Deck 3: The Neuroanatomy and Neurophysiology of Pain Control

Question 1

Match the following :

-Dendritic zone

A) Water loving
B) Passage through nerve membrane
C) Nerve bundle of nerve fibers
D) Nerve membrane
E) Covering on nerve membrane
F) Forms myelin layer
G) Ionic activity on nerve membrane
H) Area of synapses
I) Little or no stimulation on nerve
J) Gap in sheath

Answer 1

Area of synapses

Question 2

Match the following :

-Depolarization

A) Water loving
B) Passage through nerve membrane
C) Nerve bundle of nerve fibers
D) Nerve membrane
E) Covering on nerve membrane
F) Forms myelin layer
G) Ionic activity on nerve membrane
H) Area of synapses
I) Little or no stimulation on nerve
J) Gap in sheath

Answer 2

Little or no stimulation on nerve

Question 3

Match the following :

-Fasciculi

A) Water loving
B) Passage through nerve membrane
C) Nerve bundle of nerve fibers
D) Nerve membrane
E) Covering on nerve membrane
F) Forms myelin layer
G) Ionic activity on nerve membrane
H) Area of synapses
I) Little or no stimulation on nerve
J) Gap in sheath

Answer 3

Nerve bundle of nerve fibers

Question 4

Match the following :

-Hydrophilic

A) Water loving
B) Passage through nerve membrane
C) Nerve bundle of nerve fibers
D) Nerve membrane
E) Covering on nerve membrane
F) Forms myelin layer
G) Ionic activity on nerve membrane
H) Area of synapses
I) Little or no stimulation on nerve
J) Gap in sheath

Question 5

Match the following :

-Ion channel

A) Water loving
B) Passage through nerve membrane
C) Nerve bundle of nerve fibers
D) Nerve membrane
E) Covering on nerve membrane
F) Forms myelin layer
G) Ionic activity on nerve membrane
H) Area of synapses
I) Little or no stimulation on nerve
J) Gap in sheath

Question 6

Match the following :

-Impulse

A) Water loving
B) Passage through nerve membrane
C) Nerve bundle of nerve fibers
D) Nerve membrane
E) Covering on nerve membrane
F) Forms myelin layer
G) Ionic activity on nerve membrane
H) Area of synapses
I) Little or no stimulation on nerve
J) Gap in sheath

Question 7

Match the following :

-Myelination

A) Water loving
B) Passage through nerve membrane
C) Nerve bundle of nerve fibers
D) Nerve membrane
E) Covering on nerve membrane
F) Forms myelin layer
G) Ionic activity on nerve membrane
H) Area of synapses
I) Little or no stimulation on nerve
J) Gap in sheath

Question 8

Match the following :

-Neurolemma

A) Water loving
B) Passage through nerve membrane
C) Nerve bundle of nerve fibers
D) Nerve membrane
E) Covering on nerve membrane
F) Forms myelin layer
G) Ionic activity on nerve membrane
H) Area of synapses
I) Little or no stimulation on nerve
J) Gap in sheath

Question 9

Match the following :

-Node of Ranvier

A) Water loving
B) Passage through nerve membrane
C) Nerve bundle of nerve fibers
D) Nerve membrane
E) Covering on nerve membrane
F) Forms myelin layer
G) Ionic activity on nerve membrane
H) Area of synapses
I) Little or no stimulation on nerve
J) Gap in sheath

Question 10

Match the following :

-Schwann cells

A) Water loving
B) Passage through nerve membrane
C) Nerve bundle of nerve fibers
D) Nerve membrane
E) Covering on nerve membrane
F) Forms myelin layer
G) Ionic activity on nerve membrane
H) Area of synapses
I) Little or no stimulation on nerve
J) Gap in sheath

Question 11

The epineurium surrounds all of the fasciculi, their associated supporting connective tissue including blood vessels and lymphatics, and the perineuria.

Question 12

The strength of nerve impulses weakens as the energy transfers from one section of nerve membranes to the next.

Question 13

Saltatory conduction is the term for the process by which impulses are slowly conducted along nonmyelinated nerves.

Question 14

In response to stimulation, calcium ions release from the receptor sites, allowing an influx of sodium ions into the axoplasm.

Question 15

There are more positively charged ions outside the depolarized nerve cell than inside because the nerve membrane is relatively impermeable to sodium.

