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Brain Arousal Flashcards

1
Q

What are the 2 parts of consciousness?

A

Arousal

Awareness

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2
Q

What is arousal?

A

Being awake

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3
Q

What is awareness?

A

Conscious process of inputs

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4
Q

What needs to be activated in order to have arousa land awareness?

A

Cortex using brainstem

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5
Q

What is a coma?

A

Not awake or aware

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6
Q

What is a persistent vegetative state?

A

Have sleep/wake cycles

No awareness

Cortical neurons = 30 mV below threshold

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7
Q

What comprises a

Minimally conscious state?

A

Sleep/wake cycles

Evidence of awareness (can respond to simple commands)

Limited to absent communication

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8
Q

What does a comatose state result from?

A

Massive and bilateral damage to cerebral cortices

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9
Q

What can disrupt consciousness?

A

Smaller lesions in brain stem, midbrian, or hypothalamus

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10
Q

What are the levels of perception?

Least to greatest

A

Coma —> arousal wakefulness—>awareness—>alertness

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11
Q

What will a COMA have in terms of

  1. Eye/head motions
  2. Sleep/wake cycles
  3. Awareness
  4. Verbal responses ?
A
  1. May be present
  2. No
  3. No
  4. No
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12
Q

What will a PERSISTENT VEGETATIVE STATE have in terms of

  1. Eye/head motions
  2. Sleep/wake cycles
  3. Awareness
  4. Verbal responses ?
A
  1. Yes
  2. Yes
  3. No
  4. No
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13
Q

What will a MINIMALLY CONSCIOUS have in terms of

  1. Eye/head motions
  2. Sleep/wake cycles
  3. Awareness
  4. Verbal responses ?
A
  1. Yes
  2. Yes
  3. May be present
  4. May be present
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14
Q

What will AWARE/ALERT have in terms of

  1. Eye/head motions
  2. Sleep/wake cycles
  3. Awareness
  4. Verbal responses ?
A
  1. Yes
  2. Yes
  3. Yes
  4. Yes
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15
Q

What are the arousal system?

A 
EAA
Cholinergic
Noradrenergic
Serotonergic
Dopamineragic
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16
Q

What comprises the EAA arousal system?

A

Reticular activating system

Parabrachial nuclei

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17
Q

What is the role of the EAA arousal system?

A

Provides baseline excitation that is crucial to cortical activity

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18
Q

What are the nuclei found in the

Cholinergic arousal system?

A

Pedunculopontine tegmentum

Laterodorsal nuclei (PPT/LDT)

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19
Q

Where is the

Noradrenergic arousal system?

A

Locus ceruleus

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20
Q

Where is the

Serotonergic arousal system?

A

Raphe nuclei

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21
Q

Where is the

Dopaminergic arousal system?

A

Ventral tegmentum area

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22
Q

Where is the

Reticular activation system (an EAA arousal system)

A

Mid ventral potion of medulla and midbrain

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23
Q

What is the Reticular Activating system

A

Loose collection of neurons and fiber tracts that receive info from all ascending sensory tracts

As well as info from trigeminal, auditory, and visual tracts

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24
Q

Is modal specificity kept in the RAS?

Why or why not?

A

It is lost

Bc of Synaptic convergence that allows neurons of RAS to respond equally well to multiple sensory modalities

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25
Q

What are the 2 pathways used by RAS?

A

Dorsal and ventral pathway

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26
Q

What is the dorsal pathway?

A

Diffuse pathway to high levels via non-specific nuclei of THALAMUS (including intralaminar nucleus of the thalamus)

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27
Q

What is the ventral pathway?

A

Bypasses thalamus!!!!

Diffuses to high levels via basal forebrain and hypothalamus

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28
Q

Which path bypasses the thalamus?

A

Ventral

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29
Q

What do the interneurons of the ventral pathway and its neuronal population do?

A

Interneurons release GABA - Major excitatory

Neuronal population release ACh

30
Q

Where are the Parabrachial Nuclei of the EAA arousal system found?

A

In the pons

31
Q

What are the parabrachial nuclei for?

A

Crucial for arousal and activation

32
Q

What is the input to the parabrachial nuclei of the EAA arousal system?

A

All/most Sensory inputs to body

33
Q

How does the RAS and Parabrachial Nuclei of the EAA arousal system differ?

What does this mean?

A

Outputs of Parabrachial exclusively use the

VENTRAL PATHWAY

=Bypasses the thalamus

34
Q

What do both the RAS and Parabrachial Nuclei use?

A

EAA/Glutamate

35
Q

Where is the cholinergic arousal system?

A

In PPT/LDT nuclei

36
Q

Does the cholinergic arousal system keep modality specificity?

