Deck 7: Understanding and Managing Pain

Question 1

​Afferent fibers group together after leaving the skin, forming a _____.

A) ​nerve
B) ​cell
C) ​cell body
D) ​ganglion cell

Answer 1

​nerve

Question 2

​The ______ system allows us to interpret certain sensory information as pain.

A) ​somatosensory
B) ​endocrine
C) ​skeletal
D) ​muscular

Answer 2

​somatosensory

Question 3

​Participants who are socially excluded show more activity in the anterior cingulate cortex, similar to people who are experiencing _____________.

A) ​physical pain
B) ​depression
C) ​anxiety
D) ​all of the above

Answer 3

​physical pain

Question 4

​Stimulation of the A-delta fibers, since they are myelinated, leads to a _______, whereas the unmyelinated C fibers often result in _____________.

A) ​"slow pain" response; "fast pain" response
B) ​"no pain" response; "slow pain" response
C) ​"fast pain" response; "slow pain" response
D) ​"no pain" response; "fast pain" response

Question 5

​Myelinated afferent neurons are called

A) ​A fibers.
B) ​beta afferents.
C) ​C fibers.
D) ​delta afferents.

Question 6

This system conveys sensory information from the body to the brain.

A) Endocrine system
B) Digestive system
C) Somatosensory system
D) Immune system

Question 7

​Recent research gave participants __________ to reduce people's feelings of social pain.

A) ​a shock
B) ​a hug
C) ​Tylenol
D) ​Morphine

Question 8

Sherman stubbed his toe on the sidewalk. His sensation of pain traveled first to the

A) muscles in the foot.
B) brain.
C) spinal cord.
D) cranial nerves.

Question 9

​If you receive exactly the same painful stimulus to your hand or your back, which will feel more pain, and why?

A) ​Your back, because it has larger surface area
B) ​Your hand, because it has much thinner skin
C) ​Your back, because it has more pain receptors
D) ​Your hand, because it has more pain receptors

Question 10

​Nerves are:

A) ​entirely afferent.
B) ​entirely efferent.
C) ​a mixture of both.
D) ​not any of these.

Question 11

PET scan and fMRI imaging show that pain stimuli activate which parts of the brain?

A) The primary and secondary somatosensory cortices
B) The primary somatosensory cortex and thalamus
C) The anterior cingulate cortex and the cerebellum
D) Many areas of the brain, including all of these

Question 12

​When pain is experienced in some other location than the site where the pain was inflicted, this is called

A) ​phantom limb pain.
B) ​referred pain.
C) ​prechronic pain.
D) ​chronic recurrent pain.

Question 13

​Primary afferents convey sensory impulses to the

A) ​spinal cord.
B) ​peripheral nervous system.
C) ​brain.
D) ​motor neurons.

Question 14

_____ are chemicals that carry information between nerves.

A) Afferent neurons
B) Efferent neurons
C) Neurotransmitters
D) Interneurons

Question 15

​More than half of all sensory afferents are

A) ​A-beta fibers.
B) ​A-delta fibers.
C) ​C fibers.
D) ​myelinated.

Question 16

Mark got paint stripper in his eye and the hospital gave him morphine, so he was feeling no pain when he got home. Why was this drug most likely effective?

A) Because the brain is most accepting of novel types of chemicals
B) Because its properties resemble those of natural brain chemicals
C) Because it stimulates the brain to release its own neurochemicals
D) Because the mechanisms of opiates may involve both (b) and (c)

Question 17

​_______ are neurochemicals that help modulate, or lessen, the experience of pain.

A) ​Endorphins
B) ​Interneurons
C) ​Glutamates
D) ​Proinflammatory cytokines

Question 18

​_________ neurons carry nerve impulses away from the brain and toward the muscles.

A) ​Efferent
B) ​Afferent
C) ​Beta afferents
D) ​Delta afferents

Question 19

​Nociception refers to the process of perceiving ________.

A) ​stress
B) ​pain
C) ​anger
D) ​oxygen

Question 20

​The branches of nerve bundles are _______ tracts, which route information _______ the brain; and _______ tracts, which route information _______ the brain.

A) ​motor, toward; sensory, from
B) ​sensory, toward; motor, from
C) ​dorsal, toward; sensory, from
D) ​sensory, inside; motor, inside

Question 21

​Victoria has just cut her hand with a sharp knife. The pain she feels can best be described as

A) ​acute.
B) ​pre-chronic.
C) ​chronic intractable.
D) ​chronic.

