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Board Certification 2 (Purple book) > Neuro > Flashcards

Neuro Flashcards

1
Q

White matter

A

myelinated axons

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2
Q

Gray matter

A

Nerve bodies and dendrites

It’s the working area of the brain and contains the synapses

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3
Q

Sulci

A

Small shallow grooves

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4
Q

Fissures

A

Deep grooves

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5
Q

Gyri

A

raised tissue areas

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6
Q

The most basic division of the is the

A

Cerebrum and brainstem

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7
Q

Cerebrum

A

it’s the largest part of the brain, and it’s divided into the right and left hemispheres

Normal functioning requires coordination between the two hemispheres

Both hemispheres are connected by a large bundle of white matter, which is the corpus callosum.

Each hemisphere is divided into 4 lobes.

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8
Q

Left hemisphere of the cerebrum

A

In most people it’s the dominant side, and controls right sided functions

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9
Q

Corpus callosum

A

the large bundle of white matter between the 2 hemispheres.

It allows for communication between the 2 hemispheres.

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10
Q

Frontal lobe

A

Largest and most developed lobe

Motor function

Association cortex. It uses sensory info to trigger memories and lead to decision making

Executive functioning.

Speaking (Broca’s area)

Personality

Problems with the frontal lobe can effect personality, emotions, and intellect.

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11
Q

Temporal lobe

A

Understanding language (Wernicke’s area)

Hearing

Memory

Emotion

Integrating vision with other senses

Problems with the temporal lobe cause AVH, aphasia, amnesia

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12
Q

Occipital Lobe

A

It’s the main visual area

Integrates vision with other senses

Problems with this lobe can cause VH and vision problems

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13
Q

Parietal Lobe

A

Taste

Reading and writing

Problems with this lobe cause sensory-perceptual disturbances and agnosia (can’t recognize objects/people)

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14
Q

The cerebrum includes

A

the cerebral cortex

limbic system

thalamus

hypothalamus

basal ganglia

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15
Q

Cerebral cortex

A

Controls many different behaviors that make us human (speech, cognition, judgement)

Controls the contralateral (opposite) side of the body

Sensory information is relayed from the thalamus and then process in the cortex

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16
Q

Limbic System is composed of

A

Hypothalamus

Thalamus

Hippocampus

Amygdala

Basal ganglia

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17
Q

Hypothalamus

A

Basic functions:

Appetite, sleep, body temp, sex, hormones, water balance

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18
Q

Thalamus

A

A buffer to calm things down:

Relays information in such a way that the cortex doesn’t get overwhelmed

Regulates emotions

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19
Q

Hippocampus

A

Converts short term memory to long term

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20
Q

Amygdala

A

Primitives moods and feelings

connects smell to memories

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21
Q

Basal ganglia

A

Also known as the corpus striatum

Stabilizes motor functions
Initiating movement
Involuntary movements (muscle tone, posture)

Automatic functions that we don’t even think about, like walking or driving

Contains the extrapyramidal system, caudate, and putamen
Problems cause EPS (because it contains the extrapyramidal system)

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22
Q

Brainstem

A

It’s where neurotransmitters are made (it’s the primitive area, and animals need neurotransmitters too)

It includes:

Midbrain
Pons
Medulla
Cerebellum
Reticular formation system
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23
Q

Midbrain

A

The midbrain includes the ventral tegmental area and the substantia nigra (the areas where DA comes from)

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24
Q

Pons

A

The pons houses the locus ceruleus (where NE comes from)

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25
Q

Medulla

A

The medulla works with the pons, contains autonomic control centers that regulate body functions

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26
Q

Cerebellum

A

Equilibrium and balance

It has 2 hemispheres, each hemisphere controls the same side of the body that the hemisphere is on

Problems with the cerebellum are detected with the Romberg test

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27
Q

Reticular Formation system

A

Known as, the primitive brain

Gets input from the cortex and integrates postsensory pathways

Innervates thalamus, hypothalamus, and cortex

Involuntary movement, reflex, muscle tone, vital signs, alertness, focus

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28
Q

Two classes of cells are in the nervous system

A

Glia and neurons

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29
Q

Glia

A

They form myelin sheaths and nourish other cells

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30
Q

Depolarization

A

the excitatory part, when sodium and calcium flow into the cell

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31
Q

The four categories of neurotransmitters

A

Monoamines

Amino acids

Cholinergics

Neuropeptides

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32
Q

What makes something a neurotransmitter

A

It’s present in the nerve terminal

stimulating the neuron causes the transmitter to be released and have an affect on the next neuron