A

No - receives too much input

37
Q

What output pathways does the Cholinergic arousal system use?

With what NTR?

A

Dorsal and Ventral pathways

Use ACh

38
Q

What is the role of the cholinergic arousal system?

A

Provides baseline excitation that is crucial to cortical activity

Arousal and awareness

39
Q

What happens if the PPT or LDT is damaged?

A

Affects cholinergic system.

Will NOT cause a coma

BUT

Does produce severe cognitive deficits
Assoc. w/ generalized slowing of cortical processes

40
Q

Where is the NOradrenergic arousal system found?

A

Locus ceruleus

41
Q

What feeds into the Noradrenergic arousal system?

A

Paraginganto cellularis n. (Sensory Info)

Periaqueductal gray

Higher centers, incl. cortex

42
Q

How do the inputs to the Noradrenergic arousal system differ from those of the Cholinergic or EAA arousal systems?

A

Inputs have been processed more for NE!

43
Q

Does the Noradrenergic arousal system maintain modality specificity ?

A

Yes!

It’s inputs have been more processed

44
Q

What are the outputs of the NE arousal system related to?

What pathways do they use to ascend?

A

Related to consciousness

Ascend using dorsal and ventral pathways

45
Q

What are the functions of the NE arousal system?

A

Startle and alerting responses ‘

Sleep-wake

Behavioral vigilance

46
Q

Where do you find the Serotonergic arousal system?

A

In raphe nuclei

47
Q

What are the inputs to the serotonergic arousal system?

A

Sensory from Spinal cord for fine proprioception and trigeminal n.

48
Q

What is the output of the serotonergic arousal system?

What pathways does it use?

A

Quiet awareness
Arousal
Mood and affect
Modulation of pain

Uses both dorsal and ventral

49
Q

Where is the dopaminergic arousal system found?

A

Ventral tegmental area

50
Q

What provides input to the Dopaminergic arousal system?

A

Ventral tegmental area

51
Q

What is the role of the dopaminergic arousal system?

A

Cognitive functions
Motor activity
Emotion

52
Q

how do you move from

coma —> arousal/wakefulness?

A

EAA/ACh

53
Q

How do you move from

arousal/wakefulness —> awareness?

A

NE/Serotonin

54
Q

How do you move from

Awareness —> Alertness?

A

Dopaminergic system

55
Q

Describe the dorsal pathway.

A

Arousal system send axons to thalamus

Synapse and thalamicocortical neurons go to cortex

Synapse in non specific nuclei of thalamus (incl. intralaminar)

Diffuse and project to entire cortex where TCNs release EAA as NTR

TCNs also synpase on intracortical neurons to release GABA

56
Q

What do the 2 places of TCN synapsing release?

What does this cause?

A
  1. TCNs release EAA
  2. TCNs synapse on intracortical neurons to release GABA

Results in alternating waves of excitation and inhibition (waves recorded on EEG)

57
Q

Describe the Ventral System.

A

Arousal system that bypasses the thalamus

Synapses directly onto cortical neurons

(parabrachial nuclei uses this pathway exclusively)

58
Q

What does the RAS/Parabrachial EAA system do?

A

Increase general excitability of cortical neurons

59
Q

What do we see in a persistent vegetative state?

A

Neuronal loss in rostral regions of pons, midbrain, and thalamus that is greater than that of cortex

60
Q

What does the cholinergic system do?

A

Adds to general excitation made by RAS/Parabrachial system

61
Q

What system is associated with Alzheimers?

What does absence of this system cause?

A

Cholinergic system

Absent excitation makes
Mental processes slow
Impair memory formation profoundly

62
Q

What moves us from being awake to being more aware?

A

NE and Serotonergic systems

63
Q

What does the EEG alerting response mean?

A

Indicator that cortex is looking for sensory input

64
Q

What does the dopaminergic system do?

A

Adds focused awareness w/ novel stimuli

65
Q

What can patients in a persistent vegetative state do to increase cognitive funciton?

A

Tx w/ L-Dopa

66
Q

What does the Thalamus arousal system do during sleep?

A

TCNs hyperpolarized during sleep

W/ occasional bursts of AP

67
Q

What does hyperpolarizations of TCNs do during sleeP?

A

Cuts cortex off from excitatory influence during deepest level of sleep

68
Q

What NTR is associated with hyperpolarization and memory?

Between what levels is this seen?

A

EAA/ACh

Between coma and arousal/wakefulness

69
Q

What NTR is assoc. w/ startle/awareness?

Between what levels is this seen?

A

NE/5HT

Between arousal/wakefulness and Awareness

70
Q

What NTR is associated with focus and attention?

Between what levels is this seen?

A

Dopamine

B/w Awareness and Alertness

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