First Half Flashcards
1
Q
Neuraxis
A
Imaginary line that runs from the base of the spinal cord (posterior) to the front of the brain (anterior); It curves at cephalic flexure
2
Q
Cephalic flexure
A
Where the neurosis curves; it is located between the brainstem and the forebrain in humans
3
Q
Anterior/Rostral and Posterior/Caudal
A
A/R is towards the head
P/C is towards the tail (feet for humans)
4
Q
Dorsal and Ventral
A
Dorsal is towards the back/head
Ventral is towards the belly
5
Q
Lateral and Medial
A
Lateral is towards the side
Medial is towards the midline (neuraxis)
6
Q
Unilateral and Bilateral
A
Unilateral: one side
Bilateral: two sides
7
Q
Ipsilateral and Contralateral
A
Ipsilateral: on the same side of the body
Contralateral: on the opposite side of the body
8
Q
Proximal and Distal
A
Proximal: nearest point of attachment
Distal: farthest away from point of attachment
9
Q
What is an important implication of motor neuron and sensory neuron decussating at the medulla?
A
A motor neuron lesion above the medulla will cause symptoms on the contralateral side of the body. A motor neuron lesion below the medulla will cause symptoms on the ipsilateral side of the body.
10
Q
Coronal, Horizontal, Sagittal
A
Coronal: divides to front and back; direction of crown being placed on the head
Horizontal: parallel to the ground
Sagittal: divides to left and right
11
Q
MRI
A
- Detailed picture of soft tissue, but less detailed for boney structures
- No side effects
- Takes longer and higher cost
- May be difficult for those with claustrophobia (noise and space)
- May need to hold your breath and not move
- Those with metal on their body are unable to use it
12
Q
CT Scan
A
- Less detailed picture of soft tissue, but detailed for boney structures
- Little side effects
- Can be done quickly and cheaper
- Holding breath is not needed
- Those with metal implants can use it
13
Q
Nervous system can be divided into two systems
A
Central Nervous System
Peripheral Nervous System
14
Q
Central Nervous System (CNS)
A
Consists of brain and spinal chord.
Main functions include: homeostasis, interpreting sensory info, creating motor response, learning, thinking
15
Q
Peripheral Nervous System (PNS)
A
Consists of nerves that branch off spinal chord into all parts of the body.
Main function is to relay info between the CNS and the rest of the body
16
Q
What are the three levels of protection for the brain and CNS?
A
Skull/cranium
Meninges
Cerebrospinal fluid (CSF)
17
Q
What are the layers in meninges?
A
Pia mater: inner layer, closest to the brain
Arachnoid membrane: middle layer, soft and spongy
Dura mater: outer layer, closest to the skull, thick and tough
18
Q
What is the weakest point in the skull?
A
Pterion
19
Q
What is the function of the meninges?
A
Protective sheath around the brain and spinal cord
20
Q
What is the function of the cerebrospinal fluid (CSF)?
A
Provides protection, nourishment, and waste removal
21
Q
What are the ventricles and what are their functions?
A
Hollow vessels within the arachnoid membrane that produces and ensures the flow of the CSF
22
Q
What part of the brain produces the CSF?
A
Choroid plexus
23
Q
What are the usage (in %) of oxygen, glucose, and blood by the brain?
A
20% of total resting oxygen
15-20% of total blood flow goes to the brain
60% of glucose metabolism
24
Q
How is energy divided (in %) in the brain?
A
25% = maintaining neurons and glial cells
75% = electrical signaling across the brain’s circuits.
25
What is a neural tube?
Serves as the embryonic brain and spinal cord; the central nervous system. Later divides into basic brain regions
26
What does neuronal migration do and when does it occur?
Brings neuronal cells to their appropriate locations; occurs at 6-14 weeks
27
What are the similarities and differences between apoptosis and necrosis?
Apoptosis: planned and purposeful neuronal cell death; removal of damaged or unneeded neurons
Necrosis: unplanned and uncontrolled.
28
What is synaptic pruning?
A natural process that occurs in the brain between early childhood and adulthood. During synaptic pruning, the brain eliminates extra synapses for efficiency.
29
How is synaptic pruning related to Sz and ASD?
Sz: over-pruning of synapses (lower synapsis)
ASD: under-pruning of synapses (higher synapsis)
30
What are the ventricles, subdivisions, and principal structures of the Forebrain?
Ventricles: Lateral, Third
Subdivisions: Telencephalon, Diencephalon
Structures: Cerebral cortex, Basal ganglia, Limbic system, Thalamus, Hypothalamus
31
What are the ventricles, subdivisions, and principal structures of the Midbrain?
Ventricles: Cerebral aqueduct
Subdivisions: Mesencephalon
Structures: Tectum, Tegmentum
32
What are the ventricles, subdivisions, and principal structures of the Hindbrain?