Question 16

The electrical potential of a nerve axoplasm in the resting state is approximately -70 mV.

Question 17

Depolarization refers to a potential change across a nerve membrane from -70 mV to +40 mV.

Question 18

Depolarization is a reversal of ion concentrations in the recovery phase.

Question 19

A relative refractory period occurs when a nerve fiber can only be restimulated by a much stronger stimulus than the initial stimulus.

Question 20

An absolute refractory period occurs when a nerve fiber can be restimulated only by a much stronger stimulus than the initial stimulus.

Question 21

Schwann cells release neurotransmitters when stimulated by impulses.

Question 22

Nodes of Ranvier are small, raised areas on the neurolemma that permit ions to pass into the axoplasm.

Question 23

Local anesthetic drugs are effective only at the nodes of Ranvier and in order to be effective, multiple nodes must be exposed to the drug to block impulses.

Question 24

Due to the effectiveness of local anesthetic drugs, exposure of a 1 to 3 millimeter section of nerve membrane to an anesthetic solution is adequate to ensure profound anesthesia.

Question 25

All cell bodies of sensory nerves that innervate oral tissues are located in the trigeminal ganglia and participate in impulse transmission.

Question 26

The minimal threshold stimulus required to stimulate a C fiber will be sufficient to stimulate an A fiber.

Question 27

Nonmyelinated C fibers are the most common nerve fiber types on peripheral nerves and conduct slowly producing a sensation of dull and aching pain.

Question 28

A fibers are the most numerous of the fiber types. They are nonmyelinated and transmit sharp pain sensations.

Question 29

The mantle bundles are located on the outer area of the nerve membrane and the core bundles are located in the central area. Both have significance in the order of anesthesia development.

Question 30

Local anesthetic molecules have a greater affinity for protein receptor sites within the nerve membrane compared to calcium ions; therefore, they displace the calcium ion and block impulse transmission.

Question 31

The four structural parts of the neuron are the ________, ________, ________, and ________.

Question 32

Sensory neurons carry impulses to the ________ for processing.

Question 33

Motor nerves carry impulses away from the CNS to ________ and ________.

Question 34

Lipophilic membranes are described as ________.

Question 35

Nerves are classified as myelinated or nonmyelinated according to the extent of the ________ tissue that encloses them.

Question 36

Nerve membranes are called ________ and are bilayered phospholipid membranes.

Question 37

The process of sequential impulse generation to the CNS is referred to as ________.

Question 38

The ________ ion is the gatekeeper in the nerve membrane's resting state.

Question 39

The inability of a nerve membrane to be restimulated following impulse generation and conduction is known as a ________.

Question 40

Specialized connective tissue cells that surround and protect peripheral nerves are called ________.

Question 41

Myelinated nerves have minute gaps consisting of unprotected nerve membranes between adjacent Schwann cells called ________.

Question 42

________ is a process by which impulses are rapidly conducted along myelinated nerves.

Question 43

________ fibers are lightly myelinated and primarily provide a sharp pain sensation.

Question 44

The two most significant ________ of local anesthetic solutions are the perilemma and the perineurium.

Question 45

Mantle fibers within the inferior alveolar nerve innervate the ________ region.

Question 46

Which description of nerve membranes is correct?

A) Trilayered sandwich-like membranes
B) Bilayered phospholipid membranes
C) Hydrophilic ends facing inward
D) Have fatty cores that allow large hydrophilic molecules to pass into the axoplasm

Question 47

Which statement is not accurate when describing nerve impulses?

A) Electrical in nature
B) Depend on ionic activity on nerve membranes
C) Require firing threshold to transmit to CNS
D) Successive impulses decrease in size

Question 48

Which statement accurately describes the process known as saltatory conduction?

A) Impulses are rapidly conducted along myelinated nerves.
B) Impulses are slowly, uniformly conducted along nonmyelinated nerves.
C) Impulses are conducted only through the nodes of Ranvier on myelinated nerves.
D) Impulses are conducted through the Schwann cells and axoplasmic membrane to the CNS.

