lemniscus is a bundle of myelinated axons within the CNS
71
What is a midsagittal section of the brain?
A midsagittal section is a section of the brain produced by dividing the brain into left and right halves
72
What two systems provide essential nutritive support to the nervous system?
The support systems are the cerebrospinal fluid and vascular systems.
73
What is the difference in function between white and gray matter?
White matter consists of myelinated axons that convey information among parts of the nervous system. Gray matter consists of neuronal cell bodies that function in signaling and information integration.
74
"I woke up this morning with a sharp pain running down the back of my left leg; yesterday I was fine…."
Acute
75
"For 3 days now, I've had brief spells of dizziness and felt like I was about to fall."
Subacute
76
"I've been having a little trouble with coordination in my right leg over the past several months."
Chronic
77
Cells in the central nervous system (CNS) with nutritive and clean-up functions
Astrocytes
78
Cells in the peripheral nervous system that produce myelin
Schwann cells
79
Cells that receive and transmit information via propagation of an electrical signal
Neurons
80
Cells in the CNS that produce myelin
Oligodendrocytes
81
Cells that clean the neural environment and contribute to the destruction of injured or aging axons
Microglia
82
Mechanical force, temperature change, or chemical stimulus
Modality-gated
83
No stimulus required
Leak
84
Change in electrical potential across the cell membrane
Voltage-gated
85
Neurotransmitter binding to the surface of a channel receptor on a postsynaptic membrane
Ligand-gated
86
Space between the presynaptic and postsynaptic terminals
Synaptic cleft
87
Chemical used to transmit information from the presynaptic terminal to the postsynaptic terminal
Neurotransmitter
88
Molecule designed to bind a specific neurotransmitter
Receptor
89
Membrane region of the neuron that receives information from another neuron
Postsynaptic terminal
90
Axon ending that contacts a neuron, a muscle, or a gland; releases a neurotransmitter.
Presynaptic terminal
91
What events occur in the presynaptic terminal when an action potential reaches the presynaptic terminal?
The membrane of the presynaptic terminal depolarizes; voltage-gated calcium ion (Ca+2) channels open; Ca+2 influxes into the nerve terminal; synaptic vesicles move toward a release site in the membrane, fuse with the membrane, then rupture to release a neurotransmitter into the synaptic cleft.
92
How does the binding of a neurotransmitter to a receptor result in the opening of a ligand-gated ion channel?
The binding of a neurotransmitter to a receptor on the postsynaptic membrane causes the associated membrane channel to change shape, allowing it to open.
93
What is a postsynaptic potential?
A postsynaptic potential is a local change in ion concentration across the postsynaptic membrane.
94
What is an excitatory postsynaptic potential (EPSP)?
An EPSP is a local depolarization of a postsynaptic membrane from an influx of positively charged ions. (Na, Ca)
95
What is an inhibitory postsynaptic potential (IPSP)?
An IPSP is a local hyperpolarization of a postsynaptic membrane from an influx of chloride ion (Cl–) or an efflux of potassium ion (K+).
96
What happens when acetylcholine (ACh) binds to receptors associated with membrane channels on a muscle cell?
When ACh binds to the receptor, Na+ channels open and the influx of Na+ initiates a series of events that produce a mechanical contraction of the muscle cell.
97
What are the three types of synaptic connections between neurons?
Synaptic connections between neurons are axoaxonic, axodendritic, or axosomatic.
98
What is the effect of presynaptic facilitation on the action potential produced by the second axon at an axoaxonic synapse?
The action potential is longer in duration, allowing increased Ca+2 into the second synaptic terminal, and more neurotransmitter vesicles than usual move to the cell membrane and rupture. The facilitated neuron releases more transmitter than normal.
99
How are neurotransmitters removed from the synapse, allowing inactivation of ligand-gated channels receptors?
The three mechanisms of receptor inactivation are: (1) neurotransmitter diffusion away from the synaptic cleft; (2) enzymatic degradation of the neurotransmitter in the synaptic cleft; or (3) neurotransmitter reuptake by the presynaptic axon terminal.
100
What is a guanine nucleotide–binding protein (G-protein)–mediated receptor?
A G-protein–mediated receptor is a receptor that has an associated G-protein. When the receptor is bound by a neurotransmitter, the G-protein is activated and may alter the opening of membrane ion channels or may produce long-lasting changes in the neuron.
101
Alpha (α) chain separates to act as a cytoplasmic shuttle.
Third
102
Membrane channels open, or intracellular target proteins are activated.
Fifth
103
The α chain activates a target protein.
Fourth
104
Receptor protein changes shape.
Second
105
Neurotransmitters bind with the receptor.
First
106
An individual with a vestibular disorder has a decreased neural response to movements that formerly induced dizziness and nausea
Habituation
107
Ability to learn an individual’s name
LTP
108
After severing the median nerve, the distal segments of the severed axons degenerate.
