Biological Bases Flashcards
Neurotransmitter associated with Parkinson’s
How is it different in Parkinson’s?
Dopamine
Too low in basal ganglia
Diazepam/Valium medication class
Anxiolytic (Benzo)
Names of Tricyclics
Amitriptyline/Elavil
Imipramine (Tofranil)
Clomipramine (Anafranil)
nortriptyline (Pamelor and Aventyl)
desipramine (Norpramin)
Side effects of Tricyclics
Anticholinergic side effects
Cardiac/autonomic (e.g., orthostatic hypotension, drop in standing bp)
Neurobehavioral
Medications for Bipolar Disorder (Med class and names)
Lithium
Anticonvulsants - divalproex (Depakote), lamitrogine (Lamictal), carbamezepine (Tegretol), and topiramate (Topamax), valproate
Neurontin
Antipsychotics - Zyprexa, Abilify, Symbyax, risperidone
Anti-alcohol meds
Antabuse
Naltrexone
What is hemispatial neglect?
What part of the brain is affected?
One-sided neglect
Inability to attend to features in the environment contralateral to the damage
Usually damage to the right hemisphere
Ipsilateral
Same side
Anosognosia
Lack of awareness of symptoms/disorder
Agnosia
Unable to recognize a specific stimulus (object, shape, sound, smell)
Prosopagnosia
Difficulty recognizing faces
What are the effects of damage to parietal lobe?
Apraxia
Left-right confusion
Disturbance of body image
Parietal lobe functions
Pain
Pressure
Proprioception (to sense position, location, and movement of body)
Light touch
Heat
Somatosensory cortex
Frontal lobe functions
Personality
Abstract Thinking
Judgment
Inhibition
Planning/initative
EFs
Voluntary movement
What disorders are caused by low dopamine levels?
Parkinson’s
ADHD
What does Naltrexone treat?
Alcohol abuse
Lack of awareness of symptoms/disorder
Anosognosia
Unable to recognize a specific stimulus (object, shape, sound, smell)
Agnosia
Difficulty recognizing faces
Prosopagnosia
What lobe is implicated with apraxia, left-right confusion, disturbance of body image?
Parietal
Which lobe is associated with pain, pressure, proprioception?
Parietal
In which lobe is the somatosensory cortex?
Parietal
Which lobe is associated with personality?
Frontal
Which lobe is associated with the auditory cortex and the limbic system?
Temporal
Temporal lobe functions
Auditory cortex
Limbic system
Parts of the limbic system
Amygdala
Hippocampus
Symptoms of Parkinson’s
reduced voluntary movements
rigidity
tremor
bradykinesia
shuffing gait
neuropsychiatric symptoms
depression
dementia
akinesia
What is akinesia?
Difficulty initiating movement
What is bradykinesia?
Slowed initiation of movement
Symptoms of Huntington’s
Choreiform - jerking movements of pelvis, trunk, limbs
What is tardive dyskinesia?
Tongue thrusting
Face grimacing
Symptoms of Creutzfeldt-Jakob disease
Delirium - rapid changes in orientation and cognition
What causes Huntington’s?
autosomal-dominant gene
Normal sleep changes with aging
Decreased REM
Decreased slow-wave sleep
Decreased total sleep time
Need less sleep
Increased awakenings
What causes Korkasoff’s syndrome
chronic thiamin deficiency
longstanding alcohol abuse
Symptoms of Korkasoff’s syndrome
anterograde amnesia
retrograde amnesia
STM remains intact
Confabulations
Function of sympathetic nervous system
arousing body’s stress reaction
Function of parasympathetic nervous system
calms the body down after stress reaction
Function of somatic nervous system
Motor reactions
Function of autonomic nervous system
Automatic stress reactions
Includes SNS and PNS
Function of afferent neurons
Bring sensory info to brain
Function of efferent neurons
Send motor commands
Brain changes in schizophrenia
Loss of brain tissue
Enlarged lateral & third ventricles
Where is cerebrospinal fluid located?
Ventricles
Parts of the brain stem
Medulla
Pons
Midbrain
Functions of the medulla and pons
Homeostasis;
Most basic, automatic functions:
Respiration
Cardiovascular activity
Temperature regulation
Sleep
Consciousness
Function of the thyroid
Metabolism
Hormone associated with the thyroid
Thyroxin
Diseases associated with the adrenal cortex
Addison’s
Cushing’s
Functions of the basal ganglia
initiation and control of movement
neuropsychiatric symptoms/emotions
cognition
eye movement
What parts of the brain are implicated in Huntington’s?
