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Patho 1 > 4 - Brain > Flashcards

4 - Brain Flashcards

1
Q

The central driving component of the excitatory system is the _______

A

reticular substance of the pons and mesencephalon

a.k.a. the bulboreticular facilitory area

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2
Q

Signals from the reticular excitatory area pass to _______

A

the thalamus, and the thalamus sends signals on to the cerebral cortex

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3
Q

Are the following hormones excitatory or inhibitory?

Norepinephrine

Dopamine

Serotonin

A

Excitatory

Both

Inhibitory

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4
Q

Where are the neurohormones primarily located:

Norepinephrine

Serotonin

Dopamine

A

virtually every area of the brain

midline structures

basal ganglion regions

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5
Q

Identify which neurohormone is associated with the following structures:

Locus ceruleus

Substantia Nigra

Raphe Nuclei

Reticular Excitatory Area Giant Cells

A

Norepinephrine

Dopamine

Serotonin

Acetylcholine

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6
Q

What is the limbic system?

A

the entire neuronal circuitry that controls emotional behavior and motivational drives

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7
Q
A
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8
Q

What is the most obvious area that causes natural sleep?

A

Raphe Nuclei

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9
Q

What are two endogenous substances that induce sleep?

A

muramyl peptide

delta sleep-inducing peptide

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10
Q

what causes narcolepsy?

A

defects in orexin signalling

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11
Q

Which brain waves are associated with very deep sleep?

A

Delta

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12
Q

Generalized tonic-clonic (grand mal) seizures are characterized by:

A

sudden loss of consciousness in all areas of the brain

Seizure activity transmitted down the brain results in tonic and spasmodic (clonic) muscle activity

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13
Q

How long does a generalized seizure usually last?

A

3-4 minutes

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14
Q

What is the usual cause of generalized seizure?

A

Usually unknown

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15
Q

What are 5 epileptogenic factors?

A

Strong emotional stimuli

alkalosis from overbreathing

drugs

fever

loud noises/flashing lights

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16
Q

What are petit mal seizures?

A

Absence seizures

Most common in children

Usually disappear by age 30

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17
Q

Describe the function of the adrenal medulla

A

preganglionic sympathetic nerve fibers pass without synapsing from the spinal cord, through the sympathetic chains, and then through the splanchnic nerves all the way to the adrenal medulla

The adrenal medulla contains secretory cells that are actually embryologically nervous tissue, which is why they secrete epinephrine and norepinephrine as a hormone into the blood supply

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18
Q

What percentage of parasympathetic nerve fibers are within the vagus?

A

75%

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19
Q

In parasympathetic fibers, where are pre and post ganglionic fibers found?

A

The preganglionic fibers pass all the way to the organs they end on,

the postganglionic neurons are located in the walls of the organs they end on

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20
Q

Which fibers are cholinergic?

Which are adrenergic?

A

acetylcholine

adrenergic (short for adrenaline)

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21
Q

All preganglionic neurons are _______

A

cholinergic

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22
Q

Most of the postganglionic sympathetic neurons are _______

Most of the postganglionic parasympathetic neurons are ____

A

adrenergic

cholinergic

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23
Q

Acetylcholine is caused a _____ transmitter

Norepineprhine is called a _____ transmitter

A

parasympathetic

sympathetic

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24
Q

Where does acetylcholine synthesis occur?

A

terminal endings and varicosities

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25
Q

Where does norepinephrine synthesis occur?

A

begins in terminal nerve endings, completed inside the secretory vessicles

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26
Q

_______ is converted into norepinephrine in secretory vessicles

A

dopamine

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27
Q

In the adrenal medulla, norepinephrine is converted _______

A

about 80% is converted into epinephrine

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28
Q

When secreted into the blood, norepinephrine and epinephrine remain active for ________

A

10-30 seconds,

decline to extinction over a couple/several minutes via the liver

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29
Q

Acetylcholine activates two types of receptors:

A

muscarinic

nicotinic

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30
Q

Describe muscarinic receptors

A

use G proteins as their signaling mechanisms

found on all effector cells that are stimulated by postganglionic cholinergic neurons

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31
Q

Describe nicotinic receptors

A

ligand-gated ion channels

Found at the synapses between preganglionic and postganglionic neurons

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32
Q

Which lasts longer: direct sympathetic stimulation or hormonal sympathetic stimulation?