Question 22

​Kyle is experiencing headaches and his partner has taken over the household chores. Research by Pence et al. (2008) would suggest that Kyle's headaches are likely to

A) ​increase in intensity.
B) ​decrease in intensity.
C) ​completely disappear.
D) ​disappear until his partner makes him do the chores again.

Question 23

Which structure is most capable of modulating sensory input?

A) Primary afferents
B) Secondary afferents
C) Substantia gelatinosa
D) Spinothalamic tract

Question 24

​This personality trait has been associated with a "pain-resistant" personality.

A) ​Conscientiousness
B) ​Extraversion
C) ​Neuroticism
D) ​There is no "pain-resistant" personality.

Question 25

Which of the following structures located in the midbrain relieves pain when activated?

A) The medulla
B) Dorsal horn neurons
C) Periaqueductal gray
D) Substantia gelatinosa

Question 26

​The dorsal horns are located in the

A) ​brain stem.
B) ​kidneys.
C) ​midbrain.
D) ​spinal cord.

Question 27

Which of the body's own neurochemicals does NOT have opiate-like effects?

A) Bradykinin
B) Enkephalins
C) Endorphins
D) Dynorphin

Question 28

​According to the gate control theory, emotions such as ______ could increase pain by opening the gate, whereas emotions such as _____ could decrease pain by closing the gate.

A) ​happiness; depression
B) ​joy; anxiety
C) ​anxiety; happiness
D) ​depression; anxiety

Question 29

​Henry Beecher reported that many soldiers wounded at the Anzio beachhead during World War II experienced ______ pain.

A) ​chronic, intractable
B) ​stress-related
C) ​severe, excruciating
D) ​very little

Question 30

These proteins produced by the immune system increase pain sensitivity, along with increasing fatigue and sickness:

A) proinflammatory cytokines.
B) endorphins.
C) opiates.
D) both a and B

Question 31

​What proportion of people report feeling no immediate pain from scrapes, cuts, or burns compared to people feeling no immediate pain from stab wounds, sprains, or broken bones?

A) ​Approximately 25% fewer
B) ​Fewer than half as many
C) ​Almost twice as many
D) ​About three times more

Question 32

​Physicians are likely to underestimate the pain of

A) ​Asian Americans.
B) ​African Americans.
C) ​European Americans.
D) ​no ethnic group; doctors treat all patients equally.

Question 33

Which of these is NOT a distinction between chronic and acute pain?

A) Acute pain is usually adaptive; chronic pain is not.
B) Acute pain is physical; chronic pain is psychological.
C) Chronic pain is frequently reinforced environmentally; acute pain needs no such reinforcement.
D) Chronic pain has no biological benefit; acute pain warns the person to avoid further injury.

Question 34

Matthew is running a marathon and trips over a pile of acorns, but finishes the race. Afterward, he finds out his ankle is sprained. What theory best accounts for the fact that Matthew did not immediately stop running after tripping?

A) Specificity theory of pain
B) Gate control theory of pain
C) Delayed gratification theory of pain
D) None of the above theories of pain

Question 35

​The substantia gelatinosa is

A) ​in the dorsal horns of the spinal cord.
B) ​in the midbrain region, adjacent to the thalamus.
C) ​composed of a gelatin-like material that surrounds the lower portion of the brain.
D) ​a hypothetical structure that has not yet been confirmed.

Question 36

​Neurotransmitters like _____ decrease pain, but those like ________ increase the experience of pain.

A) ​serotonin . . . dynorphin
B) ​endorphins . . . glutamate
C) ​substance P . . . serotonin
D) ​endorphins . . . enkephalins

Question 37

Sensory input information passes through what brain structure?

A) The parietal lobe of the cerebral cortex
B) The pons
C) The cerebellum
D) The thalamus

Question 38

​Pain is usually defined as

A) ​a sensory experience only.
B) ​an emotional experience only.
C) ​neither a sensory nor an emotional experience.
D) ​both a sensory and an emotional experience.

Question 39

​Not all people in ERs for accidental injuries report pain, but all people who are tortured experience pain. What can explain this difference?

A) ​Beliefs
B) ​Expectations
C) ​Lack of control
D) ​Any or all of these

Question 40

What brain structure contains a representation of the skin's surface?

A) Somatosensory cortex
B) Parietosensory area
C) Sensorimotor cortex
D) Occipital cortex

Question 41

Which of these methods have been used to measure pain?

