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PAIN.MCQ
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1993-08-06
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D:Created 14.48 06/08/1993
D:Subject : Physiology
D:Topic : Pain
D:Level : Moderate
D:
D:Authors : Department of Physiology
D: The University
D: Leeds LS2 9NQ
I:MCQ SB 1
G:3
G:1:Dental Students
Q:1,2,3,4,5
G:2:Medical Students
Q:1,2,3,4,5
G:3:Science Students
Q:1,2,3,4,5
T:A
L:2
#:1
G: 10464 1 2 3
S:1
:Pain arising from the viscera:
B:N:5
B:1:T:1
:may cause reflex contraction of nearby skeletal muscle
B:2:T:1
:may cause reflex sweating, vomiting or changes in blood pressure
B:3:F:1
:is always felt in the midline
B:4:T:2
:is poorly localised compared with pain arising from superficial
:tissues
B:5:F:1
:is mediated by impulses in fast conducting fibres
F:12
:Visceral pain is caused by impulses in small myelinated and
:unmyelinated afferent nerves that run in autonomic nerves and enter the
:cord in the same segments that give rise to the sympathetic and
:parasympathetic outflows. Activity in these afferents can cause reflex
:contraction of skeletal muscle: this is the basis of the guarding and
:rigidity of abdominal muscles that can be seen in the acute abdomen. In
:addition reflex sweating, vomiting and hypertension can occur. True
:visceral pain is poorly localised, and that arising from the gut usually
:occurs in midline. However, viscera that have a unilateral innervation,
:such as the kidney, or innervation mainly from one side of the cord, such
:as the gall bladder, give rise to pain in the loin (kidney), or R
:epigastrium (gall bladder).
E:------
#:2
G: 10464 1 2 3
S:1
:Cutaneous polymodal nociceptors:
B:N:5
B:1:T:1
:respond only to injurious stimuli
B:2:T:1
:respond to skin temperatures above 45 degrees C
B:3:F:1
:have large myelinated axons
B:4:T:1
:give rise to a flexor reflex response in a spinal animal
B:5:T:2
:can be subdivided into two groups which cause fast and slow pain,
:depending on axonal diameter
F:8
:Cutaneous polymodal nociceptors respond to stimuli which are
:injurious: intense mechanical stimuli, temperature over 45 degrees C
:and chemical stimuli (such as the endogenous algesic substances which
:are released during tissue injury or inflammation - bradykinin,
:Prostaglandins E, I and F2 alpha). These receptors all have slowly
:conducting fibres, and most are C fibres although some nociceptors have
:A-delta axons: these mediate slow and fast pain respectively, and they
:induce flexor withdrawal reflexes in spinal animals.
E:------
#:3
G: 10464 1 2 3
S:2
:Transmission of impulses between nociceptors and the
:spinothalamic tract:
B:N:5
B:1:T:1
:is inhibited by impulses in low threshold cutaneous mechanoreceptors
B:2:T:1
:is inhibited by descending pathways from the brainstem
B:3:T:1
:is influenced by presynaptic inhibitory mechanisms
B:4:T:1
:can be reduced by stimulated of the dorsal columns
B:5:F:1
:is diminished by activity in unmyelinated fibres
F:10
:The transmission of noxious information through the dorsal horn is
:reduced by activation of low threshold mechanoreceptors with large
:myelinated fibres that send axon collaterals up the ipsilateral dorsal
:columns. Descending pathways from the brainstem, and in particular from
:the nucleus raphe magnus, also modulate the transmission of information
:from nociceptive primary afferents into the spinothalamic tract and
:other ascending pathways which transmit that type of information.
:These inhibitory effects are mediated by presynaptic inhibition and the
:areas of brainstem which have anti-nociceptive functions include the
:periaqueductal grey matter and the locus coeruleus.
E:------
#:4
G: 10464 1 2 3
S:1
:Cutaneous polymodal nociceptors:
B:N:5
B:1:T:1
:respond only to injurious stimuli
B:2:T:1
:respond to skin temperatures above 45 degrees C
B:3:F:1
:have large myelinated axons
B:4:T:1
:give rise to a flexor reflex response in a spinal animal
B:5:T:2
:can be subdivided into two groups which cause fast and slow pain,
:depending on axonal diameter
F:9
:Cutaneous polymodal nociceptors respond to stimuli which are
:injurious: intense mechanical stimuli, temperatures over 45 degrees C,
:and chemicals (such as the endogenous algesic substances which are
:released during tissue injury or inflammation - bradykinin,
:prostaglandins E, I and F2 alpha). These receptors all have slowly
:conducting fibres (mainly C-fibres), although some mechanical
:nociceptors have A-delta axons: these mediate slow and fast pain
:respectively, and they induce flexor withdrawal reflexes in spinal
:animals.
E:------
#:5
G: 10464 1 2 3
S:2
:Transmission of impulses between nociceptors and the
:spinothalamic tract:
B:N:5
B:1:T:1
:is inhibited by impulses in low threshold cutaneous mechanoreceptors
B:2:T:1
:is inhibited by descending pathways from the brainstem
B:3:T:1
:is influenced by presynaptic inhibitory mechanisms
B:4:T:1
:can be reduced by stimulation of the dorsal columns
B:5:F:1
:is diminished by activity in unmyelinated fibres
F:10
:The transmission of noxious information through the dorsal horn is
:reduced by activation of low threshold mechanoreceptors with large
:myelinated fibres, some of which have collaterals in the dorsal columns.
:Descending pathways from the brainstem and in particular from the
:nucleus raphe magnus, also modulate the transmission of information
:from nociceptive primary afferents into the spinothalamic tract and
:other ascending pathway which transmit that type of information. These
:inhibitory effects are mediated by presynaptic inhibition and the areas
:of brainstem which have anti-nociceptive functions include the
:periaqueductal grey matter and the locus coeruleus.
E:------
::