Exam (elaborations)
Week 1 Quiz - SCS (1).
Week 1 Quiz - SCS (1).
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Week 1 Quiz - SCSWhat is the FDA approval for SCS - ANS-The treatment of chronic intractable pain of the trunk
and/or limbs
The______ neurons transmit impulses FROM the Central Nervous System TO the muscles and
glands. - ANS-Motor (efferent)
The ______ neurons run from various types of stimulus receptors to the CNS and carry
information such as touch, odor, taste, or vision. - ANS-Sensory (afferent)
Define Nociceptive Pain - ANS-Acute pain resulting from tissue damage (cut, bruise, fracture,
burn) and the subsequent release of chemicals which act as noxious stimuli and that are
perceived as pain by the brain. Feeling goes away as affected body part heals. This feels like
aching, sharp or throbbing. (ex) arthritis
Define Neuropathic Pain - ANS-Also known as deafferention pain or neurogenic pain. This pain
is caused by disease of dysfunction originating in nerves or nervous system. Does not develop
from response to a circumstance or outside stimuli. Ex. burning, tingling, stinging, shooting pain
Patient complains of burning and stinging pain in the lower back that shoots down both
extremities. Which type of pain does this patient have and would they be a good candidate for
Neurostimulation? - ANS-Neuropathic pain; Yes they would be a good candidate.
Patient has intermittent, aching pain that is alleviated when the patient sits down and hunches
over. Is this a good candidate for Neurostimulation? Explain why or why not. - ANS-Nociceptive
pain; Not a good candidate because it's not 24/7 pain and goes away when sitting.
List 5 characteristics of chronic pain (persistent) - ANS-1. Pain w/o apparent physical basis
2. Serves no protective function
3. Pain that extends beyond the expected period of healing weeks/months/years
4. May spread and increase with intensity
5. May become stronger than the initial pain from the injury
6. Diagnosed after 3-6 months of pain
List 3 chronic pain conditions typically treated with Neurostimulation. - ANS-1. FBSS
2. CRPS 1 & 2
3. Peripheral Neuropathies
Patient has had chronic arthritis pain in the lower back for years, that does not radiate down the
legs. The pain is not alleviated by lying, sitting, standing, or sleeping. Is this a chronic pain
condition that SCS can treat? - ANS-No, arthritic pain is not treated with SCS, it is mechanical.
, Define Hyperalgesia - ANS-Increased sensitivity and lower threshold to pain stimuli
Define Allodynia - ANS-Pain that is produced by stimuli that do not normally cause pain, such as
touch, pressure, or warmth.
The doctor asks you to speak to a patient in an exam room about SCS therapy. You walk in and
notice the patient has only one shoe/sock on the right foot and is missing footwear on the left
foot. You can see the left foot is red, swollen, and painful for the patient to ambulate on. What
conclusions can you draw just from the assessment? - ANS-This patient has CRPS, allodynia,
and hyperalgesia of the left foot and would be a candidate for SCS neurostimulation.
List the 5 parts of the neuron and each of their functions. - ANS-1. Dendrites - receive signals
from other nerve cells
2. Soma (body) - houses the nucleus and it's where signal is generated or processed.
3. Axon Hillock - controls the firing of the neuron (action potential)
4. Axon - transmits the signal
5. Axon terminal - signal exits the neuron
What is an action potential? - ANS-An electrical current that travels down the axon of the
neuron. Occurs when a neuron is stimulated and a certain threshold is reached. Sodium ions
rush into the cell through channels to the cell interior and the cell becomes depolarized.
Stimulation can be natural or from neurostimulation.
You are mapping a patient with low back pain in tonic, and you are unable to get paresthesia in
the low back. After multiple changes in the polarity the patient says he only feels the tingling in
his legs. List reasons why this may be occurring? - ANS-1. Low back dorsal nerve fibers enter
laterally (T9) and may be hard to reach
2. Fewer low back fibers
3. Less myelinated than other types of nerve fibers
What two structures compromise the Central Nervous System - ANS-Brain and Spinal Cord
How can CSF produce challenges to Neuromodulators? - ANS-CSF is highly conductive and
tends to disperse all stimulation fields. 80-90% of current is wasted.
The dorsal CSF is the thickest in the mid to upper ______ region due to kyphotic curve. -
ANS-Thoracic (T5-T6)
What are the 3 layers of the meninges and describe the functions of each? - ANS-1. Pia Mater:
Innermost membrane, delicate, highly vascular & adheres to the spinal cord
2. Arachnoid Mater: Impermeable membrane b/w dura and pia. Contains CSF and has raised off
the pia mater by route. Looks like a spider web.
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