A

hormonal is 5-10x more long lasting

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33
Q

Complete cessation of blood flow to the brain causes unconsciousness after how long?

A

5 - 10 seconds

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34
Q

Which four arteries form the circle of willis?

A

Carotids (2)

Vertebrals (2)

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35
Q

What is the Virchow-Robin Space?

A

an extension of the subarachnoid space that penetrating vessels travel through

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36
Q

What is the average normal blood flow through the brain?

A

750-900ml/min

2% of bodyweight receives 15% of CO!

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37
Q

What effect on cerebral blood flow occurs when CO2/H levels are ELEVATED?

A

increased blood flow

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38
Q

How does CO2 cause vasodilation?

A

Converted to carbonic acid then bicarb and H

H causes direct vasodilation of the cerbreal vessels

39
Q

Do other substances that increase the acidity of the brain have the same effect of CO2 increases?

A

Yes

Your brain will respond to H+ concentration, regardless of origin

A lactic acidosis will still cause increased respiration/cerebral blood flow

40
Q

What is the role of astrocytes in cerebral blood flow?

A

couples neuronal activity with cerebral blood flow

41
Q

Cerebral autoregulation is effective between _________ mmHg of arterial MAP

A

60-150

42
Q

What causes seizures in pre-eclampsia?

A

cerebral blood flow autoregulation is impaited

leads to pressure-dependent increases in cerebral blood flow

Disrupts/damages vascular endothelium

causes brain edema and even seizures

43
Q

Which uses more blood: gray or white matter?

A

Gray matter

about 4x as many capillaries are in gray matter

44
Q

Brain capillaries are way less ______ than systemic capillaries

A

leaky

supported on all sides by glial feet, which provide structural support and prevent stretching/trauma

45
Q

What is the average amount of CSF?

A

150ml

46
Q

What “valve” controls flow of CSF and therefore CSF pressure?

A

The Arachnoid Villi

47
Q
A
48
Q

What is the neuromatrix theory?

A

Gate control ++

patterns of nerve impulses drawn from a multitude of factors

Stimuli may trigger the patterns but do no produce them

49
Q

What is the role of serotonin and norepinephrine in pain modulation?

A

Contribute to pain inhibition in the medulla, but excite peripheral nerves

50
Q
A
51
Q

what part of the brain is responsible for temperature management?

A

hypothalamus

52
Q

What happens in the brain when heat is needed?

A

TSH-RH released from hypothalamus

stimulates anterior pituitary to release TSH

acts on thyroid to stimulate release of thyroxine

thyroxine acts on adrenal medulla

adrenal medulla releases epinephrine

53
Q

How is heat distributed?

A

the circulatory system

54
Q

Term infants produce heat primarily through:

A

metabolism of brown fat

55
Q

What causes a fever

A

temporary resetting of the hypothalamic thermostat in response to pyrogenic cytokines and exogenous pyrogens

56
Q

Where do exogenous pyrogens and pyrogenic cytokines come from?

A

exogenous pyrogens are released by rupture of the microbe’s cell wall

pyrogenic cytokines are released by phagocytic cells as they destroy microbes within the host

57
Q

What is the final common step for fever generation?

A

Production of PGE2

acts on warm centers in the hypothalamus to reset the temp goal

58
Q

Why do people feel hot when a fever breaks?

A

The set point in the hypothalamus is returned to normal

the hypothalamus starts executing measures to reduce heat, including peripheral vasodilation, sweating, flushed skin

the person suddenly feels hot, throws off the covers and stretches out

59
Q

Higher body temperatures decreases serum levels of _______,

which are needed for bacterial replication

A

iron, zinc, copper

60
Q

RLS is more common in ______

A

women

individuals with iron deficiency

61
Q

_______ is a cofactor in dopamine production

A

iron

62
Q

What kind of virus causes pink eye?

A

viral conjunctivitis

63
Q

Which three cranial nerves are involved in ocular movement?

A

oculomotor

trochlear

abducens

64
Q

What is strabismus?

A

deviation of one eye from the other when a person is looking at an object

weak or hypertonic muscle in one of the eyes

65
Q

What is myopia?

