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Pathophysiology > Mental Health and Behavioural Disorders > Flashcards

Mental Health and Behavioural Disorders Flashcards

1
Q

What systems are activated in response to stress?

A

SNS and hypothalamus-pituitary-adrenal axis

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2
Q

What impact does chronic stress have?

A

Loss of muscle mass, nitrogen depletion, immune system suppression (decrease in T cells and their production), CVD wear and tear (with ongoing catecholamine surge)

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3
Q

Where are catecholamines produced?

A

Adrenal medulla (released by Chromaffin cells)

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4
Q

What does the body do in response to stress (real or perceived)?

A

Hypothalamus releases CRH, causes anterior pituitary to release ACTH, acts on the cortex to secrete cortisol AND aldosterone, medulla to release catecholamines

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5
Q

What happens to the feedback loop as a result of chronic stress?

A

Negative feedback loop becomes blunted, more cortisol and catecholamines released= wear and tear

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6
Q

What impacts does stress have on the brain?

A

Impairs hippocampal function (decreases volume, impairs short-term memory, alters regulation of stress response). Can lead to hippocampal atrophy and atrophy of neurons

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7
Q

What are the components of a neuron?

A

Dendrites (collects electrical signals), cell body (integrates incoming signals and generates outgoing signal to axon), axon (passes electrical signals to axon terminals), axon terminals (release neurotransmitters onto effector cells)

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8
Q

What are the four lobes of the brain and their functions?

A

Frontal (higher order, personality/behaviour, speech, planning, movement), parietal (somatosensation-pain, pressure, vibration), temporal (hearing), occipital (vision)

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9
Q

What is the role of the cerebellum?

A

Coordination of movement and balance

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10
Q

What are the functions of the brainstem?

A

Involuntary functions- breathing, arousal and sleep, eye movement

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11
Q

What is within the basal ganglia?

A

Caudate nucleus, putamen, globus pallidus, subthalamic nucleus, substantia nigra

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12
Q

What are some of the functions of the basal ganglia?

A

Initiation and regulation of movement

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13
Q

What are some of the functions of the hippocampus?

A

Learning and memory**

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14
Q

What are some of the functions of the thalamus?

A

Integrating center and relay station for sensory and motor function

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15
Q

What are some of the functions of the hypothalamus?

A

Homeostasis, behavioural drive

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16
Q

What structures are included in the limbic system?

A

Hippocampus, fornix, thalamus, amygdala, olfactory cortex, and cingulate gyrus

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17
Q

What are some of the functions of the limbic system?

A

Sets level of arousal, involved in motivation, reinforcing behaviours, regulates autonomic and endocrine function in response to emotional stimuli

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18
Q

How are neurotransmitters released?

A

Action potential reaches the axon terminal and activates Ca2+ channels, enters and stimulates exocytosis, neurotransmitters released into the synaptic cleft and bind with their receptors

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19
Q

How are neurotransmitters removed from the synaptic cleft?

A

Via diffusion, enzymatic digestion, reuptake

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20
Q

How are mental illnesses seperated?

A

Into alterations in thinking, mood, or behaviour

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21
Q

What is thought to contribute to MOST psychiatric disorders/mental illness?

A

Excessive CNS stimulation (except depression)

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22
Q

What are the three neurotransmitter systems?

A

Noradrenergic system, serotinergic system, dopaminergic system

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23
Q

What are the functions of the noradrenergic system?

A

Maintaining emotional tone (mood, arousal, wakefulness, reward), decrease associated with depression, increase associated with mania

24
Q

What are the functions of the serotonergic system?

A

Active in maintaining sleep-wake cycle, emotional tone, sensory perceptions (pain), increase associated with schizophrenia, decrease associated with anxiety and depression

25
Q

What are the four tracts of the dopaminergic system?

A

Nigrostriatal tract, tuberoinfundibular tract, mesolimbic tract, mesocortical tract

26
Q

What are the different mood disorders?

A

Depressive, bipolar, anxiety, trauma and stressor related disorders including OCD and PTSD

27
Q

What is dysthymia?

A

Persistent depressive disorder

28
Q

What is bipolar I disorder?

A

Classic manic-depressive disorder

29
Q

What is bipolar II disorder?

A

One episode of hypomania (milder forms of mood elevation) and major depression

30
Q

What is the neurochemical dysregulation hypothesis of major depression?

