Enhancing Pain Relief: Understanding Trauma Physiology

Course #9733L-


Study Points

  1. Recall how stress and the vagus nerve impact pain sensitivity.
  2. Identify how our psychology can impact pain and recovery.
  3. Define neuroplastic pain and how it can present.
  4. Define somatics and how to implement it for greater pain relief.

    1 . Which of the following statements about the biopsychosocial model of pain is FALSE?
    A) This model accounts for biological, psychological, and social factors that can impact pain.
    B) This model cures pain.
    C) This model applies to all pain-related conditions.
    D) According to this model, factors that can have an influence on pain are mood, personality, and personal beliefs.

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    2 . According to gate control theory, what kind of stimuli "closes" the gates?
    A) Anxiety
    B) Gentle touch
    C) Lack of exercise
    D) Overwhelm

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    3 . According to gate control theory, what kind of stimuli "opens" the gates?
    A) Acupuncture
    B) Depression
    C) Massage
    D) Inactivity

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    4 . What is the neuromatrix theory of pain?
    A) A theory that claims pain is caused by nerve impulse patterns generated by a neural network
    B) A theory that explores how a multitude of cognitive, biological, physiological, and behavioral, and social factors can influence or trigger chronic pain
    C) A theory that identifies how stress is connected to chronic pain patterns
    D) All of the above

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    5 . How many Americans have experienced at least some type of traumatic event in their lives?
    A) 85%
    B) 70%
    C) 50%
    D) 90%

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    6 . What is true about the vagus nerve?
    A) The vagus nerve increases sympathetic activity.
    B) The vagus nerve connects to brain regions associated with pain processing.
    C) The vagus nerve is the 9th cranial nerve.
    D) The vagus nerve innervates with all internal organs in the abdominal cavity.

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    7 . Which organ does the vagus nerve not innervate with?
    A) Kidneys
    B) Liver
    C) Adrenal glands
    D) Intestines

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    8 . Which nociceptors respond to mechanical, heat, and chemical stimuli in the organs?
    A) Silent nociceptors
    B) Visceral nociceptors
    C) Muscle nociceptors
    D) Organ nociceptors

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    9 . What is the correct order of the four phases of pain processing?
    A) Transduction, transmission, modulation, perception
    B) Transmission, transduction, modulation, perception
    C) Transmission, transduction, transformation, perception
    D) Transduction, transmission, transformation, perception

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    10 . Transduction is when
    A) tissue-damaging stimuli activates nerve endings.
    B) messages are being sent up the spinal cord to the brain.
    C) there is a reduction of activity in the transmission system.
    D) None of the above

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    11 . A client might have neuroplastic pain if their pain
    A) is consistently in one location.
    B) has a clear and predictable physical trigger.
    C) is only on one side of their body.
    D) None of the above

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    12 . What kind of personality can contribute to a higher pain sensitivity?
    A) People-pleaser
    B) Perfectionist
    C) Narcissistic
    D) Both A and B

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    13 . What is TRUE about chronic pain?
    A) Pain sensitivity can be higher in those living with trauma or with a traumatic history.
    B) Chronic pain is only considered chronic if it has persisted longer than four months.
    C) Chronic pain has a cure.
    D) Chronic pain is only considered chronic if it persists all the time.

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    14 . Which strategy would be unhelpful when working with someone in chronic pain and with a trauma history?
    A) Pacing the session appropriately and asking for consent generously to not overwhelm the client
    B) Assume the client has adequate capacity or resources to complete their at-home therapeutic exercises
    C) Observing for signs of safety in the client during a session, especially when there is an increase in proximity or more sensitive information is being discussed
    D) Empower your client with supportive language and an authentic confidence in their resiliency

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    15 . What changes might occur in someone with trauma?
    A) Upregulated response to stress
    B) Abnormal fear processing
    C) Hippocampal atrophy
    D) All of the above

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    16 . When we have a client with chronic or neuroplastic pain, we want to help them perceive their pain through the lens of
    A) comfort.
    B) safety.
    C) vulnerability.
    D) trauma healing.

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    17 . We can help our client become more motivated by
    A) having them recite positive affirmations.
    B) discovering what their needs, values, and priorities are.
    C) telling them they just need to believe in themselves.
    D) giving them "tough love" to empower them.

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    18 . Which emotions can increase the experience of pain?
    A) Happiness
    B) Fear
    C) Anxiety
    D) Both B and C

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    19 . Somatic exercises help to
    A) increase our window of tolerance to handle more stressors or input.
    B) increase parasympathetic activation.
    C) create a sense of safety in the body.
    D) All of the above

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    20 . How can we help a client come to a state of safety?
    A) Tell them they need to calm down and take a deep breath
    B) Encourage or support organic signs of safety
    C) Try a somatic exercise with them to encourage parasympathetic activity
    D) Both B and C

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    21 . Which is NOT considered a type of pain perception in the neuromatrix theory of pain?
    A) Cognitive-evaluative perception
    B) Motivational-affective perception
    C) Action-regulation perception
    D) Sensory-discriminative perception

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    22 . What is TRUE about a client in a dorsal state?
    A) There will be hypoarousal.
    B) The client may have a flat tone with minimal expressions.
    C) A client may start to dissociate.
    D) All of the above

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    23 . Which statement about the vagus nerve is FALSE?
    A) The vagus nerve has anti-inflammatory properties that may provide pain-inhibitory effects.
    B) The vagus nerve is the 10th cranial nerve.
    C) The vagus nerve increases sympathetic arousal.
    D) The vagus nerve can be stimulated through noninvasive and invasive protocols.

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    24 . What statement about nociception and nociceptors is FALSE?
    A) There are five phases of nociception.
    B) Nociception is the detection of painful stimuli.
    C) Nociceptors are nerve endings that begin the process of experiencing pain.
    D) Silent nociceptors respond to tissue injury through a noxious stimulus.

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    25 . What can increase pain sensitivity?
    A) Worry
    B) Preoccupation
    C) Expectation
    D) All of the above

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