Ventricles: Fourth
Subdivisions: Metencephalon, Myelencephalon
Structures: Cerebellum, Pons, Medulla oblongata
33
Telencephalon
- Largest component of the brain (the traditional "brain" we draw)
- Includes the L and R hemispheres
- Covered by the cerebral cortex
- Makes up 77% of the brain mass
- Divided into four lobes (frontal, parietal, occipital, temporal)
34
What connects the left and right hemispheres?
Corpus callosum
35
The convolutions of the brain
– Sulci: small grooves
– Fissures: large grooves
– Gyri: bulges between the sulci and fissures
This increases the brain's surface area by 3x
36
What is the cerebral cortex made of?
Glia, cell bodies, dendrites, and axons
37
Glia?
Supportive and nourishing cells
38
What is myelin made of?
80% lipids
20% protein
39
What are the main sulci and gyri?
* Central Sulcus: boundary between the frontal and parietal lob and the motor and sensory cortex
* Precentral Gyrus: location of Primary Motor Cortex
* Postcentral Gyrus: location of primary Somatosensory cortex (all senses except smell)
40
Homunculus
Reflects the amount of brain tissue devoted
to sensory and motor nerves in body parts
41
Which part of the brain affects empathy and guilt?
Ventromedial PFC
42
What are the key functions of the four lobes?
Frontal: executive fx (planning, reasoning)
Parietal: sensory (touch, pain)
Occipital: visual processing
Temporal: auditory
43
What structures of the brain are a part of the limbic system, and what are their main roles?
Basal ganglia: motor control and motor learning
Thalamus: "relay station"
Hypothalamus: homeostasis
Amygdala: "emotion center" (emotional valence, learning of reward/punishment)
Hippocampus: "seahorse"; formation of new memories
44
What structures make up the Diencephalon?
Thalamus and hypothalamus
45
Substantia nigra
Part of basal ganglia that produces dopamine
46
Dopamine dysfunction can result in what?
Movement disorders such as parkinsonian syndrome (i.e., Parkinson's disease), dystonia, chorea, and tics.
Suppression of Motor Function = ↓ Purposeful Movement
47
Lateralization
tendency of specialization of the brain
70-95% of Language & Analysis localized to left side, Attention & Synthesis localized to right side
48
Midbrain is made up of?
Mesencephalon, which is made up of tectum and tegmentum
49
Tegmentum is made up of?
Reticular formation
Periaqueductal grey matter (PAG)
Raphe nucleus (red)
Substantia nigra (black)
50
Cerebral peduncle
Attaches the cerebrum to the brainstem
51
Brainstem is made of?
Midbrain and hindbrain
52
Cerebellum
“little brain”
Covered by cerebellar cortex
Attached to pons by cerebellar peduncles
Coordinated motor movements and learning
Posture, balance, fine motor movement (ataxia), motor learning (works w/BG), proprioception
53
Pons
“bridge”
Between mesencephalon and medulla oblongata
Refines muscular activity
Communication between cerebellum and cerebrum
Regulates breathing and arousal
54
Medulla Oblongata
Controls basic functions of the autonomic nervous system, including:
* Respiration
* Cardiac function
* Vasodilation
* Reflexes like vomiting, coughing, sneezing, and swallowing
55
Three sections of the spinal cord
Cervical spinal cord: sends nerves to the face and neck.
Thoracic spinal cord: sends nerves to the arms, chest, and abdomen.
Lumbar-sacral spinal cord: sends nerves to the lower body.
56
A bunch of nerves at the bottom of the spinal cord
cauda equina (horse's tail)
57
Two types of spinal nerves
Afferent: towards CNS (from skin)
Efferent: outward (to muscles)
58
Dermatome
areas of skin on your body that rely on specific nerve connections on your spine.
59
Myotome
A group of muscles innervated by a single spinal nerve
60
CNS is composed of two elements and contains what type of neurons?
Elements: brain and spinal cord
Relay neurons
61
PNS is composed of three elements and contains what types of neurons?
Elements: cranial nerves, spinal nerves, peripheral nerves
Sensory and motor neurons
62
Function of the midbrain
The midbrain serves important functions in motor movement and serves as the pathway between the spinal cord, cerebellum, and forebrain.
63
Two structures in Tectum
– Superior Colliculi (visual reflexes/object tracking (orienting) )
– Inferior Colliculi (auditory system in ear)
64
Three structures in Tegmentum
– Periaqueductal gray matter (PAG)
– Raphe (red) Nucleus
– Substantia Nigra (black)
65
Periaqueductal gray matter (PAG)
Pain modulation (endogenous and exogenous opioids act here)
66
Raphe nucleus
- Coordination of sensorimotor information
- Synthesizes serotonin
- SSRIs are believed to largely impact the raphe nuclei
67
Substantia nigra
Key role in dopamine production
68
What does the cerebral peduncle do?
Attaches the cerebrum to the brainstem
69
Reticular formation
Complex network of neurons located in the brain stem
* Connections to the hypothalamus and thalamus.
* Helps support wakefulness/alertness & filters incoming information ("security")
70
Location of gray matter and white matter in brain and spinal cord
in brain, gray matter is on the outside
in spinal cord, grey matter is in the inside
71
Sensory neurons
carry signals from the outer parts of your body (periphery) into the central nervous system.
