For Quiz 2 Flashcards
1
Q
How did the larynx change evolutionarily?
A
larynx changed to allow us to make more sound, but made us more vulnerable to choking
2
Q
T/F: Those who are left-handed have less lateralization than those who are right-handed.
A
True
3
Q
What brain region is associated with Aphasia?
A
L MCA
4
Q
What are the characteristics of Broca’s Aphasia?
A
- Frontal and motor cortex = impaired speed production
- speech is slow and broken
- Expressive aphasia
- Worsens with anxiety or pressure demands
- Generally aware of their impairment
5
Q
What are the characteristics of Wernicke’s Aphasia?
A
- Posterior temporal lobe and primary auditory cortex = impaired comprehension
- Receptive aphasia
- Impaired language comprehension
- Fluent, but speak “word salad”
- Often unaware of their impairment
6
Q
T/F: Aphasia only occurs in verbal form.
A
False. Aphasia can occur for those who are deaf, and it can affect reading and writing as well.
7
Q
What is it called if you have both types of aphasia?
A
Global Aphasia
8
Q
What is the process by which experiences change our nervous system and our behavior
A
Learning
9
Q
What are the three stages of learning?
A
Stage 1: sensory information
Stage 2: short term memory
Stage 3: long term memory
10
Q
Sensory information
A
- Information is first processed through our senses
- It takes less than 1second
11
Q
Short term memory
A
- Meaningful/salient information that can be retained for less than 1 minute
- repetition or chunking can help this process
12
Q
What is the 7 +/- 2 rule?
A
In repetition or chunking, you can remember 7 +/- 2 items at a given time
13
Q
What is the process of short term memories being converted into long term memories called?
A
Consolidation
14
Q
What brain area is involved in long term memory?
A
Hippocampus
15
Q
What can help strengthen memory?
A
Increased retrieval, such as rehearsals
16
Q
What are the four types of learning?
A
Stimulus-Response Learning
Motor Learning
Perceptual Learning
Observational Learning
17
Q
What are the two types of stimulus-response learning?
A
Classical conditioning
Operant conditioning
18
Q
Which brain regions are involved in classical conditioning?
A
Amygdala
Hippocampus
Thalamus
19
Q
Which conditioning involves positive/negative reinforcement/punishment?
A
Operant conditioning
20
Q
Which brain regions are involved in operant conditioning?
A
Mesolimbic and mesocortical systems
Basal ganglia
21
Q
What is motor learning and which brain region is involved?
A
Learning a skilled task and then practicing with a goal in mind until the skill is executed automatically.
Basal ganglia
22
Q
What is perceptual learning?
A
- When repeated exposure enhances the ability to discriminate between two (or more) otherwise confusable stimuli.
- Allows us to identify and categorize objects
23
Q
What prior experiences influence perceptual learning?
A
Attribution bias
Confirmation bias
24
Q
What is observational learning, and what are some of its characteristics?
A
- Process of learning by watching the behaviors of models
- Occurs via operant conditioning and vicarious conditioning
25
What are two types of modeling in observational learning, and how are they different?
- Prosocial modeling: prompts engagement in helpful and healthy bx
- Antisocial modeling: prompt others to engage in aggressive/unhealthy bx
26
We are more likely to mimic models who:
- Perceived positively (liked, high status)
- Shared traits
- Stand out
- Familiarity
- Self-Efficacy in mimicry
27
What is the type of brain cell that respond equally when we perform an action and when we witness someone else perform the same action?
Mirror neurons
28
In which brain areas are mirror neurons concentrated in?
PFC and Amygdala
29
T/F: Brain responds the same way to performing, witnessing, and hearing an action.
True, because of mirror neurons.
30
What are some things that we experience that are enabled by mirror neurons?
- Empathy/Intention
- Skill Building through Mimicry
- Vicarious Experience
31
What are some aspects of learning that are backed by evidence?
