Chapter 49: Somatic Sensations PDF

Chapter 49: Somatic Sensations: II. Pain, Headache, and Thermal Sensations Hall: Guyton and Hall Textbook of Medical Physiology, 14th Edition MULTIPLE CHOICE 1. All the following stimuli are likely to cause bowel pain except one. Which one is this exception? a. Chemical irritation...

Chapter 49: Somatic Sensations: II. Pain, Headache, and Thermal Sensations Hall: Guyton and Hall Textbook of Medical Physiology, 14th Edition MULTIPLE CHOICE 1. All the following stimuli are likely to cause bowel pain except one. Which one is this exception? a. Chemical irritation b. Cut with sharp knife c. Ischemia d. Over-extension e. Spasm ANS: B 2. Which of the following sensory modalities uses unmyelinated fibers to convey information to the central nervous system? a. Proprioception b. Vision c. Vibration d. Pain ANS: D 3. Which of the following best describes the type of excitatory transmitter secreted from the nerve endings of type A-delta pain fibers? a. Glycine b. Substance P c. GABA d. Glutamate e. Norepinephrine ANS: D 4. Which of the following anatomical and sensory information is paired correctly? a. Dorsal column system—pain and temperature sensation b. Layers I and II of somatosensory cortex—incoming signals from the thalamus c. Free nerve ending—type C fiber d. Large representation on post central gyrus—the foot ANS: C 5. The highest degree of pain localization comes from a. simultaneous stimulation of free nerve endings and touch receptors. b. stimulation of free nerve endings by bradykinin. c. nerve fibers traveling to the thalamus by way of the paleospinothalamic tract. d. stimulation of type A-gamma fibers. ANS: A 6. Which of the following best describes the paleospinothalamic tract?  a. Contains type A-delta nerve fibers b. Terminates exclusively in the thalamus c. Transmits the “fast pain” sensation d. Terminates predominantly in the lower brain regions ANS: D 7. Which of the following substances is most likely to activate pain receptors? a. GABA b. Serotonin c. Bradykinin d. Beta-endorphin ANS: C 8. The neospinothalamic tract transmits which of the following modalities of sensation? a. Vibration sense b. Proprioceptive information c. Fast pain impulses d. Slow pain impulses ANS: C 9. Neurons involved with the endogenous analgesia system and with cell bodies in the Raphe nucleus are most likely to secrete which of the following substances? a. Acetylcholine b. Enkephalin c. Glutamate d. Norepinephrine e. Serotonin ANS: E 10. Referred pain results from an intermingling of pain fibers in which of the following structures? a. Anterolateral system b. Dorsal horn of spinal cord c. Midbrain periaqueductal gray d. Primary somatosensory cortex e. Ralph nuclei ANS: B 11. Slow pain (also called second pain) often occurs following injury to the surface of the body. Slow pain is dependent neurologically on the existence of Fast pain (also called first pain)? a. Both statements are correct. b. Both statements are incorrect. c. The first statement is correct, the second statement is not correct. d. The first statement is not correct, the second statement is correct. ANS: C 12. Stimulation of which brain area can modulate the sensation of pain?  a. Superior olivary complex b. Locus coeruleus c. Periaqueductal gray d. Amygdala ANS: C 13. Which of the following best describes the type of excitatory transmitter secreted from the nerve endings of type C pain fibers? a. Glycine b. Substance P c. GABA d. Glutamate e. Norepinephrine ANS: B 14. A 45-year-old man suffers severe, chronic pain caused by a back injury. His physician prescribes benzodiazepine sedation medications to help him sleep. Which of the following best describes why this man has difficulty sleeping without medication? a. Depression of amygdalae b. Depression of reticular activating system c. Excitation of amygdalae d. Excitation of reticular activating system e. Loss of somatic sensations f. Loss of visceral sensations ANS: D 15. Which of the following substances is mostly likely to cause ischemic pain? a. Acetylcholine b. Albumin c. Bradykinin d. Carbon dioxide e. Norepinephrine ANS: C 16. A 28-year-old student pokes his left hand with a needle. Which of the following best describes the number of neurons required to transmit the pain sensation from the left hand to the somatosensory cortex? a. One b. Two c. Three d. Four e. Five ANS: C 17. Second pain (slow pain) follows first pain (fast pain) because second pain is dependent neurologically on first pain. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but not related. c. The statement is correct, but the reason is not. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: C