Dermatome
72
Motor neurons
carry signals from the central nervous system to the outer parts (muscles, skin, glands) of your body.
Myotome
73
Interneurons
Interneurons connect various neurons within the brain and spinal cord.
74
The vagus nerve
regulates the functions of organs in the thoracic and abdominal cavities.
▪ Longest cranial nerve.
▪ Helps body exit “fight or flight”
Important in gut-brain axis
75
How many cranial nerves are there?
12
76
Autonomic Nervous System consists of two divisions
Sympathetic
Parasympathetic
77
Sympathetic nerves
"fight, flight, freeze, fawn"
–Controls functions that accompany arousal and expenditure of energy
–Coordinates responses to a stressor
–Aka Thoracolumbar System
78
Parasympathetic nerves
"rest and digest"
* Involved with increases in body’s supply of stored energy
* Coordinates rest and relax responses after the body has been stressed
* Aka Craniosacral System
* Vagus Nerve responsible for the calming following a stressful situation
79
Neurons
Most basic Information- processing and information- transmitting element of the nervous system
80
Four structures of the neuron
▪ Cell body (soma)
▪ Dendrites
▪ Axon
▪ Terminal buttons
81
Role of axon hillock
decides whether you’ve met the threshold for the action-potential
82
Schwann cell
helps maintain the myelin sheath
83
Oligodendrocytes
produces myelin sheath
84
Synapse
* Points of contact between neurons where information is passed from one neuron to the next
* Form between axons and dendrites
85
Synapse consists of
* Presynaptic neuron
* Synaptic cleft
* Post synaptic neuron
86
Glial cells
* “Glue”
*Provide nutrients to neurons
87
3 types of glial cells
–Microglia
–Astrocytes
–Oligodendrocytes
88
Microglia
* Smallest glial cells
* Clean up dead cells
* Protect the brain from invading microorganisms/toxins
* “immune cell” of the brain
89
How can microglia lead to neurodegeneration?
microglia often don’t know when to stop sending out the
inflammatory mediators
90
Astrocytes
* Star shaped
* Neuron “glue” – holds them in
place
* Engulf debris (phagocytosis)
* Provide nourishment via transfer of fuel – neurons use a lot of energy but cannot store it
* Provide electric insulation for unmyelinated neurons
* Everywhere in your body
91
Oligodendrocyte
* Produces myelin in the form of a tube by wrapping itself around the axon
* Forms sheath in segments
* Episodic gaps = Nodes of Ranvier
92
Blood Brain Barrier
- selectively permeable
- blocks all molecules except for those that are: lipid soluble, specialized sugars and amino acids, water molecules
93
Why are inhibitory reflexes sent to the brain?
it needs to control the voluntary action (e.g., neuron telling the brain not to drop
the hot bowl, because it will drop and break)
94
three activities that are happening in action potential
- Diffusion
- Electrostatic pressure
- Sodium potassium pump
95
Diffusion
movement of molecules from region of high conc. to low to achieve equilibrium
96
Electrostatic pressure
force exerted by attraction or repulsion to move ions from place to place
- Pushes ions of opposite charges together and pushes ions with same charges apart
97
Sodium Potassium pump
protein molecules embedded in the membrane
– Works to keep the ion concentrations stable even as ions cross the membrane at rest
– Continuously pushes Na+ (sodium ions) out of the axon = maintains RESTING POTENTIAL
98
Resting membrane potential voltage
A resting (non-signaling) neuron has a voltage across its membrane (-70 mv)
99
Action potential
- rapid burst of depolarization
followed by hyperpolarization
- Occurs because of diffusion and electrostatic pressure
100
Threshold of excitation
set point to produce an action
potential = -55mV
101
All or none law
there is AP or not-- the size of AP stays constant
102
Rate law
Strength is based on rate of firing
Stronger simulus, more firing
103
Role of node of ranvier
-In myelinated fibers, depolarization and repolarization processes occur from one node of ranvier to the next instead of the entire area of the membrane
-economic and speedy
104
Synaptic transmission
primary means by which neuron communicates across a synapse.
* Synaptic vesicles are made of membrane and
filled with molecules of neurotransmitters
105
types of postsynaptic potentials
*Excitatory (EPSP):Sodium Channel Opened;Depolarizing
*Inhibitory (IPSP): Potassium Channel Opened; Hyperpolarizing
106
termination of postsynaptic potentials in two ways
- Reuptake
- Enzymatic deactivation/degradation
107
Reuptake
an extremely rapid removal of a
neurotransmitter from the synaptic cleft by the terminal button
108
saltatory conduction
The way an electrical impulse skips from node to node down the full length of an axon, speeding the arrival of the impulse at the nerve terminal. AP in nodes of Ranvier, no AP in myelinated areas.
109
Neuron at rest has high concentration of which chemicals inside and outside?