Effects of exogenous transmitter causes similar effect as the endogenous transmitter

There’s a mechanism for inactivating the transmitter in the synapse when it completes its task

Exogenous drugs alter the dose-response curve

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33
Q

The 4 monoamines (aka biogenic amines)

A

DA
5HT
NE
epinephrine

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34
Q

Dopamine (not the functions, just basics)

A

Known as catecholamine

Precursor to tyrosine

Comes from the substantia nigra and ventral tegmental

Removed from the synapse by MAO

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35
Q

The 4 DA pathways

A

Mesolimbic
Mesocortical
Tuberoinfundibular
Nigrostriatal

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36
Q

NE (not the functions, just basics)

A

also called catecholamine

Precursor is tyrosine

Removed from the synapse by reuptake

37
Q

Epinephrine (not the functions, just basics)

A

Also called catecholamine

comes from adrenal glands

38
Q

Serotonin (not the functions, just basics)

A

also called indole

precursor is tryptophan

39
Q

The 4 Amino acids

A

Glutamate

Aspartate

GABA

Glycine

40
Q

Glutamate (not the functions, just basics)

A

It’s the universal excitatory transmitter

Major neuron involved in the kindling process, which is the cause of seizure disorders and bipolar

An imbalance in glutamate can cause mood disorders and schizophrenia

41
Q

Aspartate (not the functions, just basics)

A

also an excitatory transmitter, it works with glutamate

42
Q

GABA (not the functions, just basics)

A

Universal inhibitory neurotransmitter

It’s where benzos have their action, and also alcohol, barbituates, CNS depressants

43
Q

Gylcine (not the functions, just basics)

A

Another inhibitory transmitter, it works with GABA

44
Q

Cholinergics (not the functions, just basics)

A

Acetylcholine

It comes from the basal nucleus of Meynert

The precursors are acetylcoenzyme and choline

45
Q

Neuropeptides (not the functions, just basics)

A

Non-opioid type (substance P, somatostatin), opioid type (endorphins, enkephalins, dynophins)

The modulate pain

Decreased neuropeptides is thought to cause substance abuse

46
Q

Enzymatic destruction of neurotransmitters

A

It happens in the cytosol or in the synapse

They are destroyed with MAO or catechol-O-methyl transferase (COMT)

47
Q

Psychiatric presentation: decreased acetylcholine

A 
alzheimer's 
impaired memory
Speech deficit 
Uninhibited 
Euphoria

Antisocial behavior

Dry mouth, blurred vision, constipation

48
Q

Psychiatric presentation: increased acetylcholine

A

Extrapyramidal movements
Parkinson’s symptoms
drooling
somatic complaints

Overly inhibited and self conscious
anxiety
depression

49
Q

Psychiatric presentation: too little DA

A

Parkinson’s

Substance abuse

Anhedonia

Poor impulse control
Poor spatiality
Lack of abstract thought

50
Q

Psychiatric presentation: too little NE

A

depression
dullness
low energy

51
Q

Psychiatric presentation: too much NE

A

anxiety
hyperalert/startles
paranoid
decreased appetite

52
Q

Psychiatric presentation: too little serotonin

A 
depression
OCD
anxiety
Schizophrenia
irritable
hostile 
sleep problems 
decreased appetite 
decrease libido
53
Q

Psychiatric presentation: too little GABA

A

anxiety
irritable
hostile
seizures

54
Q

Psychiatric presentation: too much glutamate

A 
BP
Psychosis
Kindling
seizures 
anxiety
55
Q

Psychiatric presentation: Too little glutamate

A

memory and learning problems
low energy
distractible
Negative symptoms of schizophrenia

56
Q

Psychiatric presentation: too little opioid neuropeptides

A

substance abuse
hypersensitive to pain
decreased pleasure
dyphoria

57
Q

Dopamine (function)

A 
thinking
decisions
reward seeking
fine muscle control
Integrated cognition
58
Q

