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eLCRS - 뉴로 > Neuro 15: Consciousness + sleep > Flashcards

Neuro 15: Consciousness + sleep Flashcards

1
Q

What are the 5 behavioral criteria of sleep?

A
  • stereotypic / species-specific posture
  • minimal movement
  • reduced responsiveness to external stimuli
  • reversible with stimulation
  • brain is still active when asleep
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2
Q

What are 3 methods of monitoring sleep?

A
  • EEG
  • EOG
  • EMG
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3
Q

Describe patterns in awakefulness

A

AWAKE:

  • fast brain rhythm in EEG (beta rhythm)
  • up to 30 Hz
  • reasonable amount of muscle tone
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4
Q

What happens in Stage 1 + 2 of sleep ?

A
  • light sleep (Non Rem)
  • person = becoming drowsy
  • EEG activity = slowing
  • gradually goes from BETA –> THETA
  • 4-8 Hz
  • no eye movements
  • general muscle activity = reduced
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5
Q

What happens in stage 3 + 4 of sleep ?

A
  • (Non-Rem)
  • there is translation from THETA –> DELTA activity
  • slowest rhythm at around 1Hz
  • minimal eye movement at this point
  • continued relaxation of muscles
  • very deep sleep
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6
Q

What happens in stage 5 ?

A
  • REM sleep
  • brain activity shifts abruptly back to FAST rhythm
  • rapid eye movements
  • muscle activity = at slowest
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7
Q

Describe the sleep cycle

A

from beta activity –> rhythm gets slower + slower –> transition period –> REM sleep

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8
Q

1 sleep cycle lasts about :

A

90 minutes

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9
Q

Note: Earlier on in sleep there is more non-REM sleep

A

-

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10
Q

how does HR differ in slow wave sleep + REM sleep

A

Slow wave sleep: HR is slow

REM Sleep: HR faster

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11
Q

how does respiration rate differ in slow wave sleep + REM sleep

A

Slow wave sleep: resp rate is slow

REM Sleep: resp rate faster

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12
Q

What system controls consciousness?

A
  • reticular activating system
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13
Q

Reticular activating system starts in:

A

Reticular activating system starts in: the brainstem

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14
Q

How does the reticular activating system influence the activity of the cerebral cortex?

A

a) directly

or

b) indirectly - via the intralaminar nuclei in the thalamus
note: higher activity of reticular activating system = higher level of arousal

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15
Q

What are the 2 nuclei in the hypothalamus that influences the RAS

A
  1. lateral hypothalamus
    - -> promotes wakefulness
    - ->excitatory input to RAS
    - active during the day
  2. Ventrolateral preoptic nucleus
    - -> negative effect on RAS
    - promotes sleep
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16
Q

What does the suprachiasmatic nucleus do?

A

it synchronizes sleep with falling light level

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17
Q

How does the suprachiasmatic nucleus synchronize sleep with falling light level ?

A
  • it receives input from retina
  • when light level falls –> suprachiasmatic nucleus becomes more ACTIVE
  • and activates large no. of nuclei in the hypothalamus
  • it INHIBITS the LH nucleus
  • and STIMULATES the VLOP nucleus
    and so at end of day you become more sleepy.
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18
Q

Suprachiasmatic nucleus has projection to the ____ _____

A

pineal gland

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19
Q

What happens when the suprachiasmatic nucleus activates the pineal gland at the end of the day?

A
  • pineal gland will secrete higher level of melatonin
  • which adjusts various physiological processes in the body that fit w sleep
  • at end of the night: melatonin levels fall
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20
Q

What are some effects of sleep deprivation?

A
  • sleepiness, irritability
  • performance decrements
  • concentration difficulties
  • glucose intolerance
  • hallucinations
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21
Q

What happens after sleep loss to regulate sleep?

A
  1. there is reduced latency to sleep onset
    - -> so you go to bed earlier the next day
  2. there is increase in slow wave sleep (NREM)
    - -> you sleep for longer
  3. there is an increase in REM Sleep
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22
Q

What are 3 main functions of sleep?

A
  • restoration + recovery
  • energy conservation
  • predator avoidance
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23
Q

Most of dreaming occurs during NREM/ REM sleep

A

Most of dreaming occurs during REM sleep

24
Q

What changes occur to brain activity when dreaming?

A
  • activity of limbic system = higher than frontal lobe
25
Q

What are 3 main functions of dreams?

A
  • acts as safety valve for antisocial emotions
  • disposal of unwanted memories
  • memory consolidation
26
Q

What are 2 main causes of chronic cases of insomnia?

A
  • physiological e.g sleep apnea, chronic pain

- brain dysfunction e.g depression

27
Q

How would you treat insomnia?

A
  • try and remove cause / sleep hygiene
  • use hypnotics
  • -> which work by enhancing inhibitory (GABAergic circuits) circuits in the brain
28
Q

What is narcolepsy?