Outside: sodium, calcium, chloride
Inside: potassium, anion
110
Corticospinal tract
- In charge of voluntary muscle control
- It is a descending motor pathway
111
Pathway of corticospinal tract
Midbrain --> crus cerebri (anterior portion of the cerebral peduncle) --> pyramid of the medulla --> lateral CT or anterior CT
112
Characteristics about the upper motor neuron
- no synapses
- they form the corticospinal tract (descending motor pathway)
- consists of lateral and anterior CT
113
Lower motor neurons
directly innervate muscles to produce movement
114
Lateral v. Anterior corticospinal tract
Lateral: distal muscles, majority of the nerves in this tract decussates at the pyramid of medulla
Anterior: cervical and upper thoracic, remain ipsilateral and then crosses in the spinal cord
115
endogenous v. exogenous
endogenous: molecues body creates itself
exogenous: molecules produced outside the body that you are introducing it to your body system
116
two major aspects of drug influence
- Drug effects: observed changes
- Sites of action: drug molecule binding sites; must reach the site before able to affect bx.
117
Pharmacokinetics
what the body does to the drugs
118
Four processes of pharmacokinetics
Absorption
Distribution
Metabolism
Excretion
119
Different types of administration
- IV: fastest b/c it goes straight into your bloodstream
- intraperitoneal: to your stomach (e.g., tubefeeding)
- subcutaneous: into your fat
- intracerebral: directly into your brain; bypass the blood-brain barrier; not really done in humans but on research animals
- intracerebroventricular: straight into CSF
- oral: one of the slowest ways; first pass metabolism (broken down in saliva, down to GI tract, etc); most common way for
psychotherapeutic drugs
- sublingual: absorbing through capilaries below your tongue
- intrarectal: bypassess “first pass” metabolism
- inhalation: into your lungs
- insufflation: absorbed by the mucous membrane in your nose (e.g., snorting cocaine)
120
Why is heroin more addictive than morphine?
heroin is more addictive b/c it has higher lipid solubility than morphine
121
Where does drug exert effect?
Site of action (most of this site is related to CNS)
122
What deactivates and metabolizes drugs?
Enzymes
123
What is an example of an enzyme that has a catalytic effect on molecules and prolongs or increases the effect of the molecule?
fluoxetine/prozac
124
primary organ of excretion
kidney
125
organ that plays an active role in enzymatic deactivation
liver
126
What is used to determine the point of maximum effect?
Dose-response curve
127
What is affinity?
the capacity of a drug molecule to bind to a key site of action.
128
What 2 things impacts the effectiveness of a drug?
* Sites of Action
* Affinity of a drug for its site of action
129
What happens after the point of maximum effect?
After this point, increasing the dose does not produce a stronger effect
130
Therapeutic index (TI)
a commonly used margin of safety; a quantitative
measurement of the relative safety of a drug.
TD50/ED50
131
Greater or smaller margin of safety is desired?
greater
132
What is an ideal TI?
greater than 10
133
What are some drugs with low TI?
Lithium, Clozapine, Tricyclic antidepressants
134
Neuromodulator
a chemical that affects the neurotransmission of a whole group of neurons.
135
Ligand
neuromodulators that bind to a complementary receptor site.
136
Agonist v. Antagonist
- Agonist: binds to the receptor and stimulates a response = increased postsynaptic effects
- Antagonists: binds to a receptor and blocks or inhibits the response = decreased postsynaptic effects
137
Addictive drugs are agonist or antagonist?
Agonist (heroin, morphine, oxycodone)
138
Direct agonist and an example?
They mimic NT, binds with and activates the receptor
e.g., nicotine and methadone
139
Direct antagonist and an example?
Bind and block the receptor from being activated. Sits on receptor and prevents ion channels from opening
e.g., naltrexone
140
Indirect agonist and an example?
Attach to alternate binding site and facilitates/stimulates receptors actions
e.g., Valium, Cocaine
141
Indirect antagonist and an example?
Attach to alternate binding site and blocks/reduces the receptor actions
e.g., Reserpine
142
Why are a lot of the indirect agonists and antagonists neuromodulators?
b/c they bind to an alternative sites
143
Amino acid neurotransmitters in the brain
Excitatory - Glutamate
Inhibitory - GABA
144
Amino acid neurotransmitters in the spinal cord
Excitatory - Glutamate
Inhibitory - Glycine
145
Function of Acetylcholine in CNS and PNS
- PNS: central role in muscle contraction
- CNS: Found in specific locations and pathways in CNS. Key role in REM sleep, perceptual learning, and memory.
146
Facts about monoamines
- Neuromodulators derived from a single amino acid.
- Produced by several systems of neurons in the brain; mainly brainstem with widespread distribution around brain.
- Mediate a variety of CNS fxns (e.g.,motor control, cognition, emotion, memory processing, and endocrine modulation)
147
Three classes of monoamines and their chemicals
- Catecholamines: dopamine, norepinephrine/noradrenalin, epinephrine/adrenalin
- Indolamine: serotonin
- Ethylamine: histamine
148
Synthesis process of catecholamines
Tyrosine -> L-dopa -> dopamine -> norepinephrine
149
What are dopamine agonists and which one is more addictive (and why)?