Degeneration of Caudate Nucleus
Basal ganglia
Degeneration of acetylcholine in striatum
What parts of the brain are implicated in Parkinson’s
Cell loss in the substantia nigra
Basal ganglia
Language dominant hemisphere
Left hemisphere
Consequences of stress
Decreased immune function
Increased blood cholesterol
Neurotransmitters associated with cortisol
epinephrine
norepinephrine
Symptoms of postconcussion syndrome
Fatigue
Sleep problems
Headache
Dizziness
Irritability
Aggression
Anxiety
Depression
Labile Mood
Personality changes
Apathy
Symptoms of Frontal lobe syndromes
Perseveration
Disinhibition
Judgment problems
Functions of the hypothalamus
Homeostasis:
Temperature
Hunger
Thirst
Sex hormones
Circadian rhythm
Arousal
Which part of the brain is associated with circadian rhythm, release of sex hormones, and regulation of temperature?
Hypothalamus
Symptoms of Wernicke’s aphasia
Receptive language disorder
Comprehension disorder
Rambling and incoherent speech
What brain area is associated with Wernicke’s aphasia?
Damage to superior temporal gyrus
Symptoms of Broca’s aphasia
Slow, broken production of speech
What lobe is associated with Broca’s aphasia?
Damage to frontal lobe
Adoptive children’s IQ is more closely related to __________ than ____________
biological parent; adoptive parent
What brain structure is associated with circadian rhythm
Suprachiasmatic nucleus
Hypothalamus
Function of the pineal gland
Involved in sleep
Produces melatonin
Where is the reticular activating system located?
Brain stem
Functions of reticular activating system
filters incoming sensory info
mediates alertness
consciousness
pain
involved in circadian rhythm
regulating cardiovascular and respiratory systems
Where are the caudate nucleus and substantia nigra found?
Basal ganglia
Parts of central nervous system
Brain
Spinal cord
4 Parts of the spinal cord
Cervical
Thoracic
Lumbar
Sacral
Location of ventricles
two large lateral ventricles in each cerebral hemisphere
third ventricle - central
fourth ventricle - dorsal brain stem
Location of cortex
Outer, most visible layer of the brain
Cortex matter
Grey matter
Parts of the frontal lobe (answers listed from back to front)
primary motor cortex
premotor cortex
orbitofrontal cortex
prefrontal cortex
Functions of mirror neurons
Imitation
Empathy
What types of neurons are implicated in autism?
Mirror neurons
Disorders associated with dysfunction in PFC
ADHD
Schizophrenia
Where is Broca’s area?
Inferior lateral region of left frontal lobe
What is decussation?
Process by which incoming stimuli are transmitted to contralateral hemisphere for processing
The amygdala is involved in ________ sensory processing
Olfactory
Functions of the thalamus
Performs critical relay functions between the cortex and the brain stem
Attention
Perceptual processes
What part of the brain transmits signals between the brain stem and the cortical regions?
Thalamus
Parts of the basal ganglia
substantia nigra
caudate nucleus
putamen
globus pallidus
subthalamic nucleus
The _______ provides most of the inputs to the basal ganglia.
Cerebral cortex
The primary outputs of the basal ganglia are sent to _________.
Thalamus
Extrapyramidal syndromes involve
Coordination and rhythm of movement (bradykinesia, rigidity)
Functions of cerebellum
regulation of movement (automatic and rhythmic)
coordination of the limbs
posture
Disorder related to cerebellum
Multiple sclerosis
Parts of neuron
Soma
Dendrites
Axon
Function of myelin sheath
insulate axon, speed up transmission
Biogenic amines (neurotransmitters)
acetyycholine
serotonin
catecholamines (neurotransmitters)
Dopamine
Norepinephrine
Epinephrine
Amino acids (neurotransmitters)
GABA
Glutamate
Functions of Norepinephrine
Primarily excitation; inhibition in some areas
regulates mood
memory
alertness
ability to feel pleasure
as hormone, fight or flight
Disorders related to norepinephrine
Too high - anxiety
Too low - depression
Where are the majority of dopamine neurons found?
