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Neuro II > brain arousal > Flashcards

brain arousal Flashcards

1
Q

what are the two characteristics of persistent vegetative state

A

sleep/wake cycles

no evidence of awareness

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2
Q

what are the characteristics of a minimally conscious state

A

sleep/wake cycles
ability to respond to simple commands
limited/absent communication

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3
Q

what kind of injury most commonly causes disruption of conciousness

A

small lesions to the brainstem, midbrain or hypothalamus

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4
Q

will a patient in a coma or persistent vegetative state has eye/head motions?

A

YES, reflexes

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5
Q

what system releases excitatory amino acids?

A

reticular activating system

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6
Q

how does the dorsal pathway of the reticular activating system excite the cortex

A

via nuclei of the thalamus (INTRALAMINAR NUCLEUS OF THE THALAMUS) => diffuse pathway to higher levels

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7
Q

how does the ventral pathway of the reticular activating system excite the cortex

A

via basal forebrain and hypothalamus

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8
Q

what do the parabrachial nuclei do and why

A

release EAAs for arousal

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9
Q

do the parabrachial nuclei excite the cortex via the dorsal or ventral pathway?

A

ventral pathway only

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10
Q

do the peduncopontine tegmental and laterodorsal (PPT/LDT) nuclei excite the cortex via the dorsal or ventral pathway?

A

BOTH

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11
Q

what is the major NT of the PPT/LDT nuclei

A

ACh

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12
Q

does damage to the PPT/LDT nuclei cause coma

A

no, it causes severe cognitive deficits and slowing of cortical processes

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13
Q

how would a patient with RAS, PPT/LDT and parabrachial nuclei functioning be characterized

A

persistent vegetative state (awake, but not alert or aware)

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14
Q

what are the two inputs to the locus coereulus?

A

paragigantocellularis n

periaqueductal grey

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15
Q

what do the ascending fibers from the locus coereulus become?

A

the dorsal noradrenergic bundle

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16
Q

does the locus coereulus excite the cortex via the dorsal or ventral pathway?

A

BOTH

17
Q

what is the main function of the locus coereulus system

A

startling and alerting- pt aware of specific event

18
Q

what is the source of serotonergic input to the cortex?

A

raphe nuclei

19
Q

what is the source of noradrenergic input to the cortex?

A

locus coereulus

20
Q

what is the source of cholinergic input to the cortex?

A

PPT/LDT nuclei

21
Q

what is the function of serotonergic activation of the cortex?

A

quiet awareness

22
Q

what structure facilitates quiet awareness?

A

raphe nuclei

23
Q

does the raphe nuclei excite the cortex via the dorsal or ventral pathway?

A

BOTH

24
Q

if the noradrenergic and serotonergic pathways are functioning in a patient, how are they characterized?

A

awake and aware, NOT alert

25
Q

what kind of input facilitates alertness

A

dopaminergic

26
Q

what structure provides dopaminergic input to the cortex

A

ventral tegmental area (VTA)

27
Q

what input to the cortex facilitates cognitive function, motor activity and emotion

A

dopaminergic

28
Q

what is the route of axons on the dorsal pathway to the cortex

A

arousal center => thalamus (synapse) => cortex

29
Q

what is the route of axons on the ventral pathway to the cortex

A

arousal center => cortex => synapse on cortical neurons

30
Q

what creates the oscillations on EEG

A

intracortical neurons which interact with thalamic projections and release GABA

31
Q

in a persistent vegetative state, are cortical neurons hypo- or hyper polarized?

A

hyperpolarized 10-20 mV

32
Q

what causes memory impairment and slowing of mental processes in alzheimer’s dz

A

destruction to cholinergic systems

33
Q

during REM sleep, what physiologic changes cuts the cortex off from excitation?

A

hyperpolarization of the thalamocortical neurons

Neuro II (16 decks)

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