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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
What are the 2 pathways used by RAS?
Dorsal and ventral pathway
26
What is the dorsal pathway?
Diffuse pathway to high levels via non-specific nuclei of THALAMUS (including intralaminar nucleus of the thalamus)
27
What is the ventral pathway?
Bypasses thalamus!!!! Diffuses to high levels via basal forebrain and hypothalamus
28
Which path bypasses the thalamus?
Ventral
29
What do the interneurons of the ventral pathway and its neuronal population do?
Interneurons release GABA - Major excitatory Neuronal population release ACh
30
Where are the Parabrachial Nuclei of the EAA arousal system found?
In the pons
31
What are the parabrachial nuclei for?
Crucial for arousal and activation
32
What is the input to the parabrachial nuclei of the EAA arousal system?
All/most Sensory inputs to body
33
How does the RAS and Parabrachial Nuclei of the EAA arousal system differ? What does this mean?
Outputs of Parabrachial exclusively use the VENTRAL PATHWAY =Bypasses the thalamus
34
What do both the RAS and Parabrachial Nuclei use?
EAA/Glutamate
35
Where is the cholinergic arousal system?
In PPT/LDT nuclei
36
Does the cholinergic arousal system keep modality specificity?
No - receives too much input
37
What output pathways does the Cholinergic arousal system use? With what NTR?
Dorsal and Ventral pathways Use ACh
38
What is the role of the cholinergic arousal system?
Provides baseline excitation that is crucial to cortical activity Arousal and awareness
39
What happens if the PPT or LDT is damaged?
Affects cholinergic system. Will NOT cause a coma BUT Does produce severe cognitive deficits Assoc. w/ generalized slowing of cortical processes
40
Where is the NOradrenergic arousal system found?
Locus ceruleus
41
What feeds into the Noradrenergic arousal system?
Paraginganto cellularis n. (Sensory Info) Periaqueductal gray Higher centers, incl. cortex
42
How do the inputs to the Noradrenergic arousal system differ from those of the Cholinergic or EAA arousal systems?
Inputs have been processed more for NE!
43
Does the Noradrenergic arousal system maintain modality specificity ?
Yes! It’s inputs have been more processed
44
What are the outputs of the NE arousal system related to? What pathways do they use to ascend?
Related to consciousness Ascend using dorsal and ventral pathways
45
What are the functions of the NE arousal system?
Startle and alerting responses ‘ Sleep-wake Behavioral vigilance
46
Where do you find the Serotonergic arousal system?
In raphe nuclei
47
What are the inputs to the serotonergic arousal system?
Sensory from Spinal cord for fine proprioception and trigeminal n.
48
What is the output of the serotonergic arousal system? What pathways does it use?
Quiet awareness Arousal Mood and affect Modulation of pain Uses both dorsal and ventral
49
Where is the dopaminergic arousal system found?
Ventral tegmental area
50
What provides input to the Dopaminergic arousal system?
Ventral tegmental area
51
What is the role of the dopaminergic arousal system?
Cognitive functions Motor activity Emotion
52
how do you move from coma —> arousal/wakefulness?
EAA/ACh
53
How do you move from arousal/wakefulness —> awareness?
NE/Serotonin
54
How do you move from Awareness —> Alertness?
Dopaminergic system
55
Describe the dorsal pathway.
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
What do the 2 places of TCN synapsing release? What does this cause?
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
Describe the Ventral System.
Arousal system that bypasses the thalamus Synapses directly onto cortical neurons (parabrachial nuclei uses this pathway exclusively)
58
What does the RAS/Parabrachial EAA system do?
Increase general excitability of cortical neurons
59
What do we see in a persistent vegetative state?
Neuronal loss in rostral regions of pons, midbrain, and thalamus that is greater than that of cortex
60
What does the cholinergic system do?
Adds to general excitation made by RAS/Parabrachial system
61
What system is associated with Alzheimers? What does absence of this system cause?
Cholinergic system Absent excitation makes Mental processes slow Impair memory formation profoundly
62
What moves us from being awake to being more aware?
NE and Serotonergic systems
63
What does the EEG alerting response mean?
Indicator that cortex is looking for sensory input
64
What does the dopaminergic system do?
Adds focused awareness w/ novel stimuli
65
What can patients in a persistent vegetative state do to increase cognitive funciton?
Tx w/ L-Dopa
66
What does the Thalamus arousal system do during sleep?
TCNs hyperpolarized during sleep | W/ occasional bursts of AP
67
What does hyperpolarizations of TCNs do during sleeP?
Cuts cortex off from excitatory influence during deepest level of sleep
68
What NTR is associated with hyperpolarization and memory? Between what levels is this seen?
EAA/ACh Between coma and arousal/wakefulness
69
What NTR is assoc. w/ startle/awareness? Between what levels is this seen?
NE/5HT Between arousal/wakefulness and Awareness
70
What NTR is associated with focus and attention? Between what levels is this seen?
Dopamine B/w Awareness and Alertness

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