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NeuroEndo Exam 2 > Lecture 6: Brain Arousal Systems > Flashcards

Lecture 6: Brain Arousal Systems Flashcards

1
Q

Eye/head motions

Sleep/wake cycle

Awareness

Verbal responses

Which are active in Coma patients

A

None but eye/head motions due to spinal or cortical reflexes may be seen

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2
Q

Eye/head motions

Sleep/wake cycle

Awareness

Verbal responses

Which are active in patient who is in a persistent vegetative state

A

Eye/ head motions

Sleep/wake cycles

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3
Q

Eye/head motions

Sleep/wake cycle

Awareness

Verbal responses

Which are active in patient who has minimal consciousness

A

Eye/head motions

Sleep/wake cycle

Awareness - inconsistent or intermittent

Verbal responses - inconsistent or itermittent

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4
Q

Eye/head motions

Sleep/wake cycle

Awareness

Verbal responses

Which are active in patient who is aware/alert

A

All of them

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5
Q

What are the levels of cosciousness

A
  1. Alertness
  2. Awareness (minimal consciousness)
  3. Arousal/Wakefulness (Persistent vegetative)
  4. Coma
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6
Q

What are the two parts of consciousness?

A

Arousal (being awake) Awareness (conscious processing of inputs)

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7
Q

What parts of of consciousness is missing in a coma?

A

Arousal and Wakefulness (EEG shows nothing)

Awareness

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8
Q

What parts of of consciousness is missing in a persistent vegetative state?

A

Awareness (Arousal is present on EEG)

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9
Q

What has to be damaged in cerebral cortex to cause comatose state?

A

Bilateral and massive damage

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10
Q

Injuries to what areas often cause disruptions to consciousness leading to a persistent vegative state?

A

Brainstem, Midbrain & Hypothalamus

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11
Q

What is the status of cortical neurons in a persistent vegetative state?

A

Hyperpolarized (30 mv below threshold)

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12
Q

State the Arousal System Heirachy

A
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13
Q

What NTs take one from a coma to Arousal/Wakefulness?

A

EAA

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14
Q

What supplies EAA

A

Reticular Activating System (RAS) - mid-ventral portion of medulla & midbrain

Parabrachial Nuclei - pons

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15
Q

What supplies the Cholinergeric system

A

Pedunculopontine Tegmental (PPT) Laterodorsal Nuclei (LDT)

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16
Q

Where supplies the Noradregenic (Norepinephrine) System

A

Locus Ceruleus

17
Q

Where are Dopaminergic inputs received from

A

Ventral Tegmental Area & Substantia Nigra

18
Q

What is the soruce of Seratonergic system?

A

Raphe Nucleus

19
Q

Why is Reticular Activating System not specific?

A

All sensory pathways converge at RAS and there is too much input - basically RAS is just an event detector

20
Q

How does RAS tell the cortex that something happened?

A
  1. Dorsal pathway
  2. Ventral pathway
21
Q

Where do the dorsal pathways go?

A

Arousal systems send axons to thalamus and synapse. Axons from thalamus then go to cortex to synapse.

22
Q

What are the axons from the thalamus to the cortex called in the dorsal pathway?

A

Thalamocortical neurons

23
Q

Ventral Pathway

A

Skips thalamus via basal forebrain and hypothalamus and send axons straight to cortex to synapse directly onto cortical neurons

24
Q

Difference between ventral and dorsal pathway

A

Ventral pathway

Release NTs produced by specific system

Dorsal pathway

  1. first synapse in thalamus - releases the NTs produced by the specific pathway.
  2. Second synapse in cortex - release NTs produced by specific system
25
Q

Differentiate between RAS & Parabrachial Nuclei

A

RAS located in midventral portion of medulla & midbrain / Parabrachial Nuclei located in pons

RAS outputs utilizes dorsal & ventral pathways / Parabrachial Nuclei only uses ventral pathway

Both are involved in general sensation

Both release EAA

26
Q

Differentiate between RAS & PPT/LDT

A
  1. Both RAS & PPT/LDT are involved general sensation and send their axons via the doral & ventral pathways.
  2. RAS releases EAA (EAA system)
  3. PPT/LDT releases Acethylcholine (Cholingeric system)
27
Q

What happens if there is damage to PPT/LDT?

A

Severe Cognitive Defects & Slowing of Cortical processes as seen in Alzheimer’s

28
Q

What NTs take one from Arousal/Wakefulness (PVS) to Awareness (minimal consciousness)?

A

Norepinephrine & Serotonin

29
Q

What pathways are used to produce awareness

A

Both dorsal and ventral

30
Q

What does it mean for sensory inputs to the Locus Coereuleus to be processed?

What does it release?

A

Sensory is no longer general as seen in RAS, PPT/LDT or parabrachial nuclei. Sensory receved in specific

Norepinephrine

31
Q

What is the role of norepinephrine?

A

Startle and Alert (EEG Manifestation)

Sleep - wake

behavioral vigilance

32
Q

Where is serotonin released and what is the role of serotonin?

A
  1. Raphe Nuclei
  2. Quiet Awareness (general awareness)

Mood & affect

Modulation of pain

33
Q

What NT takes one from Awareness to Alertness and where is it produced?

A

Dopamine

Ventral Tegmental Area (VTA)

34
Q

What does dopamine do?

A

Cognitive Function

Motor Activity

Emotion (pleasure)

35
Q

How are oscillations created on EEG?

A

Thalamocortical NTs release EAA (excitatory) and also bind to intracortical neurons to release GABA (inhibitory)

36
Q

What is affected in patients with Alzheimer’s?

A

Cholinergic systems: slow mental processes and impaired memory formation

37
Q

What can treat some people in a persistent vegetative state

A

L - dopa (Levodopa)

NeuroEndo Exam 2 (13 decks)

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