Amphetamines and methamphetamines: more addictive b/c it blocks reuptake AND reverse transporters
Cocaine: just blocks reuptake
150
What is the primary effect of dopamine?
movement, attention, learning, and reinforcing effects of substances
151
What is the primary effect of norepinephrine?
vigilance and attentiveness
152
T/F: dopamine has to exist first for norepinephrine to exist
True
153
Locus Coeruleus (nucleus in the pons)
Where most noradrenergic systems (norepinephrine) begin
154
What are the primary effects of serotonin?
mood and pain regulation
control of eating, sleeping, arousal, and dreaming
155
What are the precursors of dopamine, norepinephrine, and serotonin?
Dopamine: tyrosine
Norepinephrine: dopamine
Serotonin: tryptophan
156
Are dopamine, serotonin, and norepinephrine excitatory or inhibitory?
dopamine: excitatory and inhibitory
serotonine: inhibitory
norepinephrine: excitatory
157
What are surplus and deficit effects of dopamine?
Surplus: Sz, substance addiction
Deficit: Parkinson's, anxiety, memory, challenges, ADHD
158
What are the surplus and deficit effects of serotonin?
Surplus: autism, mania
Deficit: depression and other mood d/os
159
What are the surplus and deficit effects of norepinephrine?
Surplus: anxiety
Deficit: several psychiatric conditions
160
Tolerance
A decrease in the effectiveness of a drug that is administered repeatedly. It is the body's attempt to maintain homeostasis.
161
Pharmacokinetic tolerance
body breaks down drug preventing it from reaching receptors.
162
Pharmacodynamic tolerance
- Decrease in receptor affinity for drug.
- Damaged receptors
- Receptor down-regulation (decrease in receptor)
163
Sensitization
An increase in the effectiveness of a drug as it is administered repeatedly.
164
Dependence
The physical or psychological symptoms that occur that make someone feel like they must continue taking a substance; lack of substance results in withdrawal
165
Positive v. Negative
Reinforcement v. Punishment
Positive: add something to the environment
Negative: remove something from the environment
Reinforcement: to increase the behavior
Punishment: to decrease the behavior
166
What are the brain regions that substances affect, and what are their effects?
Basal Ganglia: motivation, habits, routines. Repeated exposure decreases sensitivity, which results in tolerance.
Amygdala: anxiety, irritability, and unease. Withdrawal feelings result in motivation to seek out drug.
PFC: plan, solve problems, make decisions, and exert self-control over impulses. Reduces impulse control.
167
What are brain structures involved in the reward system?
Ventral tegmental area (VTA), nucleus accumbens, amygdala, hippocampus, prefrontal cortex
168
VTA in the reward system
- Dopamine-rich nucleus that mediates reward system
- Located in midbrain, next to the substantia nigra
- Sends dopamine to the nucleus accumbens, amygdala, hippocampus, and prefrontal
cortex.
- Increased VTA pathways is implicated in OCD
169
Nucleus accumbens in the reward system
- Involved in all motivationally-relevant stimuli = rewarding or aversive.
- Interface between motivation + action (connection to caudate nucleus)
170
Amygdala in the reward system
- Happiness & Enjoyment.
- Anxiety, irritability, and unease - Withdrawal feelings = Motivation to seek out drug
171
Prefrontal cortex in the reward system
Reasoning, problem-solving, impulse control, creativity, perseverance.
172
Two dopamine pathways
Mesolimbic and Mesocortical
173
Mesolimbic Dopamine Pathway
- Route between VTA, Nucleus accumbens, and limbic system (hippocampus & amygdala).
- Key Pathway in Pleasure and Reward (learning something is pleasurable and rewarding--remember, hippocampus is responsible for making new memories)
- Substance use
174
Mesocortical Dopamine Pathway
Route between VTA/Nucleus accumbens and PFC.
175
Stress increases which hormone?
Corticotropin-releasing hormone (CRH)
176
How does CRH affect brain areas?
- Strengthens the Amygdala
- Weakens the hippocampus & prefrontal cortex
177
What does increased stress (increased CRH) result in?
- Negative emotional state
- Lack of executive control, which increases risk of relapse
- Memory of relief/cravings
178
What are the two control orientation in stress management?
Primary: attempts to directly influence environment
Secondary: individual accommodates to the situational demands.
179
Difference between East and West in stress perception (generally speaking)?
East: higher stress from psychosocial distress; more somatic symptoms
West: stress from individual failure; more psychological symptoms
180
Hypofrontality is commonly seen in which disorder and have high comorbidity with what?
Seen commonly in Schizophrenia, high comorbidity with SUDs
(thus, Sz has high comorbidity with SUDs as well)
181
What kind of neural effect does cocaine, pathological gambling, and nicotine have in the PFC?