Wallerian degeneration
109
After an injury to axons of the ulnar nerve, the associated cell bodies undergo degenerative changes.
Central chromatolysis
110
After severing the median nerve, the proximal segments of the severed axons regrow.
Sprouting
111
Resolution of local edema causes synapses that were inactive because of compression of the presynaptic neuron to resume functioning.
Recovery of synaptic effectiveness
112
Synapses that were inactive before a lesion become active after the lesion.
Unmasking of silent synapses
113
After the destruction of some axon branches of a presynaptic neuron, the remaining axon branches receive all of the neurotransmitters that were shared by more endings
Synaptic hypereffectiveness
114
New receptor sites on the postsynaptic membrane develop after presynaptic terminals are destroyed.
Denervation hypersensitivity
115
Changes in cortical representation occur after amputation or prolonged nonuse.
Functional reorganization
116
Overexcitation of a neuron that leads to death of the neuron.
Excitotoxicity
117
How is unconscious sensory information used by the nervous system?
Unconscious sensory information is used for the control of automatic adjustments during postural and movement control.
118
Where are the cell bodies of most peripheral sensory neurons located?
The cell bodies of most peripheral sensory neurons are located in the dorsal root ganglia or cranial nerve ganglia.
119
List the classifications of peripheral sensory axons from the largest to the smallest diameter.
From the largest to the smallest diameter, the peripheral sensory axons are Ia, Ib, II, Aδ, and C.
120
What is a nociceptor?
A nociceptor is a receptor that responds to stimuli that damage or threaten to damage tissue.
121
What type of afferent fibers conveys information from free nerve endings?
The Aδ and C axonal afferents convey sensory information from free nerve endings.
122
Respond to quick stretches of the central region of intrafusal fibers.
Primary endings
123
Specialized muscle fibers with noncontractile central regions whose nuclei are arranged in single file.
Nuclear chain fibers
124
Motor neurons that innervate the contractile ends of intrafusal fibers.
Gamma efferents
125
Respond to tonic stretch of the central region of intrafusal fibers.
Secondary endings
126
Specialized muscle fibers with noncontractile central regions whose nuclei are arranged in a clump.
Nuclear bag fibers
127
Pain, temperature, itch, or tickle
Aδ or C
128
Touch, vibration, skin stretch, or pressure
Aβ
129
Maintained muscle stretch or joint movement
II
130
Tendon or ligament tension
Ib
131
Quick stretch information from the muscle spindle
Ia
132
Is high-fidelity, discriminative awareness a function of the conscious relay pathways or divergent pathways?
Conscious relay pathways convey sensory information to the primary sensory cortex for high-fidelity, discriminative awareness of the location and nature of the stimulus.
133
Which of the spinocerebellar tracts function as internal feedback tracts?
The anterior spinocerebellar and rostral spinocerebellar tracts provide internal feedback from interneurons located between the descending motor tracts and the alpha motor neurons.
134
What is the function of the first-order neuron in a sensory pathway?
The first-order neuron conducts an electrical potential in response to stimulation of a peripheral receptor. The first-order neuron thereby conveys information from the peripheral receptor to a second-order neuron within the central nervous system (CNS).
135
Conveys information from the face to the pons.
Trigeminal nerve neuron
136
Conveys information from the medulla to the thalamus.
Second-order neuron
137
Conveys information from receptors in the limbs and trunk to the medulla.
Peripheral/dorsal column neuron
138
Conveys information from the thalamus to the cerebral cortex.
Third-order neuron
139
Name the two high-fidelity pathways that convey unconscious proprioceptive information to the cerebellar cortex.
Posterior spinocerebellar and cuneocerebellar pathways
140
Name the two internal feedback tracts that monitor the activity of spinal interneurons and the activity of descending motor signals from the cerebral cortex and brainstem.
Anterior spinocerebellar and rostral spinocerebellar tracts
141
Exerting pressure on the skin with a monofilament
Tactile threshold
142
Gentle poking with a pin, interspersed with light touches with the blunt end of the pin
Sharp, fast pain
143
Light touching of two points on the skin using smaller distances between the points until the points cannot be distinguished as separate points
Two-point discrimination
144
Light touching of both sides of the body simultaneously
Bilateral simultaneous touch
145
Drawing a line (using a dull point) on the patient’s skin
Directional cutaneous kinesthesia
146
Name the test that applies electrical stimulation to the skin over a peripheral nerve and then records the resulting electrical activity from the skin over the upper cervical region or from the scalp over the primary somatosensory cortex.
Applying electrical stimulation to the skin over a peripheral nerve and then recording the resulting electrical activity from the skin over the upper cervical region or from the scalp over the primary somatosensory cortex measures somatosensory-evoked potentials.
147
Name the test that uses electrical stimulation of the skin over a peripheral nerve and then records the electrical activity from the skin over another point along the same peripheral nerve
Electrically stimulating the skin over a peripheral nerve and then recording the electrical activity at another point along the same peripheral nerve measures nerve conduction velocity.