- Interleaving/Spaced Learning
- Writing rather than typing
- Studying in natural light
- Power Nap (caffeine hack)
- Context-Dependent learning
32
What is spaced learning?
Taking break between learning periods (e.g., study a bit today, study a bit tomorrow, so your brain has time to process and accumulate learning)
33
What is interleaving?
When studying for three different topics, switching topics every 45 minutes and rotating
34
What are two types of long-term memory, and how are they different?
Explicit (conscious; aka declarative)
Implicit (unconscious; aka procedural)
35
What is procedural memory?
Unconscious recall of how to perform an action or skill (e.g., remembering how to ride a bike)
36
What are the two types of declarative memory, and how are they different?
Episodic: involve context (e.g., where
you parked your car)
Semantic: involve facts without context (e.g., the sun is a star)
37
HM had his hippocampus and amygdala removed for his seizures. What happened afterwards?
- Reduction in seizure
- increase in IQ
- emotions stable
- complete amnesia ("today I woke for the first time")
38
Hippocampus volume loss is seen in which population?
Alzheimer dementia, depression, childhood stress, ETOH, PTSD, BPD
39
At what age does memory peak?
Age 8
40
What are the two types of amnesia, and how are they different?
Anterograde: loss of ability to form new memory (but repeated task can become procedural memory)
Retrograde: loss of memory for event prior to injury (in extreme cases, procedural memories can be lost)
41
What are the two mechanisms of stroke?
- Something blocking blood supply to part of the brain
- A blood vessel in the brain bursts
42
What is the mechanism of infarct?
tissue necrosis
43
What is the #1 risk factor of CVD?
Hypertension (BP higher than 140/90)
44
What are some other risk factors of CVD?
Diabetes
Smoking
Obstructive sleep apnea
Obesity
45
What are the three types of stroke?
Ischemic stroke
Hemorrhagic stroke
Transient ischemic attack (TIA)
46
Ischemic stroke
- Obstruct in the flow of blood in the brain
- Thrombus (blood clot in blood vessel) or embolus (piece of plaque traveled to the artery in the brain)
- Brain tissue dies slowly; the brain tries to compensate until it can’t any longer
47
T/F: Blood is poison for the brain, and this could lead to seizure
True
48
Hemorrhagic stroke
Caused by bleeding in the brain
49
What is the more common type of stroke?
Ischemic (88%)
50
TIA
- A stroke that lasts only a few minutes.
- 1/3 will eventually have a stroke (precursor)
- 50% within 1 year
51
What is the process of immediate cause of neuron death in ischemic stroke?
Excessive amounts of glutamate (decreased O2 -> excessive glutamate -> overstimulation of NMDA receptors -> over activation of microglia -> cell death)
52
Circle of Willis
Where the internal carotid arteries branch into smaller arteries that supply oxygenated blood to over 80% of the cerebrum.
53
Three blood vessels that internal carotid arteries (ICA) send blood to:
Anterior cerebral artery
Middle cerebral artery
Posterior cerebral artery
54
Middle Cerebral Artery
- where 90% of strokes occur
- Largest of the brain arteries
- Supplies most of the outer surface of the frontal, parietal, temporal lobes and the basal ganglia.
55
MCA stroke symptoms
- Contralateral Weakness & Sensory Loss in UPPER extremities
- Homonymous Hemianopia (loss of visual field)
- Speech Deficits (for L MCA)
- Neglect and poor motivation (for R MCA)
56
Anterior Cerebral Artery
- Stroke in this area less common (L > R)
- Feeds deep structures in the brain, frontal, parietal, corpus callosum and bottom of the cerebrum
57
ACA stroke symptoms
- Contralateral Motor and sensory loss in Lower Extremities
- Poor gait and coordination (clumsy)
- Slowed initiation (Abulia)
- Flat Affect
- Urinary Incontinence
58
Posterior Cerebral Artery
- Accounts for 5-10% of strokes
- Supplies blood to cerebellum and brainstem
59
PCA stroke symptoms
- Impaired consciousness (pons)
- Nausea/Vomiting (medulla)
- Ataxia (cerebellum)
- Vision changes
- Nystagmus
60
Facts about arteriovenous malformations (AVM)
- Tangle of arteries and veins without connecting capillaries
- Acquired through inborn genetic mutation
- 1-2% of all strokes
- Variable size (2mm to several cm)
- Compresses neighboring structures and "steals” blood flow from surrounding regions
- Sx onset between ages 10-40
- Intracranial Hemorrhage most common presentation
61
What are the three common psychiatric considerations post-stroke?
