Neuropsych Flashcards
0
Q
What is the difference between retroactive amnesia and anterograde amnesia?
A
Retrograde amnesia–amnesia of memories of events prior to trauma.
Anterograde amnesia–amnesia of memories after a trauma.
1
Q
Describe the different aphasias, wernicke’s, broca, and conduction. What do they have in common?
A
All have impaired repetition of verbal tasks.
Wernicke’s–can’t comprehend language. Do speak fluently but meaningless sentences.
Broca–problems with articulation, changes in prosody (rhythm and tone), and some comprehension problems.
Conduction..connection of these two areas damaged. Path betwn reception and articulation damaged.
They understand language, speak fluently but have anomia and difficulty repeating what they heard.
2
Q
What is the difference between the recency effect, Barnum effect, and the auto kinetic effect?
A
Recency effect—improved memory for later items in a word series.
Barnum effect–ppl identify with vague descriptions of themselves, like a horoscope.
Auto kinetic effect– illusion of movement that occurs when a stationary pinpoint of light is shined in a dark environment.
3
Q
Pt with OCD and Tourette’s presents. Where is the neurological problem?
- Temporal lobe
- Amygdala
- Prefrontal cortex
- Basal ganglia
A
Both linked to basal ganglia which has a group of nuclei deep in the brain involved in the initation of movement.
Tourette’s–caudate nucleus smaller and is predictive of severity.
Substantial nigra, ventral striatum, globus pallidus also involved.
Basal ganglia get instructions from prefrontal cortex.
4
Q
Where is the amygdala and what are its functions?
A
Amygdala is part of the limbus system.
Involved with emotion
Especially aggression.
5
Q
Long term potentiation is a process that affects:
- Homeostasis
- Emotional development
- Addiction
- Memory
A
- Process by which short term memories become long term is called long term potentiation. Repeated stimulation of a synapse through rehearsal leads to chemical and structural changes in dendrites receiving neuron. So neuron is more sensitive to stimulation.
6
Q
Which neurotransmitter is implicated in the etiology of dementia of the Alzheimer’s type?
- Dopamine
- norepinephrine
- Serotonin
- Acetylcholine
A
- Lower levels of a phosphate that is a precursor to Ach.
7
Q
72 yr old with hypertension has a stroke, resulting weakness of left hand and arm. Ct would also show:
- Left visual field damage and visualspatial deficits.
- Rt visual field and visualspatial
- Left visual field and language deficits.
- Rt visual field and language deficits.
A
Weakness in left side indicates right hemisphere damage. Ea side of the body is controlled by opposite hemisphere. Visual spatial is a right hemisphere fx.
Language deficits expected with damage to left hemisphere.
11
Q
What does acetylcholine do?
A
Excitatory or inhibitory nt depending on location.
Control voluntary movement Learning Memory Sexual behavior Sleep
Depletion leads to memory loss associated with Alzheimer’s dementia and normal aging.
12
Q
What disorders have abnormal levels of dopamine?
A
Dopamine plays a role in movement, learning, mood and reinforcing effects of stimulants, nicotine, opiates and nicotine.
Abnormal levels linked to Depression Schizophrenia Tourette's ADHD Huntington's disease Parkinson's
13
Q
What 2 things impact the speed of conduction?
A
Conduction is electrochemical process by which info is received and processed in a nerve cell. Inside cell negatively charged. When get stimulation from other cells the balance changes and the interior is less negative. It becomes depolarized and triggers am action potential.
Speed impacted by
Diameter of the axon..larger is faster
Axon covered by myelin. Thicker increases speed.
14
Q
Which neurotransmitter plays a role in long term potentiation, which is involved in the formation of memories? A. GABA B. acetylcholine C. Norepinephrine D. Glutamate
A
D.
15
Q
Two disorders associated with the malfx of pancreas are: A. Addison and Cushing disease B. diabetes mellitus and insipid is C. Diabetes mellitus and hypoglycemia D. Addison's and hypoglycemia
A
C
16
Q
What is GABA?
A
Main inhibitory neurotransmitter that contributes to motor control and regulates anxiety.
Abnormalities linked to Insomnia Anxiety disorders Huntington's disease Parkinson's
17
Q
What is glutamate?
A
The main excitatory neurotransmitter. Role in memory and learning. Long term potentiation.