Substantia nigra
Overactivity of dopamine in frontal lobes is implicated in ______
Schizophrenia
Functions of dopamine
Emotions
Movement
Endocrine functioning
Attention
Sociability
Motivation
Desire
Pleasure
Reward-driven learning
Functions of serotonin
Primarily inhibitory
Regulation of mood
anger
aggression
Anxiety
Appetite
Learning
Sleep
Sexual functioning
level of consciousness
pain
Disorders associated with serotonin
OCD
Depression
Anxiety
Common locations of Acetylcholine
Parasympathetic nervous system
Autonomic nervous system
Primary neurotransmitter found at neuromuscular junctures (synapse between neuron and muscle cells)
Function of acetylcholine
movement
activating reticular activating system
regulates alertness
attention
learning
memory
Functions of GABA
major inhibitory neurotransmitter of CNS
emotion
balance
sleep patterns
Disorders associated with GABA
Too low: Anxiety, agitation, epilepsy
Functions of glutamate
primary excitatory neurotransmitter of CNS
basic building block of proteins
learning
memory
Problems associated with glutamate
Excitotoxicity (excessive levels cause cell death due to excessive stimulation and excitation)
Cell death following TBI and stroke
Agonist
Binds at receptor sites and mimics action of the neurotransmitter (boosting the system)
Inverse agonist
Binds at receptor sites, but has the opposite effect (reducing efficacy of neurotransmitter system)
Antagonist
Blocks or reverses the effects of agonists when agonists are present, but have no effect on their own
Pharmacodynamics
biochemical and physiological effects of drugs
Pharmacokinetics
how the body handles drug through absorption, metabolism, and elimination
Therapeutic index
The ratio of the amount of drug that causes the desired benefit to the amount of the drug that produces dangerous side effects (desirable to have high index)
Therapeutic window
range of a drug dose that can result in desired clinical efficacy without resulting in unsafe side effects
Benzodiazepines drugs
alprazolam ( Xanax)
clonazepam (Klonapin)
diazepam, (Valium)
lorazepam (Ativan)
Benzodiazepines treat
Anxiety
Seizures
Alcohol withdrawal
Effects of benzos
sedative
anxiolytic
anti-convulsant
Neurotransmitters effected by benzos
enhance release of GABA
block release of stress hormones
Side effects of benzos
drowsiness
confusion
feelings of detachment
dizziness
imbalance
dependence
increase effect of depressants (e.g., alcohol)
Barbiturates effects and side effects
previously used for sedation, now replaced by benzos
tolerance
physical dependence
severe withdrawal symptoms
enhance function of GABA
Used in the treatment of Parkinson’s
L-Dopa (increases dopamine)
Classes of antidepressants
MAOIs
Tricyclics
SSRIs
SNRIs
NDRIs
What else do antidepressants treat?
Anxiety
ADHD
Eating disorders
Neurotransmitters affected by tricyclics
Serotonin
Norepinephrine
(Reuptake blocked; more available)
Neurotransmitters affected by MAOIs
Serotonin
Norepinephrine
Dopamine
(Blocks respective monoamine transporters, increasing levels in synaptic cleft)
MAOI drugs
phenelzine (Nardil)
tranylcyromine (Parnate).
MAOI side effects
serious drug-drug interactions
serious drug-food interactions
Most serious when taken with tyramine - hypertensive crisis
SSRI drugs
fluoxetine (Prozac)
paroxetine (Paxil)
fluvoxamine (Luvox)
sertraline (Zoloft)
citalopram (Celexa)
escitalopram (Lexapro)
SSRI side effects
gastrointestinal side effects
headache
sexual dysfunction
insomnia
psychomotor agitation
occasional extrapyramidal reactions.
What class of medication is bupropion/Wellbutrin?
NDRI
What class of medication is venlafxine/Effexor
SNRI
What OTCs can help in treatment of depression?