Depresion, anxiety, psychosis
62
What are some facts about depression post-stroke?
- Occurs in 1 out of 3 survivors
- 6x greater risk of having depression 2-3 years post stroke
- More common in L frontal and basal ganglia strokes
- adversely effects functional recovery
- Antidepressant is crucial because there is neurochemical imbalance in the brain
- Risk Factors: Premorbid depression & Social isolation post stroke
63
What are some facts about anxiety post-stroke?
- 1 in 4 survivors meet GAD criteria post-stroke
- Less common than depression
64
What are some facts about psychosis post-stroke?
- More common in R-temporo-parietal-occipito area lesions, seizures, and subcortical atrophy
- Pseudobulbar Affect = 10-15% post stroke patients
- Hypomanic symptoms = 1%
65
What is pseudo bulbar affect?
Post-stroke psychosis symptom where the individual's body is unable to regulate their emotional expression (e.g., the person is watching something very sad, but they laugh)
66
If you suspect a stroke, BE FAST:
Balance
Eyes
Face
Arms
Speech
Time
67
What is tissue plasminogen (tPA)?
- One of the most effective treatment for stroke
- Must be administered within 4.5 hours
- helps restore blood flow to brain regions affected by stroke, but after 4.5 hours, increases hemorrhagic effect
68
What is the correctional mechanisms that replenish the body’s depleted stores of water or nutrients?
Ingestive Behavior
69
What is the fluid distribution in our body?
2/3 intracellular
1/3 extracellular
70
What are the two types of extracellular fluid?
- Intravascular (blood plasma)
- Interstitial (fluid that bathes the cells)
71
What is tonicity?
The ability of a surrounding solution to cause a cell to gain or lose water via osmosis in the relationships between interstitial and intracellular regions.
72
What bodily functions are based on negative feedback loop?
Hunger and thirst
73
How long does it take for the body to realize negative feedback loop of hunger?
20 minutes
74
What are the two types of thirst, and how are they different?
Osmometric: Interstitial fluid is hypertonic (e.g., salty food), which triggers cell dehydration; standard every-day thirst
Volumetric: Intravascular volume decreases (hypovolemia) caused by bleeding, vomiting, diarrhea; leads to increased blood pressure
75
T/F: Dehydration of cells is part of body’s natural dying process.
True
76
If IV fluids do not remain in the vascular system, it can cause:
Edema
Swelling
Eventual respiratory distress
77
Ketosis (resulting from reduction in eating) can have what effects on the body?
Reduction in appetite and thirst
Pain relief
Euphoria
78
What is the hormone released by the stomach when individuals are fasting or the digestive system is empty?
Ghrelin
79
When does ghrelin increase and decrease?
Increase: before eating
Decrease: after eating
80
How is ghrelin level related to cortisol level?
Inversely
Low ghrelin= increased cortisol (stress/anxiety)
High ghrelin= decreased cortisol (reduced stress/anxiety)
81
What is the brain-body mechanism of ghrelin?
- Ghrelin binds to receptors in the hypothalamus -> Activates Orexin producing neurons
-> Stimulates eating behaviors/hunger (e.g., GI contraction aka “growling”)
82
What is the Prader-Willi syndrome?
A genetic disorder where the individual never feel satiated (hyper-phagia due to excessive levels of ghrelin)
83
Which brain regions does ghrelin activate?
Lateral and Ventromedial hypothalamus
84
What is the function of Lateral Hypothalamus in eating?