A
  • fallin asleep repeatedly throughout the day

with disturbed sleep during the night

29
Q

What is cataplexy?

A

sudden onset of muscle weakness that may be precipitated by excitement / emotion

30
Q

What might be the cause of narcolepsy?

A

–> often due to dysfunction of control of REM sleep

or due to orexin/hypocretin deficiency

31
Q

How might night shift lead to sleep disorders?

A
  • causes physiological processes to become desynchronized
32
Q

Define consciousness

A

state of being aware of + responsive to one’s surroundings

33
Q

What are 3 main disorders of consciousness?

A
  1. coma
  2. vegetative state
  3. minimally conscious state
34
Q

What is meant by coma?

A

state of being unarousable/ unresponsiveness lasting more than 6 hours in which a person:

  • can’t be awakened
  • fails to respond normally to painful stimuli / light/ sound
  • NO normal sleep-wake cycle
  • does not initiate voluntary action
35
Q

What is meant by vegetative state?

A
  • state of wakefulness without awareness with preserved capacity for:
  • spontaneous stimulus
  • sleep-wake cycles
  • and reflexive/spontaneous behaviors
  • characterized by complete absence of behavioral evidence for self/ environmental awareness

(lights are on - but no one’s home)

36
Q

What is meant by Minimally conscious state?

A
  • state of severely altered consciousness
  • where there is minimal but clearly discernible behavioral evidence of self/environmental awareness.
  • characterized by inconsistent but reproducible response above level of spontaneous or reflexive behavior
  • with some degree of interaction with surrounding
37
Q

Which part of the brain is affected in vegetative state?

A
  • there is destruction of cortex + hemisphere
38
Q

Which part of the brain is affected in locked in syndrome?

A
  • there is damage to ventral pons
39
Q

Which part of the brain is affected in brain stem death?

A
  • irreversible damage to brain stem
40
Q

What type of test is used to monitor the level of arousal?

A

electroencephalography

41
Q

What are some causes of coma?

A

a) hemisphere lesion
e. g cerebral infarct
- cerebral hemorrhage
- abscess
- tumor

b) brainstem
- brainstem infarct
- tumor
- abscess
- cerebellar hemorrhage
- cerebellar infarct

c) metabolic
- drug overdose
- hypoglycemia
- hypercalcaemia

d) diffuse injury
- meningitis
- head injury
- epilepsies

others: diffuse axonal injury, posterior fossa lesion

42
Q

what is used to classify coma?

A

glasgow coma scale

score of 3 = serve brain injury + brain death

low GCS - think about protecting airway (<8)

43
Q

how might you improve sleep? (sleep hygiene)

A
  • establish fixed times for going to bed / waking up
  • only go to bed when you are tired
  • avoid caffeine
  • avoid eating heavy meal at late night
  • don’t use back-lit devices shortly before going to bed
44
Q

What is meant by Hypersomnia

A

excessive daytime sleepiness

45
Q

What are some Common cause of hypersomnia?

A 
main cause: can't sleep at night 
- obstructive sleep apnea 
- restless elg syndrome 
- neurodegenerative diseases e.g parkinson 
- anxiety 
etc.
46
Q

how would you quantify sleep in a test?

A
  • epworth sleepiness scale

rating likelihood of dozing in various situations e.g whilst sitting + reading

47
Q

What does reticular formation do?

A

involved in:

  • cardiovascular control
  • sleep and consciousness
  • pain modulation
  • in maintaining posture
48
Q

note:
Brain activity = both integrated + differentiated.
e.g general seizures = highly integrated, but not differentiated

A

-

49
Q

note: cognitive function = occurs through various network of brain regions

A

-

50
Q

How is PCI used to quantify level of consciousness?

A

induce TMS –> measure rain activity with EEG afterwards a) if awake = pulse moves around brain
b) if asleep = signal doesn’t spread throughout brain

51
Q

What is locked in syndrome?

A

When there is:

  • no motor output
  • but consciousness / awareness is normal
52
Q

Arousal: Yes
Awareness: No

A

Vegetative state

53
Q

Arousal: No
Awareness: No

A

Coma

54
Q

Whats the difference between hemianopia and visual neglect

A

hemianopia - visual defect due to lesion to underlying pathway

visual neglect - higher order problem
- underlying pathway is intact
but perception is different (preference to one side)

55
Q 
Note: EEG 
lower frequency (e.g theta + delta)= usually bad 
higher frequency (e.g alpha) = usually more linked to cognitive function
A

alpha = good sign

- more prominent posteriorly, when eyes are closed/

56
Q

What happens in Diffuse axonal injury

A
  • patient would have higher order cognitive function defects
  • e.g shown during a conversation

eLCRS - 뉴로 (16 decks)

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