Reduces the existence/activation of the grey matter in PFC
182
peptides
two or more amino acids linked by peptide bonds;
endogenous opioids are almost all peptides
183
What are the most common endogenous peptides?
- Enkephalins (natural ligand)
- Endorphins
- Dynorphins
184
T/F: Natural opioid receptors exist in the body, and your body naturally produces and releases opioids to opioid receptors
True
185
What are the functions of opioid?
- Modulation of pain response - Reward and reinforcement
- Inhibits flee response
186
How does one get addicted to opioid?
- Drugs of abuse/Exogenous Peptides --> increased endorphins and enkephalins--> huge dopamine surge
- Since this dopamine surge is far more greater than "normal" pleasurable activities (exercise, socializing, eating, sex), over time these pleasurable activities become not enough
187
Per CDC what is a moderate drinking in males and females?
Female: up to 1 drink per day
Male: up to 2 drinks per day
188
Per CDC, how many drinks is a heavy drinking in males and females?
Female: 8 or more per week
Male: 15 or more per week
189
Per CDC, how many drinks is a binge drinking in males and females?
Females: 4 or more
Males: 5 or more
190
Per CDC, how many drinks is a binge drinking in males and females?
Females: 4 or more
Males: 5 or more
191
How do factors like sugar, carbonation, and menstruation affect alcohol absorption/metabolism?
Sugar: lowers absorption
Carbonation: increases absorption
Menstruation: lowers metabolism
192
What is a congener level?
Congener is genetic mutation that contributes to hangover severity; higher congener contributes to hangover resistance
193
Which SES population experiences the greatest ETOH use?
Each ends of the SES spectrum
194
Which organs do alcohol absorption, metabolism, and excretion occur?
Absorption: small intestine
Metabolism: liver
Excretion: kidney (urine)
195
How does food inhibit alcohol absorption?
by causing oxidation of alcohol & closing the pyloric sphincter
196
What is the metabolism chain of alcohol?
- Alcohol metabolized by Alcohol Dehydrogenase (ADH)(requires B vitamins), which creates Acetaldehyde
- Acetaldehyde metabolized by aldehyde dehydrogenase (ALDH), which creates acetate
-Basically, alcohol+ADH = Acetaldehyde,
Acetaldehyde+ALDH =Acetate
197
what biological mechanism defines intoxication?
consuming etoh faster than liver can break it down (usually 1 drink per hour)
198
What does ETOH do to the CNS?
ETOH is a CNS depressant
199
What effect does indirect GABAa receptor agonist have?
Sedation and memory functioning impairment (hippocampus)
200
What happens with the over-inhibition of GABAa?
The body creates a new baseline with less receptors (downregulation). When the body is going through withdrawal and drugs are taken again, it can result in seizure.
201
What is receptor down regulation?
a decrease in total receptor number in the cell caused by long-term exposure to agonists
202
What happens to the body/brain with inhibition of GABA?
- Cerebellum: loss of coordination & consciousness
- PFC: decreased inhibition
- Blocks Vasopressin: increased urination & dehydrtion
203
What's the role of thiamine in the brain?
Thiamine plays roles in brain cell energy production & maintenance and synthesis of myelin
204
What causes Wernicke-Korsakoff Syndrome?
Thiamine deficiency
205
Wernicke’s Encephalopathy
- Acute phase
- needs to be treated immediately or it can result in death
- delirium, incoordination, memory deficits, etc
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Korsakoff psychosis
- Chronic phase
- Can develop after WE or without
- Greater anterograde amnesia (ability to form new memories) than retrograde
- not treatable nor reversible
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Confabulation
false memory of the past, and the brain fills in the space with false information
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What is fetal alcohol syndrome disorders and some of the key features?
FASD is an umbrella term for a range of physical, cognitive, and behavioral disorders caused by prenatal alcohol exposure.
Features: short nose, low nasal bridge, flat mid face, thin upper lip, etc
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What chemicals in the brain do stimulants affect, and how does it show?
- epinephrine/norepinephrine (E/NE)
- dopamine (DA)
- serotonin (5-HT)
- Cause alertness, attention, energy
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What are some medical uses for stimulants?
Pain management, ADHD, asthma, obesity, narcolepsy
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What are some risk factors of stimulants?
- Reduced seizure threshold
- increased BP,HR,HTN= increased risk of stroke and MI
- Poor appetite, mood swings, anxiety, insomnia
- Toxic levels and result in paranoia, psychosis
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What are the 2 mechanisms of absorption of nicotine?
- Tobacco smoke: enters bloodstream via lungs
- Smokeless tobacco: mucosal membrane of mouth, nose, or
skin
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What are the effects of nicotine?
- Mimics Ach: arousal, learning, memory, and emotions
- Binds to nicotinic receptors and changes cerebral metabolism
- Stimulates adrenal glands, resulting in increased BP, HR, respiration, alertness
+ epinephrine
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T/F: body has natural endocannabinoid system, which comprises of CB1 and CB2
True
215
What are the main functions of the CB1 and CB2 receptors?