Produces orexin and motivates eating behavior
Activated: overeating
Deactivated: stop eating
85
What is the function of Ventromedial Hypothalamus?
Activated: suppression of eating
Deactivated: overeating
86
What happens to ghrelin level with adjustable gastric band?
Ghrelin level initially drops, but increases by 50% at 8 months
87
Which chemicals produce significant weight loss in obesity?
Naltrexone (an opioid antagonist) and bupropion
(a dopamine agonist)
88
T/F: Nutritional value of food does not affect satiation.
False. Higher the nutritional value, the longer satiation lasts
89
T/F: Having more options for food and having larger plate size increases food intake.
True
90
Which vitamin deficiency is correlated with depression?
Vitamin D
91
What are some symptoms of magnesium deficiency?
- Increased agitation and anxiety
- headaches and sleeplessness
- restless leg syndrome
92
T/F: Omega-3 fatty oils can be an effective add-on for treatment (therapy) for depression.
True
93
What are some brain mechanisms seen in anorexia?
- Loss of gray and white matter in the brain
- Enlarged ventricles and widened sulci (shrinkage of brain tissue)
- Inhibited emotional facial expression
* Tissue loss can be reversed with successful treatment of the eating disorder
94
T/F: Anorexia is environmental, and its effect on tissue loss is irreversible.
False. Anorexia is 58-76% hereditary, and tissue loss can be reversed.
95
Which brain regions are associated with Bulimia nervosa?
- Precuneus (lower blood flow to this region)
- Amygdala (higher activation)
96
What are the most common causes of TBI for adolescents/YA and older adults?
Adolescents/YA: motor vehicle collisions
Older adults: falls
97
What are the two primary types of brain injuries, and how are they different?
Closed BI: no break in the skull
Penetrating BI: break in the skull (bone fragments can damage brain tissues and blood vessels); cognitive impairment tend to be more focal
98
What are the two common kinds of closed BI?
- Coup contrecoup
- Diffuse axonal injury
99
What are some facts about diffuse axonal injury?
- tearing of brain's connecting nerve fibers (axons) as the brain shifts and rotates inside the skull.
- damage to white matter
- changes are microscopic; difficult to see on CT/MRI
- can lead to disorders of consciousness
- three grades (Grade 1 is mild, Grade 3 is severe)
100
What are some secondary injuries that can result from TBI?
- increased intracranial pressure
- hypoxia
- hypotension
- hypothermia
- electrolyte disturbances
- toxic amino acids
- oxygen radicals
101
What are some facts about chronic traumatic encephalopathy (CTE)?
- produces neurodegeneration due to repeated head trauma
- commonly found in athletes
- can only be confirmed postmortem
- abnormal tau protein accumulation can look similar to Alzheimer's disease
- reduced brain volume and ventricular enlargement
- mood and cognitive impairment can appear years later (dysexecutive functioning and mood lability)
102
What are the three classifications of TBI?
Mild: unconscious for less than 30min, PT amnesia lasting less than a day
Moderate: unconscious for 30 min-24 hours, PT amnesia lasts 1-7 days
Severe: unconscious for more than 24 hours, PT amnesia lasts over a week
103
What are some conditions that should be considered when using the Glasgow coma scale?
If the client has used substance, medications, intubation, injury to the eye, hemiplegia, language
104
How can post traumatic amnesia behaviorally present?
- confused and disoriented
- agitation and aggression
- inability to recognize loved ones
- childlike/clingy behavior
- confabulation
105
What is the RLAS-R used for?
Measuring level of assistance needed after post traumatic amnesia
106
How long does it take for cognitive changes to resolve after mild TBI?
Within weeks to at most 3 months without treatment
107
How long does it take for cognitive changes to resolve after moderate to severe TBI?
Two or more years
108
What are some non-injury risk factors that can influence TBI outcomes?