NE functions

A

Fight or flight

Alertness 
Focus
Orientation
Learning
Memory
59
Q

Serotonin functions

A 
Mood
Sleep
Libido
Pain perception
Regulating aggression

Temperature

Precursor for melatonin

60
Q

Acetylcholine functions

A

Attention
Memory

Mood

Thirst
REM sleep
sex
muscle tone

61
Q

GABA functions

A

Reduces arousal
Reduces aggression
Reduces anxiety
Reduces excitement

62
Q

Glutamate functions

A

Memory

Sustained automatic functions

63
Q

Opioid peptides functions

A

Modulate emotions
Reward center
Memory

64
Q

Psychiatric presentation: too much DA

A

improved creativity
improved abstract thinking
improved executive functioning
Improved spatiality

65
Q

psychiatric presentation: too much serotonin

A

Rare hallucinations
Aggression
sedation

66
Q

Psychiatric presentation: too much GABA

A

Sedation
impaired memory
reduced cellular excitability

67
Q

Psychiatric presentation: too much opioid neuropeptides

A

Insensitive to pain
catatonic
AH
impaired memory

68
Q

The 3 basic categories of neuroimaging

A

Structural

Functional

Structural + Functional

69
Q

Structural imaging types

A

Computed Tomography (CT)

MRI

70
Q

CT scan

A

a structural imaging technique

It paints a picture based on which areas are the most dense

It can tell you, maybe, if there’s a brain based problem, but it doesn’t tell you anything specific about a psych disorder.

Good: It’s cheap and everyone has the equipment

Bad: Not that sensitive. Can’t differentiate white from gray. Can’t see things close to the bone, can’t see brain atrophy, can’t see sagittal and coronal views.

71
Q

MRI

A

It’s a kind of structural imaging

It works by giving you a series of 2 dimensional images.

Good: Everyone has the equipment, you can see things close to the skull, you can tell whats white and whats gray, and it has better resolution than a CT.

Bad: Expensive, many contraindications (pacemakers and other metallic stuff), claustrophobic.

72
Q

Functional imaging types (mainly used for research)

A

EEG

MEG (Magnetoencephalography)

SPECT (single photon emission computed tomography)

PET (positron emission tomography)

73
Q

EEG

A

Least expensive

Tells you about the electrical functioning in the CNS

74
Q

Magnetoencephalography (MEG)

A

Similarr to the EEG but detects different electrical activities, often used together with EEG

75
Q

SPECT

A

Tells you about the cerebral blood flow, expensive (but cheaper than PET), not everyone has the equipment,

76
Q

PET scan

A

It works by positrons interacting with electrons.

It’s very expensive and requires a whole team to operate it.

77
Q

Combined structural and functioning imaging

A

fMRI

3D event-related fMRI

Fluorine magnetic spectroscopy

78
Q

NE receptors

A

a1

a2

79
Q

Acetylcholine receptors

A

Nicotinic

Muscarinic

80
Q

GABA receptors

A

GABAa

GABAb

81
Q

Glutamate receptors

A

AMPA

NMDA

82
Q

Autosomal dominant conditions

A

may be present in more than 1 generation and in up to 50% of offspring when 1 parent is affected (such as Marfan syndrome)

83
Q

Recessive conditions

A

They appear only in 1 generation, affecting people who have 2 copies of the faulty gene, one from each unaffected parent. (hemochromatosis, cystic fibrosis)

84
Q

X-linked disorders

A

They are caused by faulty genes on an X chromosome (fragile X syndrome, color blindness)

85
Q

Risk assessment for genetic disorders is based on

A

inheritance patterns and may be expressed in a percentage of risk

86
Q

Genetics over view

A

There are 46 chromosomes, 23 pairs

The 4 bases of DNA are adenine, thymine, cytosine, and guanine. A is paired with T.

mRNA codes for amino acids

The genome is a complete set of DNA

A phenotype is the observable characteristics (for example, someone is a fast metabolizer of the CYP450 meds)

Gene therapy is when a faulty gene is replaced with a healthy one

Personalized medicine is health care based on genetics

87
Q

Gene expression and Disease

A

Single nucleotide polymorphisms detect single based changes in DNA sequence

Reduced penetrance of a gene decreases changes of disease in person at genetic risk

Variable expression of a gene for a disorder occurs at the cellular level

88
Q

HLA-B 1502 allele

A

The FDA requires testing for these allele in Asians taking carbamazepine

Board Certification 2 (Purple book) (22 decks)

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