A) Self-reports
B) Behavioral assessment
C) Physiological measures
D) All of these

Question 42

Which of these findings casts doubt on the specificity theory of pain?

A) Researchers have failed to find specific skin receptors devoted to relaying pain.
B) Phantom limb pain occurs in 70% of amputees.
C) Injury can occur without pain, such as that experienced by the soldiers at Anzio beach.
D) All of these are challenges to the validity of the specificity theory of pain.

Question 43

Which of these techniques measures muscle tension as an index of pain?

A) Electromyography
B) Thermography
C) Blood flow in the temporal artery
D) Heart rate

Question 44

​A personality inventory sometimes used to assess pain is the

A) ​California Personality Inventory.
B) ​Minnesota Multiphasic Personality Inventory.
C) ​Edwards Personality Schedule.
D) ​Guilford-Zimmerman Temperament Survey

Question 45

​The theory of pain proposed by Melzack and Wall has been called the _____ theory.

A) ​gate control
B) ​sensory decision
C) ​cognitive-emotional
D) ​tension-reduction

Question 46

​Specificity theory hypothesizes that

A) ​a person's interpretation of pain is more important than tissue damage in determining the intensity of pain.
B) ​acute pains tend to intensify over time.
C) ​the experience of pain matches the amount of tissue damage or injury.
D) ​chronic pain can become acute over time.

Question 47

With regard to gender,

A) women sense pain more quickly than men.
B) women are more likely to hide their pain.
C) men are more likely aware of their pain.
D) men are less likely to report their pain.

Question 48

​During childbirth, women in some cultures exhibit many more signs of pain than women in other cultures. This observation shows that

A) ​the experience of pain varies from culture to culture.
B) ​cultural practices can influence the expression of pain.
C) ​natural childbirth produces less pain than opiate drugs.
D) ​women showing little pain during labor are using self-hypnosis.

Question 49

​According to the gate control theory of pain, the structure that is the likely location of the gate is

A) ​the substantia gelatinosa.
B) the ventral horns of the spinal cord.​
C) ​the transverse section of the medulla.
D) ​supraspinal nerve endings.

Question 50

​What is the relationship between the experience of pain and some types of psychopathology?

A) ​People with personality disorders have heightened pain perception.
B) ​People with pain-prone personalities tend to have borderline personality disorder.
C) ​People with pain-resistant personalities tend to have bipolar disorder.
D) ​It is unclear whether psychopathology leads to chronic pain, or vice versa.

Question 51

​The gate control theory of pain assumes

A) ​the physiological reality of pain.
B) ​the nature of motor output factors in pain perception.
C) ​that chronic pain is heavily influenced by both spinal cord and brain activity.
D) ​that sensory input is not the only factor in pain perception.

Question 52

​According to the neuromatrix theory, the neuromatrix is a network of brain neurons composed of loops between

A) ​the thalamus and the cortex.
B) ​the cortex and limbic system.
C) ​the thalamus and limbic system.
D) ​both (a) and (b) rather than (c).

Question 53

​Melzack proposed the _______ theory, which is an extension of the gate control theory.

A) ​sensory decision
B) ​specificity
C) ​neuromatrix
D) ​cerebellar

Question 54

​People in pain frequently receive attention and sympathy, which may provide ____________ for these pain behaviors.

A) ​reinforcement
B) ​negative scheduling
C) ​punishment
D) ​generalization

Question 55

​According to the gate control theory of pain, the spinal cord

A) ​mechanically relays sensory input information.
B) ​modulates the input of sensory information.
C) ​does not have the physiological capacity to affect pain perception.
D) ​is less important in pain perception than the cerebellum.

Question 56

​Heart rate predicts perceptions of pain, but only for ________.

A) ​children
B) ​the elderly
C) ​men
D) ​women

Question 57

​The Visual Analog Scale is considered to be

A) ​a self-report measure.
B) ​an evoked potential measure of pain.
C) ​a behavioral assessment of pain.
D) ​a pain questionnaire.

Question 58

​In some cultures, people undergo initiation rituals that call for them to have their body pierced, cut, tattooed, burned, or beaten. These individuals.

A) ​feel no pain during these initiation rituals.
B) ​show little or no pain from accidental injuries.
C) ​feel pain, but are culturally trained not to show it.
D) ​offer proof that pain is completely psychological.

Question 59

​The most widely used pain questionnaire was developed by Ronald Melzack and is known as the

A) ​Melzack and Wall Pain Questionnaire.
B) ​Visual Analog Scale.
C) ​Minnesota Multiphasic Personality Inventory.
D) ​McGill Pain Questionnaire.

