Neuro Flashcards
Name all portions of the limbic system (4)
- Amygdala
- Hippocampus
- Anterior Cingulate
- Cerebellum
Focuses on
a. aggression
b. fear/anxiety
c. emotions
What does the amygdala do?
It focuses on emotions, stress, learning, and memory.
What does the hippocampus do?
This part of the brain focuses on cognitive function, decision making, empathy/impulse, and emotions?
Anterior cingulate
It focuses on maintenance of balance and posture.
What does the Cerebellum do?
Depression in older adults.
Symptoms also include irritability, agitation, hallucinations, and delusionals
Pseudodementia definition
What kind of screening should you do for pseudodementia?
Do cognitive screening.
Primary dx is depression and they are often confused with dementia related symptoms.
Early signs of HIV dementia
- Cognitive decline
- Motor + Behavioral abnormalities
What are the steps to do with a patient who has early signs of HIV dementia from IV drug use?
- Order HIV test
- Then remove anti-retroviral therapy treatment.
- Refer PCP.
This is a brain disorder that can lead to problems with thinking, movement, behavior, and mood.
Common symptom is recurrent VH.
Lewy Body disease
Pick’s disease is what part of the brain?
- Frontotemporal (dementia)
- Frontal Lobe (dementia)
- Personality
- Behavioral
- Language changes
- Also effects social skills
Early stages of Pick’s disease
What does frontal lobe dementia cause?
It causes inappropriate social behavior and aggression.
Huntington’s Disease is also known as?
Subcortical Dementia
Huntington’s disease is characterized by what?
- Mostly characterized by motor abnormalities.
- Psychomotor slowing and difficulty with complex tasks.
What is produced in the locus coruleus and medullary reticular formation
Where is norepinephrine produced?
Raphe nuclei of the brainstem
Where is serotonin produced?
- Substantia nigra (regulates motor movement)
- Ventral tegmental area (VTA)
- Nucleus Accumbens
Where is Dopamine produced?
Is synthesized by the basal nucleus of Meynert.
Acetylcholine-where is it synthesized?
What are the four dopamine pathways?
- Mesolimbic
- Mesocortical
- Nigrostriatal
- Tuberoinfundibular
Hyperactivity of dopamine mesolimbic pathway mediates what?
It mediates positive psychotic symptoms.
Decreased dopamine in the mesocortical pathway is responsible for what?
It is responsible for negative and depressive symptoms of schizophrenia.
Mesocortical pathway is projected where?
Dorsolateral prefrontal cortex.
(Meso and dorso kinda rhyme)
Nigrostriatal pathway is responsible for what?
It mediates motor movements.
Dopamine blockage in the nigrostriatal pathway can lead to what increased neurotransmitters? And what symptoms does it cause?
- Increased acetylcholine levels.
- Increased salivation, teary eyes, and akathisia.
In the nigrostriatal pathway, what can metoclopramide (Reglan) cause?
It can cause EPS symptoms like TD and parkinsonism.
Increase in acetylcholine and decrease dopamine levels. This can lead to what?
EPS
Blockage of D2 receptors in this pathway can lead to increase prolactin levels which lead to hyperprolactinemia.
Tuberoinfundibular pathway
Due to the tuberoinfundibular pathway, high levels of prolactin, this can include symptoms of? (4 of them)
- Amenorrhea
- Galactorrhea
- Sexual dysfunction
- Gynecomastia
Long-term hyperprolactinemia can be associated with what?
Osteoporosis
Prolactin levels
Men and Women
Men = less than 20ng/ml
Women = less than 25ng/ml
Positive symptoms from excess dopamine between VTA and NA, antipsychotics decrease dopamine and therefore decrease positive symptoms (hallucinations).
Mesolimbic pathway
Dopamine going from VTA to cortex schizophrenia = decreased dopamine = negative symptoms (pleasure, facial expression, emotion)
Mesocortical pathway
Dopamine going from Substantia Nigra to Striatum = mediates motor movements.
We induce PARKINSONIAN symptoms if antipsychotic makes dopamine decrease.
Nigrostrial pathway
Parkinsonian symptoms and treatment
Decreased dopamine = cog wheel rigidity, resting tremors, shuffling gait.
Treatment = anticholinergic
Pathway between hypothalamus and pituitary gland
Tuberoinfundibular pathway
In the Tuberoinfundibular pathway
Too much dopamine = ??
Decreased prolactin
Tuberoinfundibular pathway
Decreased dopamine =??
Increased prolactin which also = galactorrhea and amenorrhea
EPS symptoms include: (4 of them)
- Dystopia
- Akathesia
- Parkinsonism
- TD
Dystonia symptoms and tx
- Sustained muscular contraction
- Ocuogynic crisis
- Treatment = anticholinergic
Akathesia definition and treatment
- Restlessness, pacing, tapping (ants in the pants)
- Treatment = beta blockers
Tardive Dyskinesia symptoms and treatment
- Lip-tongue smacking, repetitive, & uncontrolled.
- Treatment = d/c antipsychotic and +/- Clozapine
Neurological Malignant Syndrome symptoms
- Confusion
- Muscle rigidity
- Fever
- Tachycardia
NMS causes rhabdo. What Labs to check?
- CK
- K
- WBCs