- CB1: mediates most of the psychoactive effects of cannabinoids in brain (regulates neurotransmission)
- CB2: regulates immune and inflammatory pathways
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What is the endocannabinoid (neuromodulator) that is naturally found in human bodies?
Anandamide
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What are the most notable cannabinoids?
Delta-9-tetrahydrocannabinol (THC) & cannabidiol (CBD)
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What effects do cannabinoids have?
energy, mood, appetite, and perception of time.
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How does traditional use and recreational use of marijuana differ?
They differ in dosage
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How is inhalation and oral absorption of cannabis differ?
-Inhalation: peak plasma concentration in 3-10 mins, and higher bioavailability (10%-35%)
-Oral: peak plasma concentration at 120 mins, and lower bioavailability (6%- 20%)
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Where do cannabis accumulate in the body?
adipose tissue
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T/F: Cannabis is able to cross the placenta and can be released in breast milk
True
223
What is the effect of THC in the brain and chemicals?
-Activates hypothalamus and thalamus (increased hunger and thirst)
-Reduced activation of cerebellum and hippocampus (reduced coordination and memory) as well as amygdala
-Decreased GABA (inhibitory), increased Glutamate and Dopamine (excitatory)
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Glucose
- primary source of fuel for the brain
- provides precursors for NT synthesis & apoptosis
- Glucose levels correlated with thinking, memory, learning
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Brain-derived neurotrophic factors (BDNF)
BDNF plays an important role in neuronal survival and growth, serves as a neurotransmitter modulator, and participates in neuronal plasticity, which is essential for learning and memory.
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What does high sugar diet do to BDNF?
It lowers BDNF in the body, which increases the risk of neurodegenerative disorders due to atrophy and small vessel disease
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What is the AMA recommended consumption level of sugar per day?
6-9 tsps per day
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Hallucinogens
Drugs that alter a person’s awareness of their surroundings as well as their own thoughts and feelings.
229
What are the two categories of hallucinogens?
Classic: impacts serotonin (e.g., LSD, psilocybin, peyote)
Dissociative: interferes with glutamate--contributes to reduced control and disconnection (e.g., PCP, ketamine, cough syrup)
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What does social media "likes," "re-tweets," and "novelty" do to the brain?
Increases mesolimbic activation
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Why do we sleep? Sleep is important for:
- Immune system functioning
- Neurological development
- Memory processing
- Many, many other functions
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T/F: Every living animal with a CNS sleeps
True
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T/F: Those lower on the food chain tend to sleep longer than those higher up
False. Those higher on the food chain tend to sleep longer than those lower down
234
T/F: the size of the neocortex is positively correlated to daily sleep amount
False. The size of the neocortex does not correlate positively with daily sleep amount
235
What are two ways of measuring sleep stages?
Common: EEG
Gold standard: polysomnography (measures brain waves, blood oxygen levels, heart rate, breathing, and eye and leg movement
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Synchronous delta activity in measuring sleep
If the cells are active at about the same time, their electrical messages are synchronized and appear as a large, clear wave in the EEG data.
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Desynchronous beta wave activity in measuring sleep
If neurons are active at different times, their electrical messages are desynchronized and appear as small, chaotic waveforms without a clear pattern in the EEG data.
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What are the five stages of sleep?
Waking
NREM stage 1
NREM stage 2
NREM stage 3
REM
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What are the characteristics of NREM stage 1?
- transition between wakefulness and sleep
- lightest stage of sleep (may not realize you were sleeping)
- theta waves
- 2-5% of total sleep time
-hypnic jerks can happen
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What are the characteristics of NREM stage 2?
- about half the night is spent in N2
- slowed heart rate, breathing, muscle activity, eye movements
- reduced body temperature
- sleep spindles and K complexes happen here
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What are sleep spindle?
brief powerful bursts of synch activities; important for memory consolidation
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What are K complexes?
sharp high voltage biphasic waves; involved in responding to external threats
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What are the characteristics of NREM stage 3?
- aka deep sleep or slow wave sleep (SWS)
- 20% of total sleep is spent here
- sleep in this stage increases with higher level of physical or cognitive exertion
- thought to be most restorative sleep stage (memory consolidation and waste clearance)
- predominates the first half of the night
- very synchronous "orchestra" of brain activity
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What are the characteristics of the REM sleep?
- rapid eye movement sleep
- muscle paralysis
- dreams are thought to occur here
- can be easily awoken from this stage
- desynchronized EEG (EEG similar to that of waking stage)
- facilitates synaptic plasticity
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How long does each sleep cycle last?
approximately 90 minutes
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Which sleep stages predominates the first have of the night and which the second half?
First half: SWS
Second half: REM
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Which brain regions are active and not active during REM and dreaming?
Active: extra striate cortex (part of visual cortex)
Inactive: prefrontal cortex and striate cortex (part of visual cortex for visual input)
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T/F: Brain regions active during a dream are active in the same way in real life
True
249
What is rebound phenomenon?
increased frequency, depth, and intensity of rapid-eye-movement (REM) sleep following sleep deprivation or significant stressors.