Question 49

Saltatory conduction is defined as the

A) Slow transmission of a nerve impulse due to diffusion of sodium across nerve membrane
B) Rapid diffusion of sodium chloride into the nerve cell during impulse conduction
C) Slow conduction of an impulse along a nonmyelinated nerve at the nodes of Ranvier
D) Rapid transmission of nerve impulses along a myelinated nerve fiber

Question 50

The axoplasm of a nerve at rest:

A) Is electrically positive at +70 mV.
B) Is electrically negative compared to the extracellular environment.
C) Contains more sodium ions than the extracellular environment.
D) Contains less calcium ions than the extracellular environment.

Question 51

In the resting state, a nerve membrane has an electrical potential of:

A) -40 mV to +40 mV.
B) +40 mV.
C) +70 mV to +90 mV.
D) -70 mV.

Question 52

Which two ions are responsible for the uninterrupted maintenance of the resting potential across the nerve membrane?

A) K+ and Na+
B) K+ and Cl-
C) Ca+ and Na-
D) H+ and Cl-

Question 53

Which positively charged ion functions as a gatekeeper in ion channels?

A) Calcium
B) Sodium
C) Potassium
D) Hydrogen

Question 54

Which of the following does not occur upon rapid depolarization?

A) Calcium rapidly floods into the axoplasm
B) Sodium rapidly floods into the axoplasm
C) Electrical potential of the axoplasm is +40 mV
D) Absolute refractory state

Question 55

Which of the following sequences best describes the events in a successful impulse generation?

A) Stimulation, firing threshold, rapid depolarization, slow repolarization, resting state
B) Stimulation, slow depolarization, firing threshold, rapid depolarization, recovery
C) Resting state, stimulation, slow depolarization, rapid depolarization, firing threshold
D) Resting state, stimulation, slow depolarization, rapid depolarization, slow depolarization

Question 56

Which statement describes slow depolarization?

A) Allows dehydrated sodium ions to enter the negatively charged axoplasm causing the threshold for firing threshold
B) Allows release of the sodium ions from the receptor sites in the ion channels allowing negative ions to enter the axoplasm
C) Occurs until the axoplasm has depolarized 15 to 20 mV to reach -50 to -55 mV, which is the firing threshold
D) Occurs until the calcium ions rebind with the receptor sites to reach firing threshold at -50 to -55 mV

Question 57

Which statement best describes rapid depolarization?

A) The membrane rapidly depolarizes at the site of stimulation causing a firing threshold that is followed by displacement of the calcium ions.
B) The membrane rapidly depolarizes once the firing threshold has been achieved allowing a flood of sodium ions into the axoplasm.
C) The membrane rapidly depolarizes along the entire nerve until the strength of the stimulus increases enough to cause an impulse.
D) The membrane rapidly depolarizes following the refractory resting state.

Question 58

Which statement best describes the relative refractory state when the membrane has not fully returned to its resting state?

A) The same strength of a single stimulus can create a firing threshold.
B) No amount of stimulus relative to the previous impulse will produce a firing threshold.
C) Rapid repetition of the same strength stimulus will create a firing threshold.
D) A larger stimulus than the previous stimulus can produce a firing threshold.

Question 59

Which statement best describes the repolarization process?

A) The nerve membrane has reestablished a potential of +70 mV.
B) Positively charged sodium ions return to the axoplasm due to the negative charge of the axoplasm during polarization.
C) Positively charged sodium, calcium, and potassium ions are actively transported from the axoplasm to the extracellular environment.
D) Calcium ions re-bind to the receptor sites to ensure that Na+ will not continue to depolarize the axoplasm.

Question 60

Which of the following is correct when a nerve is in the resting state?

A) Na+ concentration is the highest inside the axoplasm
B) Nerve membrane is more negative on the extracellular side
C) Nerve axoplasm is approximately -70 mV
D) Nerve membrane will respond to any stimulus

Question 61

The process of sequential impulse generation to the CNS is called:

A) Impulse generation
B) Firing potential
C) Firing threshold
D) Propagation

Question 62

Myelin is composed of:

A) Connective tissues
B) Fatty tissues
C) Neuron tissues
D) Phospholipid tissue

Question 63

Which cells produce myelin?

