660 exam 3

Question 1

Which neurotransmitters is the sleep wake cycle regulated by?

Answer 1

DASH - N

Dopamine
Acetylcholine
Serotonin
Histamine

Norepinephrine

Question 2

What regulates wakefullness

Answer 2

Orexin

keeps you awake

Question 3

Loss of orexin regulation can cause what?

Answer 3

narcolepsy

Question 4

Where is the sleep switch of the brain?

Answer 4

Ventrolateral preoptic nucleus

Active while sleeping –secretes GABA

Question 5

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

Answer 5

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

Question 6

What is the “On” switch of the brain?

Answer 6

Activation of the TMN

• causes release of histamine, norepinephrine, and orexin

Question 7

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

Answer 7

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

Question 8

How does cortical arousal work?

Answer 8

Like a knob on the radio vs a switch

Can have hypo or hyper arousal

A1, H1, and M1

Question 9

Insomnia neurotransmitters

Answer 9

Overactivity of:
- Histamine
- ACH
- Norepinephrine

Question 10

Types of insomnia

Answer 10

Initial: hard to fall asleep

Middle Insomnia: Sleep is choppy

Terminal: wakes too early

Question 11

What kind of neurotransmitter medication do you use for insomnia

Answer 11

H1 antagonist
M1 antagonist
A1 antagonist

Question 12

How does histamine promote wakefullness?

Answer 12

activates G protein

Question 13

Which medications for Sleepiness during the day

Answer 13

Stimulants, Caffeine, Modafinil

Question 14

Which two brain regions are associated with anxiety?

Answer 14

Amygdala and Hippocampus

Question 15

Main job of the amygdala

Answer 15

emotional regulator of the fear response

Question 16

Main job of the hippocampus

Answer 16

storing memory & re-experiencing

Question 17

Two parts of anxiety

Answer 17

Fear: amygdala
– physical/physiological symptoms

Worry: CSTC loop
– psychological symptoms

Question 18

Amygdala physical symptoms of anxiety

Answer 18

irritability, restlessness, muscle tension, insomnia

Question 19

Neurotransmitters involved with anxiety in the amygdala

Answer 19

Serotonin, GABA, Voltage gated ion channels

Norepinephrine - anxiety/panic symptoms

increases glutamate transmission

A1 and B1 release - autonomic activity

Question 20

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

Answer 20

CSTC circuit

• Anxious misery
• Apprehension
• Obsession

Question 21

What medications for worry caused by overactivation of the CSTC loop

Answer 21

GABA agents (benzos)
— enhances GABA in PFC

Alpha2 ligand binding agent
— Blocks excessive release of glutamate

Serotonin agents
— increase serotonin in CSTC loop

Question 22

Hippocampus r/t fear

Answer 22

internal fear monger

remembers something – triggers fear when it’s encountered again

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

Question 23

Anterior Pituitary r/t anxiety

Answer 23

feelings of anxiety and depression

• increase cortisol lvls
• increase risk for cardiometabolic disease

Question 24

Parabrachial nucleus (PBN) r/t anxiety

Answer 24

Regulates heart rate and breathing

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

Question 25

Periaqueductal gray (PAG) r/t anxiety

Answer 25

regulates: HR, bld pressure, autonomic process

produces fearful & defensive reactions
- flight/fight
- freezing
- defense/avoidance

Question 26

Prefrontal Cortex r/t worry

Answer 26

Thinking, decision making

Associated with worry –> CSTC worry loop

Excessive dopamine leads to increased worry

Question 27

Generalized anxiety disorder is …

Answer 27

generalized fear and worry

Question 28

Panic disorder is …

Answer 28

anxiety + worry about panic attack

Question 29

OCD is …

Answer 29

Excessive obsessions and compulsions to thoughts or behaviors

Individual is personally bothered by their behavior

Question 30

PTSD is …

Answer 30

Traumatic event - re-experiencing memories

Question 31

Treat PTSD

Answer 31

Paroxetine - first line

caution with benzos

Question 32

Ascending pain pathway

Answer 32

periphery to dorsal horn to brain

Question 33

Descending pain pathway

Answer 33

regulates ascending pain information

– dampens pain signals coming from the periphery

– decreased output from descending pain pathways can increase pain response

Question 34

Pain r/t PFC

Answer 34

contributes to cognitive dysfunction

Question 35

Most common pain receptor

Answer 35

Mu

Question 36

+ Naloxone

Answer 36

blocks the inflammatory response of pain

Blocks TLR4 receptors - may help reverse chronic pain

Question 37

TCA and SNRI for chronic pain

Answer 37

enhances descending pain pathways

increases dampening of pain signals from the periphery

Question 38

What causes peripheral neuropathy

Answer 38

Inflammation or dmg to an injured nerve
– can be central or peripheral

Question 39

What are the causes of neuropathic pain

Answer 39

trauma - phantom limb

DM

Autoimmune

Question 40

Neuropathic pain - pathways

Answer 40

Involves ascending/afferent pathway

Question 41

Hyperalgesia is what

Answer 41

increased sensitivity to painful stimulus

– touch/pressure
– pinprick
– heat/cold

Question 42

Allodynia is what

Answer 42

Pain caused by nonpainful stimuli

– light touch

Question 43

What is suprasegmental central sensitization

Answer 43

enhances the process and keeps it going

makes it permanent

Ex: Fibromyalgia