148
Why does peripheral demyelination often affect proprioception and vibratory sense more severely than temperature discrimination?
Peripheral demyelination most severely affects the large diameter, heavily myelinated axons (Ia, Ib, II), resulting in diminished or absent proprioception and vibratory sense.
149
Painful eruptions occur on the skin in a unilateral single-dermatome distribution
Varicella zoster
150
All sensations (except proprioception from the face) are lost from the right side of the face and body. All sensations are intact on the left side of the face and body
Lesion in the left posterolateral region of the rostral pons or the midbrain
151
All sensations bilaterally are completely lost below the L2 dermatome. (Sensation in the L1 dermatome is intact, and sensation is impaired in the L2 dermatome.)
Complete transection of the spinal cord
152
Pain and temperature sensation are lost from the left side of the face, combined with the loss of pain and temperature sensation from the right side of the body; all other sensations remain intact
Lesion in the left posterolateral medulla or lower pons
153
Conscious proprioception, two-point discrimination, and vibration sense are lost bilaterally below the T10 dermatome; all other sensations remain intact.
Lesion to the dorsal column of the spinal cord
154
Nonnarcotic analgesics, which decrease the synthesis of prostaglandins
Periphery
155
Stimulation of opioid receptors and descending inhibition
Periaqueductal gray, raphe nuclei, and locus coeruleus
156
Hormonal regulation
Hypothalamus, pituitary gland, and adrenal medulla
157
Inhibitory interneurons, which release enkephalins or dynorphins
Dorsal horn of the spinal cord
158
Expectations, distraction, placebos, and excitement
Cerebral cortex
159
Why is the identification of referred pain important in physical therapy practice?
Identifying referred pain is important in physical therapy to ensure appropriate treatment, since referred pain is most often associated with inflammation or irritation of visceral tissue. The patient must be directed to the appropriate practitioner for diagnosis and treatment.
160
Why is distinguishing between acute and chronic pain essential?
Therapists must distinguish between acute and chronic pain because the causes of acute and chronic pain are different, thereby requiring different treatment approaches. Modalities and soft-tissue treatments associated with acute pain are often not effective or appropriate for the treatment of chronic pain.
161
What does “chronic pain as a disease” mean?
Chronic pain as a disease means that the neurons signaling pain are pathologically active. Despite the absence of continuing tissue damage and lack of noxious stimulation, the brain perceives pain.
162
Explain the analogy between a malfunctioning burglar alarm and pathological pain.
A malfunctioning burglar alarm signals a burglary when there is no burglary occurring. Pathological pain signals tissue injury in tissues that are not injured.
163
List the three categories of pathologic pain.
The three categories of pathologic pain are neuropathic, pain matrix dysfunction, and pain syndromes.
164
What causes the pain in post-herpetic neuralgia, diabetic neuropathy, and Guillain-Barré syndrome?
The pain in post-herpetic neuralgia, diabetic neuropathy, and Guillain-Barré syndrome is caused by the central nervous system response to small fiber deafferentation.
165
What causes the pain in fibromyalgia?
The pain in fibromyalgia is caused by pain matrix dysfunction. Pain inhibiting regions in the cerebral cortex have less gray matter and are significantly less active than normal, and pain signals are biologically amplified.
166
What is the primary precipitating factor in the development of complex regional pain syndrome (CRPS)?
Disuse or nonuse is the primary precipitating factor for CRPS.
167
Four months of lower back pain with shooting, burning pain radiating down the back of both lower limbs and decreased endurance of abdominal and low back muscles
Chronic pain syndrome
168
Pain caused by a tumor pressing on nociceptors in the spinal cord meninges
Nociceptive chronic pain
169
Phantom limb pain
Neuropathic chronic pain
170
Gallbladder pain perceived as originating in the right subscapular region
Referred pain
171
Fibromyalgia
Pain matrix dysfunction
172
Preganglionic autonomic neurons
Acetylcholine
173
Parasympathetic postganglionic neurons
Acetylcholine
174
Sympathetic postganglionic neurons that innervate most vessels in skeletal muscle
Norepinephrine
175
Sympathetic postganglionic neurons that innervate the heart
Acetylcholine
176
Loss of control of smooth muscle in blood vessels, temperature regulation, and sweating in a peripheral nerve distribution
Complete severance of a peripheral nerve
177
Interference with regulation of blood pressure, heart rate, or respiration; may affect pupil constriction, tear production, salivation, or visceral regulation
Lesion in the brainstem
178
Disruption of behavior and metabolism; may cause abnormalities of weight control and thermoregulation
Lesion in the hypothalamus region
179
Total loss of voluntary control of the bladder, bowel, and genital function; poor regulation of blood pressure and core body temperature
Complete severance of the cervical spinal cord