- pre-injury psychiatric status (anxiety/depression)
- conduct issues/incarceration
- age at injury (the younger, the better)
- level of education (higher education, higher cognitive reserve)
- stable employment
- marital status (social support)
- physical injuries sustained as well
109
T/F: Stable employment 6 months pre-injury is the best predictor of return to employment post-injury.
True
110
How are post-concussion syndrome and somatization different?
Post-concussion syndrome: conscious attempt of over presenting symptoms for primary (e.g., Munchausen)or secondary (malingering) gain
Somatization: unconscious (e.g., somatic symptom disorder, illness anxiety disorder)
111
What are some microbes in our body?
- Bacteria (most often talked about)
- Archaea
- Fungi
- Protists
- Viruses
- Phages
- Microscopic animals
112
How many bacterias are in our body?
46 million
113
What is a commensal bacteria?
“communalness” of bacterias where their existence is dependent on each other
114
What are some neurochemical compounds that are produced in our guts?
- GABA
- Serotonin
- Dopamine
115
What are the difference between alpha and beta diversity?
Alpha diversity: how many species are present and how evenly they are represented in an individual
Beta diversity: comparing individuals to different samples
116
What are some impact that microbiota have in our body?
- impact gut-brain access
- organ development
- endocrine regulation
- immunoregulation
- metabolism
117
What are some impact that microbiota have in our body?
- impact gut-brain access
- organ development
- endocrine regulation
- immunoregulation
- metabolism
118
What are some immunoregulatory disorders that can result from decreased biodiversity?
- Asthma
- Crohn's
- MS
- type 1 diabetes
119
T/F: Inflammation can contribute to depressive symptoms
True
120
What is the biomarker for inflammation?
CRP
121
What are some facts that demonstrate correlation between trauma and microbiome?
- individuals with increased CRP (pre-deployment) had significant higher rate of developing PTSD
- rate of autoimmune conditions is higher for those with PTSD
- higher childhood trauma is correlated to lower microbiome abundance
- gut microbiome after TBI changes rapidly within 72 hours-7days, but it comes back
122
T/F: Those with PTSD tend to have low responsiveness of vagal tone.
False. Those with PTSD tend to have over-responsiveness of vagal tone
123
What's the difference between prebiotics and probiotics?
Prebiotics: substrate (aka food) for bacteria to grow (creating infrastructure, such as fiber, for bacteria to grow)
Probiotics: something that affects/adds to the microbiome
124
T/F: Stroke is the second leading cause of disability in adults
False. Stroke is THE leading cause of disability in adults.
125
What is a simple definition of stroke?
Interruption of normal blood flow to the brain
126
Hunt-Hess/Fisher comatose grading
*for SAH severity measurement
-Grade I: Asymptomatic or mild headache (lower mortality)
-Grade V: coma (higher mortality)
127
T/F: Aphasia is part of L ACA stroke.
False. Aphasia is part of L MCA stroke
128
What is the common cause and symptoms of Subarachnoid hemorrhage (SAH)?
-Common cause: aneurysm
-Common symptoms: sudden onset of headache and nausea, visual change, loss of consciousness
129
Hemiplegia v. Hemiparesis
Hemiplegia: paralysis affecting one side of the body
Hemiparesis: lesser degree of weakness than hemiplegia
130
What is apraxia?
Loss of ability to execute skilled or learned movement patterns on command in the absence of weakness, sensory loss, comprehension difficulty,
131
What is agnosia?
Disorder of recognition; Acquired inability to associate a perceived unimodal stimulus (i.e. visual, auditory, tactile) with meaning.
132
What symptom is different in intraparenchymal hemorrhage v. SAH?
Alteration of consciousness (v. loss of consciousness)
133
ICA Syndrome
Involves the MCA and ACA circulations
Can be very catastrophic
134
Lateral Medullary Syndrome (Wallenberg)
- Damage to the “fuse box” (medulla oblongata), the conduit of greater parts of the brain
-Symptoms include dysphagia, persistent vertigo, inability to swallow, loss of proprioception