St. John’s wort
S-adenosyl methionine (SAMe)
5-HTP
Omega-3 fatty acids
folic acid
Neurotransmitters affected by first-gen antipsychotics
Dopamine
Neurotransmitters affected by second gen antipsychotics
Dopamine
Serotonin
First gen antipsychotic medications
haloperidol (Haldol)
thioridazine (Mellaril)
molinidine (Moban)
thiothixene (Navane)
fluphenazine (Prolixin)
trifluoperazine (Stelazine)
chlorpromazine (Thorazine)
Side effects of first gen antipsychotics
extrapyramidal symptoms:
parkinsonism - bradykinesia, tremor, rigidity
acute dystonia - muscle spasms of tongue, face, neck, back
akathisia - restless movements, anxiety, agitation
tardive dyskinesia - results from prolonged use, may be irreversible - involuntary stereotyped movements of face, tongue, trunk, and extremities
neuroleptic malignant syndrome - life-threatening reaction - catatonia, stupor, fever, autonomic instability
Orthostatic hypotension
sexual dysfunction
Sedation
anticholinergic effects
Define anticholinergic effects
dry mouth
constipation
difficulty with urination
Atypical antipsychotics are _____ generation
second
second generation antipsychotic medications
olanzapine (Zyprexa)
quetiapine (Seroquel)
ziprasidone (Geodon)
aripiprazole (Abilify)
paliperidone (Invega)
iloperidone (Fanapt)
asenapine (Saphris)
clozapine (Clozaril)
risperidone (Risperdal)
Clozapine is one of the _____ effective atypical antipsychotic and the most _____ in terms of side effects.
more effective; most dangerous
Define Fatal agranulocytosis
What medication is most likely to cause it?
dangerously low white blood cell count causing decreased ability to fight infection
clozapine
Common disorders treated with risperidone
first line for new onset schizophrenia
agitation and aggression in dementia and bipolar
approved for minimizing self-harm in autism and disruptive behavior disorders of childhood/adolescence
Common side effects of 2nd generation antipsychotics
milder extrapyramidal symptoms than first gen
dangerous metabolic effects:
weight gain
diabetes
dislipidemia
Which neurotransmitters are affected by litihium?
norepinephrine
serotonin
common side effects of lithium
nausea
diarrhea
vomiting
thirst
excessive urination
weight gain
hand tremor
reversible increase in white blood cell count frequently occurs
lithium has a ______onset of action and a ______ therapeutic index
Slow; narrow
Chronic use effects of lithium
hypothyroidism
goiter
rarely, kidney damage
symptoms of Lithium toxicity
lethargy
ataxia
slurred speech
shock
delirium
coma
death
Atypical antipsychotics used in treatment of bipolar disorder
Zyprexa
Abilify
Symbyax (for bipolar depression)
What neurotransmitter is affected by anticonvulsants?
GABA (enhanced)
Side effects of Lamictal
Stevens-Johnson syndrome (potentially fatal skin rash)
Natural opiates
opium, morphine, and codeine
Semisynthetic opiates
morphine, heroin, Percodan (oxycodone hydrochloride and aspirin) and Dilaudid (hydromorphone hydrochloride)
Opiate withdrawal symptoms
diarrhea
vomiting
chills
fever
tearing and runny nose
tremor
abdominal cramps
pain
Neurotransmitters affected by psychostimulants
norepinephrine
dopamine
Two types of neuroimaging techniques
structural
functional
Structural imaging techniques
CT
MRI
Neuroangiography
Wada
Computerized Tomography (CT)
x-ray of brain from different angles to obtain detailed images of soft tissues, bone, liquid, and air
On CT scans hyperdense tissue appears _____ and hypodense tissue appears _____
white; black
_____ scan is often used in the ED to detect acute hemorrhage or skull fracture following trauma
CT
CT scans are helpful for
detecting acute hemorrhage or skull fracture, neoplasms (tumors), mass effect (displaced tissue around growing mass), ventricular enlargement
Magnetic Resonance Imaging (MRI) can detect
small lesions (e.g., plaques of multiple sclerosis)
subtle tumor
chronic hemorrhage
MRI images are
high-contrast, high-resolution images with good anatomical detail
in comparing MRI to CT, ____ costs more and takes longer
MRI
Neuroangiography is used for evaluating
vascular disease
Wada is a type of ____ test
neuroangiography
Wada is used to
localize language function, particularly for epilepsy patients undergoing brain resection
Functional imaging tests
Electroencephalography (EEG)
Positron emission tomography (PET)
Functional magnetic resonance imaging (fMRI)
PET scans used for
mapping the distribution of neurotransmitters and identifying brain dysfunction due to stroke, epilepsy, tumor, dementia, and other brain-impairing conditions.