A) Sensory neurons
B) Myelinated neurons
C) Schwin cells
D) Schwann cells

Question 64

Nerve impulses travel rapidly on myelinated nerves because:

A) Myelin allows for a consistent incremental impulse over the membrane surface
B) Impulses travel through the membrane, generating new impulses at each node
C) Impulses bypass nodes and travel up to 8-10 mm to subsequent nodes, decreasing the length of nerve over which impulses must be generated
D) Transmit rapidly because they are small nerves

Question 65

What are the functions of Schwann cell sheaths?

A) Protection and insulation for cell bodies
B) Protection for the nodes of Ranvier and neurons
C) Protection and insulation for the neurons
D) Produce Schwann cells and cell membranes

Question 66

What is the correct relationship of Schwann cells to the nodes of Ranvier?

A) Schwann cells are located in the nodes of Ranvier.
B) Schwann cells are twice as thick as the nodes of Ranvier.
C) Nodes of Ranvier are gaps between Schwann cells.
D) Nodes of Ranvier are wrapped around the Schwann cells.

Question 67

In myelinated nerves, local anesthetic molecules are effective:

A) As they diffuse through the myelin sheath.
B) As they diffuse at the synapse.
C) Only at the cell body.
D) Only at the Nodes of Ranvier.

Question 68

Which statement correctly describes sensory and motor neurons?

A) Sensory neurons are efferent and conduct impulse away from the CNS.
B) Sensory neurons are afferent and conduct impulses toward the CNS.
C) Motor neurons participate in impulse conduction toward the CNS.
D) Motor neurons and sensory neurons have cell bodies that participate in the conduction of nerve impulse transmission.

Question 69

Which statement correctly describes the cell bodies of sensory and motor neurons?

A) Motor neuron cell bodies are located away from the axon.
B) Sensory neuron cell bodies participate in impulse transmission.
C) Sensory neuron cell bodies do not participate in impulse transmission.
D) Motor neuron cell bodies do not participate in the impulse transmission.

Question 70

Nerve impulses are initiated in the:

A) Dendritic zone
B) Axon.
C) Cell body.
D) Terminal arboration

Question 71

All oral cell bodies of sensory nerves are located in the:

A) Axon
B) Dendrite zone
C) Ganglia
D) Nerve membrane

Question 72

Which statement inaccurately describes nerve fiber types?

A) Dental pulp has more A than C nerve fiber types.
B) C fibers are more numerous in the peripheral nervous system.
C) A delta fibers are lightly myelinated and are responsible for the sensation of sharp pain.
D) C fibers are nonmyelinated and are responsible for the sensation of dull and aching pain.

Question 73

The immediate painful sensation from a traumatic injury to the lip is transmitted to the brain by which nerve fiber type?

A) A delta fibers
B) C delta fibers
C) B fibers
D) A and C fibers

Question 74

What is the function of the endoneurium?

A) Insulates the electrical activity of individual nerve fibers
B) Bundles nerve fibers into fasciculi
C) Is the inner layer of the perineurium
D) Provides metabolic support for the neuron membranes

Question 75

What is the function of the perineurium?

A) Forms the epineural sheath
B) Bundles nerve fibers into fasciculi
C) Produces connective tissues that insulate nerves
D) Forms a sheath around Schwann cells

Question 76

Which nerve layers represent the most significant barriers to the diffusion of anesthetic solutions and the development of anesthesia?

A) Perilemma and fasciculi
B) Fasciculi and epineurium
C) Perilemma and perineurium
D) All neuromembranes present a significant barrier to diffusion.

Question 77

What are three divisions of the dental plexus?
A. Interdental, interradicular, and periodontal
B. Inner dental, interradicular, and dental
C. Inner dental, interradicular, and periodontal
D. Interdental, interradicular, and dental

Question 78

The aromatic, lipophilic portion of an anesthetic molecule allows the anesthetic solution to:

A) Diffuse through the nerve membrane
B) Bind at the receptor site
C) Diffuse through the interstitial tissues
D) Be more effective in the presence of inflammation

Question 79

With which ion does the local anesthetic molecule compete within the nerve membrane?

A) Sodium
B) Calcium
C) Potassium
D) Hydrogen

Question 80

Which statement is true regarding the specific protein receptor theory?

A) Local anesthetic molecules compete with sodium ions for receptor sites.
B) Local anesthetic molecules displace calcium ions at receptor sites.
C) It explains why local anesthetic molecules affect only sensory nerves.
D) It blocks proteins that cover specific protein receptors on Schwann cells.