660 exam 3 Flashcards

1
Q

Which neurotransmitters is the sleep wake cycle regulated by?

A

DASH - N

Dopamine
Acetylcholine
Serotonin
Histamine

Norepinephrine

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2
Q

What regulates wakefullness

A

Orexin

keeps you awake

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3
Q

Loss of orexin regulation can cause what?

A

narcolepsy

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4
Q

Where is the sleep switch of the brain?

A

Ventrolateral preoptic nucleus

Active while sleeping –secretes GABA

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5
Q

What is the control center for the sleep/wake cycle?

A

The hypothalamus
– it houses the TMN (tuberomamillary nucleus) and the VLPO (ventrolateral preoptic nucleus

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6
Q

What is the “On” switch of the brain?

A

Activation of the TMN

  • causes release of histamine, norepinephrine, and orexin
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7
Q

What is the body’s internal clock and what is it activated by?

A

Suprachiasmatic Nucleus (SCN)
Melatonin - darkness
Light - sunlight/daytime

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8
Q

How does cortical arousal work?

A

Like a knob on the radio vs a switch

Can have hypo or hyper arousal

A1, H1, and M1

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9
Q

Insomnia neurotransmitters

A

Overactivity of:
- Histamine
- ACH
- Norepinephrine

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10
Q

Types of insomnia

A

Initial: hard to fall asleep

Middle Insomnia: Sleep is choppy

Terminal: wakes too early

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11
Q

What kind of neurotransmitter medication do you use for insomnia

A

H1 antagonist
M1 antagonist
A1 antagonist

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12
Q

How does histamine promote wakefullness?

A

activates G protein

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13
Q

Which medications for Sleepiness during the day

A

Stimulants, Caffeine, Modafinil

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14
Q

Which two brain regions are associated with anxiety?

A

Amygdala and Hippocampus

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15
Q

Main job of the amygdala

A

emotional regulator of the fear response

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16
Q

Main job of the hippocampus

A

storing memory & re-experiencing

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17
Q

Two parts of anxiety

A

Fear: amygdala
– physical/physiological symptoms

Worry: CSTC loop
– psychological symptoms

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18
Q

Amygdala physical symptoms of anxiety

A

irritability, restlessness, muscle tension, insomnia

19
Q

Neurotransmitters involved with anxiety in the amygdala

A

Serotonin, GABA, Voltage gated ion channels

Norepinephrine - anxiety/panic symptoms

increases glutamate transmission

A1 and B1 release - autonomic activity

20
Q

What is the worry loop of anxiety? And what s/s

A

CSTC circuit

  • Anxious misery
  • Apprehension
  • Obsession
21
Q

What medications for worry caused by overactivation of the CSTC loop

A

GABA agents (benzos)
— enhances GABA in PFC

Alpha2 ligand binding agent
— Blocks excessive release of glutamate

Serotonin agents
— increase serotonin in CSTC loop

22
Q

Hippocampus r/t fear

A

internal fear monger

remembers something – triggers fear when it’s encountered again

Traumatic memories stored – activate the amygdala - re-experience
—Hallmark feature of PTSD

23
Q

Anterior Pituitary r/t anxiety

A

feelings of anxiety and depression

  • increase cortisol lvls
  • increase risk for cardiometabolic disease
24
Q

Parabrachial nucleus (PBN) r/t anxiety

A

Regulates heart rate and breathing

Activation of PBN causes a person to have difficulty breathing and increased HR
- sense of being smothered

25
Periaqueductal gray (PAG) r/t anxiety
regulates: HR, bld pressure, autonomic process produces fearful & defensive reactions - flight/fight - freezing - defense/avoidance
26
Prefrontal Cortex r/t worry
Thinking, decision making Associated with worry --> CSTC worry loop Excessive dopamine leads to increased worry
27
Generalized anxiety disorder is ...
generalized fear and worry
28
Panic disorder is ...
anxiety + worry about panic attack
29
OCD is ...
Excessive obsessions and compulsions to thoughts or behaviors Individual is personally bothered by their behavior
30
PTSD is ...
Traumatic event - re-experiencing memories
31
Treat PTSD
Paroxetine - first line caution with benzos
32
Ascending pain pathway
periphery to dorsal horn to brain
33
Descending pain pathway
regulates ascending pain information -- dampens pain signals coming from the periphery -- decreased output from descending pain pathways can increase pain response
34
Pain r/t PFC
contributes to cognitive dysfunction
35
Most common pain receptor
Mu
36
+ Naloxone
blocks the inflammatory response of pain Blocks TLR4 receptors - may help reverse chronic pain
37
TCA and SNRI for chronic pain
enhances descending pain pathways increases dampening of pain signals from the periphery
38
What causes peripheral neuropathy
Inflammation or dmg to an injured nerve -- can be central or peripheral
39
What are the causes of neuropathic pain
trauma - phantom limb DM Autoimmune
40
Neuropathic pain - pathways
Involves ascending/afferent pathway
41
Hyperalgesia is what
increased sensitivity to painful stimulus -- touch/pressure -- pinprick -- heat/cold
42
Allodynia is what
Pain caused by nonpainful stimuli -- light touch
43
What is suprasegmental central sensitization
enhances the process and keeps it going makes it permanent Ex: Fibromyalgia