Question 60

​Valid and reliable measures of pain are important to health psychologists primarily because

A) ​such measurements permit accurate evaluation of various pain therapy programs.
B) ​self-reports are more useful than physiological measures.
C) ​pain is a product of both physiological and emotional factors.
D) ​behavioral assessments are more reliable and valid.

Question 61

​Rosa suffers from recurrent attacks of pain that are accompanied by exaggerated sensitivity to light, loss of appetite, and nausea. From these characteristics you would diagnose Rosa as having

A) ​migraine headaches.
B) ​tension headaches.
C) ​cancer pain.
D) ​phantom limb pain.

Question 62

​International studies show almost ____ of all cancer patients' pain was untreated.

A) ​10%
B) ​20%
C) ​50%
D) ​90%

Question 63

​Chronic pain affects approximately ____ of the population in the United States.

A) ​50%
B) ​10%
C) ​75%
D) ​30%

Question 64

​Wendy suffers from headaches that occur nearly every day for about a month, but then go away for about a year or more. From this description, it appears that Wendy suffers from

A) ​cluster headaches.
B) ​migraine headaches.
C) ​tension headaches.
D) ​none of the above.

Question 65

​_______ occurs when the body needs more and more of the drug to reach the same effect, and _______ occurs when removal of the drug causes withdrawal symptoms.

A) ​Withdrawal; dependence
B) ​Dependence; withdrawal
C) ​Tolerance; dependence
D) ​Dependence; tolerance

Question 66

​The two most common types of pain are

A) ​cancer and headache.
B) ​arthritis and low back.
C) ​headache and low back
D) ​cancer and low back.

Question 67

Unlike rheumatoid arthritis, osteoarthritis

A) affects young and old equally.
B) affects primarily men.
C) is an autoimmune disorder.
D) affects primarily older people.

Question 68

​Carlos is a 45-year-old civil engineer who has never had a migraine headache. His chances of a first migraine are

A) ​very high.
B) ​about 50/50.
C) ​very low.
D) ​nonexistent.

Question 69

​One variation of cognitive behavioral therapy encourages participants to _____ their pain and focus their attention on valued activities.

A) ​deny
B) ​accept
C) ​enjoy
D) ​commit to

Question 70

Cognitive behavioral therapy has been shown to be effective in relieving pain for

A) headache patients.
B) fibromyalgia patients.
C) patients with AIDS pain.
D) all of the above patients.

Question 71

The three primary kinds of headaches are

A) migraine, cluster, chronic.
B) chronic, tension, cluster.
C) migraine, cluster, tension.
D) tension, migraine, chronic.

Question 72

Jesse's leg was amputated when he was 20. Almost 10 years later, he still occasionally feels pain in that missing limb. This pain is called

A) missing limb pain.
B) phantom limb pain.
C) amputation pain.
D) neuroses.

Question 73

​With regard to migraine headaches,

A) ​men are somewhat more likely than women to have migraines.
B) ​women are much more likely than men to have migraines.
C) ​women are slightly more likely than men to have migraines.
D) ​women and men are about equally susceptible to migraines.

Question 74

Which of these conditions may contribute to low back pain?

A) Pregnancy
B) Improper lifting of heavy objects
C) Aging
D) All of these

Question 75

​_____ pain is the most common of all syndromes of pain with a lifetime incidence rate of more than 99%.

A) ​Headache
B) ​Low back
C) ​Burn
D) ​Knee

Question 76

Low back pain has many causes. About what percent of back pain patients have an identified, physical cause for their pain?

A) 20%
B) 50%
C) 75%
D) About 40% of men and about 60% of women

Question 77

The tendency to catastrophize is associated with

A) magnification of pain.
B) lessening of pain.
C) no differences in perception of pain.
D) magnification of pain, but only with other people present.

Question 78

​For phantom limb pain, the pain is more likely in the missing limb when:

A) ​there was much pain before the amputation.
B) ​there was no pain before the amputation.
C) ​all phantom pain has the same intensity.
D) ​the limb that was amputated was a leg.

Question 79

What type of pain has a gradual onset, sensations of tightness around the neck and shoulders, and a steady ache on both sides of the head?

A) Lower back pain
B) Migraine headache
C) Cluster headache
D) Tension headache

Question 80

What types of headaches are more common in men than in women?

A) Chronic
B) Cluster
C) Migraine
D) Tension