250
Lucid dreams
A state where one is “physiologically asleep while at the same time aware that they are dreaming, able to intentionally perform diverse actions"
251
What does brain activity in SWS look like?
- it involves a lot of different neuronal regions that require a synchronized “orchestra” of firing
- memory consolidation
- largely based in the prefrontal cortex
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What can sleep deprivation result in?
- Memory loss
- Concentration difficulties
- Moodiness
- Dyscoordination
- Paranoia
- Hallucinations
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Fatal familial insomnia
Inherited neurological disorder that is a result of damage to portions of thalamus. It is a progressive insomnia that can result in death in 1 year
Possible etiology: lack of sleep means toxins in the brain is not cleared up, resulting in damaging effects
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T/F: sleep is important following physical exertion
False. Relationship between sleep and exercise is subtle. Sleep probably not needed for restoration of physiological functioning
255
What are two main neurological processes that occur when we sleep?
- Waste clearance
- Memory consolidation
256
What is glymphatic flow?
Like the lymphatic system, but relying on glial cells. CSF and ISF goes through your brain and pull away built-up protein
257
Synaptic homeostasis theory
During SWS, synapses are pruned back, increasing efficiency of stronger connections and decrease unnecessary/redundant connections
258
REM sleep is important for what and during which developmental period is it spent more in?
Important for early neurological development, learning and memory
Highest portion of REM sleep during infancy and childhood
259
REM and SWS facilitate consolidation of what kinds of memories?
REM: non-declarative memories
SWS: declarative memories
260
T/F: Older adults spend more time in SWS sleep than younger adults do
False. Older adults spend less time in SWS sleep than younger adults do, possibly because different brain areas are degenerating or becoming less effective
261
Adenosine
- inhibitory
- it is a byproduct of ATP usage
- accumulation of adenosine increases sleepiness
- increases slowly during the day and produces sleepy feelings at night
- it is recycled at night
262
What is the mechanism and role of caffeine?
- blocks adenosine receptors
- reduces FEELINGS of sleepiness, but fatigue is increased
263
What happens chemically with sleep deprivation?
Decrease in glycogen store, and increase in adenosine (resulting in sleepiness)
264
Histamine
- processed by hypothalamus, then to cerebral cortex
- increases wakefulness
- activate the release of acetylcholine
265
ACh is highest in which sleep cycles?
Awakened state and REM cycle
266
3 groups of ACh neurons are located in which parts of the brain?
1 in the Hippocampus
2 located in the Pons and Forebrain
267
Why is serotonin low during REM?
Because your body doesn't want you to move when you are asleep (serotonin is most active during waking period)
268
Arousal & Sleeplessness is controlled by which catecholamine via which brain region?
norepinephrine, and mediated by the Locus Coeruleus in the
pons.
269
Higher Locus Coeruleus firing indicates what response?
Higher vigilance and focus
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T/F: Catecholamine agonists (e.g.,amphetamines) produce arousal and sleeplessness.
True
271
Orexin
- Secreted by the Hypothalamus
- Stimulates other neurons to promote alertness & energy metabolism
- high during exploratory activity
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Melatonin
- Produced by the Pineal Gland in response to evening/darkness about 2 hours before normal sleep time
- Serotonin is converted into melatonin
- only needs about 1-2mg of exogenous melatonin 30min-1hr before bedtime for effectiveness
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Primary v. secondary insomnia
- Primary insomnia: difficulty falling asleep after going to bed or after awakening during the night.
- Secondary insomnia: inability to sleep due to another mental or physical condition (e.g., pain, medication)
274
Drug dependency insomnia occurs in how many days?
3
275
Chronic use of sleep-promoting drugs can cause what?
Rebound insomnia (difficulty sleeping that occurs when a person stops taking a medication that usually helps them sleep)
276
Narcolepsy
- orexin-related neurological disorder
- those with narcolepsy is missing more that 85% of orexin-producing neurons
- hereditary
- inappropriate occurrence of REM-related symptoms
- three primary symptoms: sleep attack, cataplexy, sleep paralysis
- treated with modafinil
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REM sleep behavior disorder
- Lack of muscle paralysis during REM, resulting in acting out of dreams
- Typical onset after age 60
- Believed to be neurodegenerative (~90% develop Parkinsons Disease, or Dementia with Lewy Body)
- treated with clonazepam
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What are the two types of sleep apnea?
- Obstructive Sleep Apnea: due to narrowing of airway (obesity, enlarged tonsils, hormonal changes)
- Central Sleep Apnea: brain does not signal need to breathe.
279
Maladaptive SWS behaviors
- bedwetting due to muscle control being off
- sleepwalking (wake them up!)
- nigh terrors
- most frequently seen in children, and it self-resolves over time
280
T/F: up to 80% report sleep problems after TBI
True
281
Various nap lengths and their effects
10-20min: best for boost of energy afterwards
30min: can leave you more groggy afterwards
60-90min: can help with learning afterwards
282
pick up from emotions
