Chapter 47: Pain

Chapter 47: Pain

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. Pain is thought of as
a. a subjective experience that is difficult to measure objectively.
b. associated with changes in vital signs reflecting its intensity.
c. experienced in the same way by all individuals.
d. always the result of tissue damage that activates nociceptors.
ANS: A
Because pain is a subjective experience, defining and assessing it are difficult. Pain is not always associated with a change in vital
signs. Pain is whatever the experiencing person says it is, and may vary according to each individual. Most pain begins in the
periphery when free nerve endings called nociceptors are stimulated.
REF: Pg. 959
2. The gate control theory of pain transmission predicts that activity in touch receptors will
a. enhance perception of pain.
b. decrease pain signal transmission in the spinal cord.
c. activate opioid receptors in the CNS.
d. increase secretion of substance P in the spinal cord.
ANS: B
The gate control theory is used to explain how stimulation of large “touch” neurons could inhibit the transmission of nociceptor
impulses. Central to the gate control theory is the capacity for interneurons in the spinal cord to modify the transmission of
nociceptor impulses. The gate control theory is not based on a theory that activity in touch receptors will enhance perception of
pain. Opioid receptors are thought to be the mediators of presynaptic inhibition. One way to inhibit synaptic transmission is through
presynaptic inhibition of substance P release from nociceptor neurons.
REF: Pg. 962
3. Referred pain may be perceived at some distance from the area of tissue injury, but generally felt
a. on the same side of the body.
b. with slightly less intensity.
c. within the same dermatome.
d. within 10 to 15 cm area.
ANS: C
Referred pain is perceived in an area other than the site of the injury. It is often felt at some distance from the point of nociceptor
activation. Pain is generally referred to other structures in the same sensory dermatome. The brain cannot differentiate the two
sources of pain signals and tends to attribute the visceral pain to a body surface location regardless of on which side of the body the
injury occurs and on which side of the body the referred pain is felt. Referred pain is not felt with less intensity. Referred pain is not
perceived at a distance that is within 10 to 15 cm.
REF: Pg. 970
4. Slow pain sensation is transmitted primarily by
a. group Ia afferents.
b.  motor neurons.
c. unmyelinated C fibers.
d. A fibers.
ANS: C
The majority of pain sensations travel via C fibers and project to areas of the brain that evoke emotional responses such as
displeasure and anxiety. Unmyelinated C fibers transmit pain more slowly. Pain transmitted by C fibers is poorly localized and has a
dull or aching quality that lingers long after the initial sharp pain abates. Group Ia afferents are not the source of slow pain
sensation. Slow pain sensation is not transmitted by  motor neurons. The nature of the pain carried by the fast-traveling A fibers
is characterized as sharp, stinging, and highly localized.