A

Monoamine hypothesis suggests MDD result of decreased norepinephrine, serotonin, and/or dopamine levels within the synaptic cleft

31
Q

What other neuroanatomic and functional abnormalities are seen in major depression?

A

Altered serotonin receptor expression, alterations in the norepinephrine system, changes to cerebral blood flow

32
Q

What are some of the pathophysiological processes thought to contribute to bipolar?

A

Genetics, neurochemical dysregulation (increased levels of serotonin, dopamine, norepinephrine), alterations in neuroendocrine system, increased ventricular volume, reduced prefrontal cortex, inflammatory component

33
Q

What pathophysiological changes occur in generalized anxiety disorder?

A

Decreased serotonin secretion/increased reuptake, genetics, alterations in distribution of benzo receptors

34
Q

What are some clinical manifestations of PTSD?

A

Lack of concentration, flashbacks to event that cause destress and emotional numbing, hyperviligance, irritability, sleeping difficulties, exaggerated startle

35
Q

What pathophysiological processes occur in PTSD?

A

Decreased volume of the hippocampus, decreased benzo receptor distribution in prefrontal cortex

36
Q

What is the role of GABA?

A

Blocks signals in brain and results in calming effect, controlling nerve cell hyperactivity

37
Q

What is the pathophysiological process behind OCD?

A

Abnormal communication b/t basal ganglia and prefrontal cortex, increased activity in the prefrontal cortex, decreased serotonin synthesis

38
Q

What is an example of a thought disorder?

A

Schizophrenia

39
Q

What characterizes schizophrenia?

A

Disorganized thoughts, often in the form of hallucinations, delusions, cognitive defects. Dysfunctions with perception, emotion, language, memory and judgment

40
Q

What are positive symptoms in schizophrenia?

A

Situations where individual loses touch with reality and experiences something that should be absent (hallucinations, delusions, disorganized speech)

41
Q

What are negative symptoms in schizophrenia?

A

Absence of something that SHOULD be occurring (affective flattening, anhedonia, alogia (inability to speak), avolition (lack of interest in goal directed behaviour)

42
Q

What is the role of glutamate?

A

Abundant excitatory neurotransmitter, plays role in memory, cognition and mood regulation

43
Q

What are some of the neurotransmitter alterations in schizophrenia?

A

Decreased GABA production in dorsolateral prefrontal cortex, decreased glutamate production, brain dopamine tracts altered

44
Q

What occurs in the dopamine tracts in schizophrenia?

A

Mesolimbic looks at emotion, rewards, memory and motivation (innervates hippocampus, amygdala, nucleus accumbens). Increased dopamine release in these areas= positive symptoms. Mesocortical involved in motivation and emotion (innervates dorsolateral prefrontal cortex), decreased dopamine reduces the activation= negative symptoms

45
Q

What is the key neurotransmitter in schizophrenia?

A

Dopamine, increased levels

46
Q

What are some examples of behavioural disorders?

A

Habituation and addition, eating disorders

47
Q

What occurs with dopamine in addiction?

A

Drugs of abuse activate the brain-reward pathways, have increase amount of dopamine in the synaptic cleft= sensation of reward, need larger amounts of dopamine to produce the same effect over time

48
Q

What are the key eating disorders?

A

Anorexia, binge eating disorder, bulimia nervosa

49
Q

What is the role of serotonin in eating disorders?

A

Disturbances in serotonin could contribute to appetite dysregulation, anxious and obsessional behaviours, extremes of impulse control. See decreased levels of serotonin

50
Q

What is the primary response of norepinephrine?

A

Vasoconstriction, stimulation of the A1 adrenergic receptors

51
Q

During a synapse, what change occurs after the neurotransmitter binds to the receptor?

A

Permeability of the postsynaptic neuron changes and consequently its membrane potential

52
Q

What are cholinergic receptors?

A

A part of the parasympathetic nervous system. Binds to acetylcholine

53
Q

What are adrenergic receptors?

A

A part of the sympathetic nervous sytem, binds catecholamines

54
Q

Can chemical synapses between neurons send messages in both directions?

A

No- neurotransmitter is stored on one side of synaptic cleft and receptor sites are on the other side

55
Q

List some of the lab values that may be abnormal in someone with anorexia.

A

Electrolytes, glucose, estrogen and sex hormones, kidney function, thyroid function, iron, acid/base imbalances, may see leukopenia/anemia/thrombocytopenia

56
Q
A

Pathophysiology (12 decks)

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