A

nearsighted, difficulty seeing objects that are far away

axis of the eyball is too long

66
Q

what is hyperopia?

A

farsightedness, difficult seeing things that are near

axis of the eyeball is too short

67
Q

What kind of lens corrects myopia

Hyperopia?

A

concave

convex

68
Q

What is presbyscusis?

A

Loss of hearing in old age

69
Q

Which cranial nerves are involved in olfaction?

A

Olfactory

Trigeminal

70
Q

pupils are helpful in evaluating which part of the CNS?

A

brainstem

71
Q

A large dose of _______ will fully dilate and fix pupils

A

anticholinergics

atropine and scopolamine

72
Q

Overdosing on opioids will exhibit what pupillary changes?

A

Pinpoint pupils

73
Q

What does vomiting without nausea indicate?

A

direct involvement of the central neural mechanism

74
Q

Vomiting often accompanies CNS injuries that:

A
  1. involve the vestibular nuclei, esp with diplopia
  2. impinge directly on the fourth ventricle
  3. produce brainstem compression 2/2 increased ICP
75
Q

What is the difference between brain death and cerebral death?

A

Irreversible cessation of function of the ENTIRE brain (including brainstem).

Cerebral death is the death of the cerebral hemispheres but not the brainstem and cerebellum

76
Q

Damage/dysfunction in what area causes aphasia?

A

Left cerebral hemisphere (Broca’s and Wernicke’s Area)

77
Q

Aphasia is usually associated with CVAs that involve with artery?

A

Middle cerebral artery (or one of its branches)

78
Q

What is agnosia?

A

defect of pattern recognition

can’t tell what a safety pin is by feeling it, but can by seeing it or vice versa

Lots of varieties

79
Q

What is the difference between expressive aphasia and dysarthria?

A

Expressive aphasia involves cognitive inability to form words

dysarthria is more to do with the physical inability to form words 2/2 nerve dysfunction. It’s not cognitive

80
Q

What causes Alzheimer’s?

A

Acculumation of neuritic plaques containing a core of abnormally folded amyloid beta and tau proteins

intraneuronal tangles

degeneration of basal forebrain cholinergic neurons leads to loss of acetylcholine

81
Q

What diseases cause seizures?

A

Anything that alters the neuronal environment

82
Q

What is the tonic phase of a seizure?

A

muscle contraction with increased muscle tone

excitation of the subcortical, thalamic, and brainstem areas

83
Q

What is the clonic phase of a seizure?

A

alternating contraction and relaxation of muscles

begins when inhibitory neurons in the cortex react to the cortical excitation

84
Q

What qualifies as status epilepticus? (3)

A
  1. continuous tonic clonic seizures lasting more than 5 minutes
  2. rapidly recurring seizures before the person has fully regained consciousness
  3. a single seizure lasting more than 30 minutes
85
Q

What is an optimal cerebral perfusion pressure?

A

70-90

86
Q

What is the ideal MAP for a patient with altered cerebral flow?

A

90

87
Q

What are the three types of cerebral edema?

A

vasogenic (most common, increased permeability)

cytotoxic (usually ischemia/hypoxia)

interstitial (noncommunicating hydrocephalus)

88
Q

What is the difference between communicating and non-communicating hydrocephalus?

A

noncommunicating (obstructive): obstruction within the ventricular system

communicating (nonobstructive): impaired reabsorption of CSF

89
Q

What is the most common cause of communicating hydrocephalus?

A

Subarachnoid hemorrhage

90
Q

What are the hallmark pathologic features of Parkinson’s?

A

loss of dopaminergic pigmented neurons in the substantia nigra

degeneration of the basal ganglia with formation of Lewy bodies

91
Q

What do “amyotrophic” and “lateral” refer to in ALS?

A

amyotrophic: refers to the progressive muscle wasting (lower motor neuron component)

Lateral: refers to the scarring of the corticospinal tract in the lateral column (the upper motor neuron component)

92
Q

What are the two pyramidal tracts?

A

Corticospinal

Corticobulbar

93
Q

Which two types of motor dysfunction comprise the extrapyramidal motor syndromes?

A

basal ganglia motor syndromes

cerebellar motor syndromes

Patho 1 (17 decks)

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