HESI EXIT ADVANCED PATHOPHYSIOLOGY 2022 COMPLETE EXAM QUESTIONS AND ANSWERS

ADVANCED PATHOPHYSIOLOGY REAL EXAM 60 QUESTIONS AND ANSWERS |RATED A+| What is a protective and complex phenomenon composed of sensory experiences (time, space, intensity), emotion, cognition, and motivation? - ---CORRECT ANSWER--- Pain Portion of the nervous system responsible for sensation and perception of pain can be divided into 3 areas: - ---CORRECT ANSWER--- A: Afferent pathways B interpretive centers in the brainstem, midbrain & diencephalon C: descending pathways from the brain to the dorsal horn of spinal cord. Nociceptors are pain receptors that detect a wide range of stimuli and respond to: - ---CORRECT ANSWER--- Chemical, mechanical, and thermal stimulation The afferent system is: - ---CORRECT ANSWER--- Composed of nociceptors the dorsal horn of the spinal column (second-order neurons) and afferent neurons in the Aδ and C fibers (first-order neurons);spinothalamic tract (third-order neurons). Myelinated Aδ receptor transmission is - ---CORRECT ANSWER--- Fast and conveys mechanical and thermal localized pain. Unmyelinated polymodal C fiber transmission is: - ---CORRECT ANSWER--- Slower and conveys sharp, diffuse burning and aching sensations These primary-order neurons terminate on second-order neurons. - ---CORRECT ANSWER--- Three classes of second-order neurons modulate pain transmission: - ---CORRECT ANSWER--- projection cells, excitatory interneurons and inhibitory interneurons. The second-order neurons are located: - ---CORRECT ANSWER--- in the spinal cord laminae The second-order neurons function as - ---CORRECT ANSWER--- a pain gate to regulate pain transmission. Second-order neurons cross over the cord and ascend primarily in - ---CORRECT ANSWER--- the lateral the spinothalamic tract to projection centers including the thalamus reticular formation, and PAG matter. Third-order neurons carry information to the - ---CORRECT ANSWER--- sensory cortex and reticular and limbic systems for pain processing and interpretation. Efferent pathways from the PAG are responsible for modulation or inhibition of afferent pain signals. - ---CORRECT ANSWER--- The thalamus cortex, and postcentral gyrus perceive, describe, and localize: - ---CORRECT ANSWER--- Pain The reticular formation and limbic system control the - ---CORRECT ANSWER--- emotional and affective response to pain. Pain threshold is the point at which pain is perceived. Pain threshold does not vary significantly among people or within the same person over time. - ---CORRECT ANSWER--- Pain tolerance is the duration of time or the intensity of pain that an individual will ensure before initiating overt pain response. - ---CORRECT ANSWER--- Tolerance varies widely among individuals and in the same individual over time and in the same individual over time. - ---CORRECT ANSWER--- Descending inhibitory or facilitatory pathways facilitate pain. - ---CORRECT ANSWER--- Segmental inhibition is the peripheral stimulation of nociceptors by touch nuclei, and neurotransmitter inhibit or vibration or pressure resulting in closure of the spinal cord pain gate. - ---CORRECT ANSWER--- The higher brain centers also can - ---CORRECT ANSWER--- influence painful stimuli (heterosegmental control of nociception) as well as inhibition from the caudal medulla (diffuse noxious inhibitory controls). Thus pain can be modulated with: - ---CORRECT ANSWER--- Stimulation from the periphery or by descending impulses from the brain Cognitive expectation can attenuate or intensify pain and this is known as the: - ---CORRECT ANSWER--- Placebo and nocebo effects. Pain neurotransmitters can be classified as inflammatory excitatory, and inhibitory modulators of pain. - ---CORRECT ANSWER--- Inflammatory neurotransmitters are usually excitatory. Gammaaminobutyric acid (GABA) and glycine are inhibitors of pain. - ---CORRECT ANSWER--- Endogenous opioids are a family of morphine-like neuropeptides that inhibit transmission of pain by acting on: - ---CORRECT ANSWER--- specific opiod receptors (mu [μ] kappa [κ], and delta [δ]). Classifications of pain include - ---CORRECT ANSWER--- A: nociceptive pain (with a known physiologic cause) B: nonnociceptive pain (neuropathic pain) Acute pain - ---CORRECT ANSWER--- signal to the person of a harmful stimulus Chronic pain - ---CORRECT ANSWER--- Persistence of pain of unknown cause or unusual response to therapy. Acute pain may be - ---CORRECT ANSWER--- (a) somatic (superficial) (b) visceral (internal) (c) referred (present in an area distant from its origin). Somatic pain arises from - ---CORRECT ANSWER--- connective tissue, muscle, bone, and skin and is sharp and localized. Visceral pain is from - ---CORRECT ANSWER--- internal organs and is transmitted by sympathetic afferents and is poorly localized. Referred pain usually arises from the viscera and terminates - ---CORRECT ANSWER--- in an area of the spinal cord that is conjoined with fibers originating in the skin and other areas and thereby produces the perception of pain at the referred site. that is conjoined with fibers originating in the skin and other areas and thereby produces - ---CORRECT ANSWER--- the perception of pain at the referred site. - ---CORRECT ANSWER--- Physiologic responses to acute pain include - ---CORRECT ANSWER--- increased heart rate, respiratory rate, and blood pressure; pallor or flushing; dilated pupils; and diaphoresis. Blood glucose level is elevated; gastric secretion and motility are decreased; and blood flow to the viscera and skin is decreased. Chronic pain generally lasts - ---CORRECT ANSWER--- at least 3 months and may be persistent. for example, low back pain myofascial pain syndromes, chronic postoperative pain, and chronic pain associated with cancer. Neuropathic pain is usually - ---CORRECT ANSWER--- chronic. abnormal peripheral and central pain processing.