EEG used for
detecting widespread abnormality in brain function in a variety of contexts (e.g., sleep, anesthesia, coma, traumatic brain injury, and epilepsy)
the neurological basis for OCD and tourettes is found in
the basal ganglia
What is a tonic-clonic seizure
seizure involving a tonic stage (continuous tension or contraction) then clonic stage (rapid involuntary alternate muscle contractions and relaxation)
What type of seizures involve tonic clonic seizures
Grand mal
What are petit mal seizures?
absence seizure, occur most frequently in chilldren, last 1 to 10 seconds, begin with brief changes in consciousness, then blinking or rolling eyes, blank stare, or mouth movements
Partial seizures (e.g., Jacksonian seizure)
initially localized motor seizure that then expands to adjacent brain areas
Complex partial seizures
frequently preceded by an aura, usually include purposeless behavior (aimless wandering), lip smacking, and unintelligble speech
Wernicke’s encephalopathy
results from: long term alcohol use, thiamine deficiency; symptoms include eye problems, gait and balance problems, and drowsiness and confusion; most cases proceed into Karkasoff’s syndrome
Side effects of beta blockers
sexual dysfunction, dizziness, drowsiness, shortness of breath, angina, cold hands and feet, difficulty sleeping, nightmares
Propranolol med class
beta blocker
What is L-Dopa/Levodopa?
amino acid used to treatment movement components of Parkinson’s by increasing dopamine; possible side effect is psychosis
What class of medications associated with most dangerous withdrawal effects?
Benzos
What substances are associated with most dangerous withdrawal symptoms
Alcohol
Neuron firing all or nothing principle
Neurons either fire all the way or not at all, magnitude of firing is not dependent on the strength of the stimulus, provided the threshold is met
Functions associated with acetylcholine
voluntary movement, learning, memory
Functions of serotonin
mood, sleep, appetite, sex, aggression
Function of norepinephrine
mood
Function of GABA
anxiety, seizures
Neurotransmitters involved in voluntary movement
acetylcholine, dopamine
_______ refers to a disease of unknown origin
idiopathic
_________ refers to illness or complications caused in the course of receiving medical treatment
Iatrogenic
_______ is something that should be ineffective but which causes symptoms of ill health (i.e., an ill effect caused by the suggestion or belief that something is harmful)
nocebo
Cortex is related to _____ level functions and subcortex is where we process _____ functions
higher
more primitive
_______ relays information between the cortex and subcortex
thalamus
According to the __________ theory of emotion, all emotions are essentially the same in terms of physiological arousal and people experience a particular emotion only after they experience physiological arousal and then assign a cognitive label to that arousal.
Schachter-Singer (1962)
Damage to which of the following areas of the brain is responsible for the memory impairment associated with Wernicke-Korsakoff syndrome?
thalamus and mammillary bodies
_____ waves begin in stage 1 sleep and continue in stage 2, when they are interrupted by _____ and _____.
Theta
sleep spindles
K complexes
The etiology of neurocognitive disorder due to Alzheimer’s disease has been linked to a low level of _____ and a high level of _____. (neurotransmitters)
acetylcholine
glutamate
Negative emotions are processed primarily in the _____ hemisphere, and damage to this hemisphere can produce _____.
right
inappropriate indifference or euphoria
Positive emotions are processed primarily in the _____ hemisphere, and damage to this hemisphere can produce _____.
left
depression or emotional volatility
_____ emotions are primarily processed in the left hemisphere, and ____ emotions are primarily processed in the right hemisphere
Positive
negative
Changes in synapses associated with the formation of long-term memories depend on the synthesis of ___.
RNA
Hindbrain structures
Medulla
Pons
Cerebellum
Medulla functions
involuntary mouth and throat movements (swallowing, coughing, sneezing)
regulates essential functions like respiration, heart rate, bp
Pons functions
connects two halves of cerebellum
coordinate movements on two sides of body
relays messages between cerebellum and cerebral cortex
respiration
deep sleep, REM sleep
Cerebellum functions
Voluntary movements
posture and balance
processing and storing implicit and procedural memories
attention
linguistic processing
visuospatial abilities
Midbrain structures
Reticular formation
Substantia nigra
Reticular formation functions
regulation of muscle tone
coordination of eye movements
control of pain
reticular activating system- mediates consciousness and arousal, sleep/wake cycle, alerts cerebral cortex to incoming sensory signals
Substantia nigra functions
reward-seeking
drug addiction
motor control (with basal ganglia)
Subcortical forebrain structures
Hypothalamus
Thalamus
Basal ganglia
limbic system
Cones vs rods
Cones work best in bright light, more responsible for visual acuity and color
Rods are important for peripheral vision, vision in dim light