Implicated in Alzheimer's Huntington's Parkinson's Seizure Stroke
18
Q
What does serotonin play a role in?
A
Regulation of anxiety, mood, memory, aggression, pain, sleep, appetite, sexuality. (M2aps2)
Many meds that regulate anxiety or depression affect serotonin.
19
Q
In most ppl the right hemisphere is dominant for: A. Spoken language B. positive emotions C. Visual spatial skills D. All the above
A
Right hemisphere
Visual spatial relations
Creativity
Holistic thinking
Negative emotions
Left hemisphere..usually dominant
Language
Logic
Analytic thinking
Positive emotions
20
Q
When split brain patients were shown a pic to the left visual field only. What happened?
A
Pt could not verbally id object or pick or out from many objects w rt hand. Could pick w left hand.
Show pic to right visual field only. Could verbally identify and pick out object w rt hand. Not able to w left.
21
Q
What is getstmanns syndrome?
A
Caused by lesions in the left parietal lobe.
Agraphia
Acalculia
Finger agnosia
Left rt disorientation
22
Q
What makes up the hind brain? What are their functions and disorders?
A
Medulla…regulates vital fx….death
Reflexes
Pons..connects 2 parts cerebellum
Relays sensory and motor info
Regulates arousal
Cerebellum..balance, coordination, posture…ataxia, tremors, loss of balance
23
Q
What makes up the midbrain? What are their functions and related disorders?
A
Reticular activating system…sleep wake cycle, screens incoming sensory info…coma
Substantial niagra..voluntary movement and reward seeking…
Parkinson’s
24
Q
What makes up the forebrain? What are their functions and related disorders?
A
Hypothalamus..homeostasis, motivated behaviors, strong feelings into physical responses….
Hormonal/emotional disturbances
Inability regulate eating, drinking, temp
Thalamus..relays sensory info to cortex (not olfaction)…
Language, memory, motor
Hypothalamus
Mammillary bodies damaged (thiamine due drinking) korsakoffs
Suprachasmic nucleus regulates circadian
Basal ganglia..(caudate nucleus, globus pallidus, putmen)…voluntary movement, outward emotional expression, sensory movement …
Tourette’s, OCD, ADHD, Parkinson’s, schiophrenia, Huntington’s.
Limbic system..
Amygdala..integrate emotional rx, emotions attached to sensory, mediated defensive/aggressive behavior…lack emotional response, kluver-bucy
Hippocampus…memory consolidation…Alzheimer’s, dementia
Septum..inhibits emotions
cingulate cortex..pain perception and regulates emotions
25
Q
What areas make up the frontal lobes? What are the functions and related disorders?
A
Primary cortex
Premotor cortex
Broca’s area aphasia
Prefrontal cortex (damage causes dysexecutive syndrome, pseudo depression, pseudopathology, ADHD, bipolar, schizophrenia)
26
Q
What makes up the temporal lobe?
What is the function and related disorders?
A
Auditory processing (receptive), long term memory, and emotion.
Auditory cortex…auditory agnosia, auditory hallucinations,
Wernicke’s area aphasia
27
What does the parietal lobe contain and what are the disorders in this area?
Somatosensory cortex..touch, kinesthesia, pressure, pain, temperature, integrates
Somatosensory agnosia
Apraxia (purposeful movement even with normal fx)
Contra lateral neglect..lack interest one side body
Getstmanns syndrome (ageaphia, acalculia, finger agnosia, left rt disorientation)
28
What does the occipital lobe do and what are common disorders?
Visual processing
Cortical blindness
Blind spots
Loss of depth perception
Jx occipital, temporal, parietal causes prosopagnosia
29
What do the different hemispheres of the cerebral cortex do in regard to emotions?
The left or dominant side is associated with positive emotions. Lesions produce depression, anxiety, fearfulness.
The right or nondominant side is associated with negative emotions, such as apathy, indifference, inappropriate euphoria
30
Describe the James Lang theory of emotion.
Arousal is interpreted as emotion.
Afraid because we tremble.
Sad because we cry
31
Describe the cannon bard theory of arousal.
Simultaneous activity (sympathetic nervous system and cortex)
Arousal and emotion same time.
Sympathetic nervous system produces physical arousal (same for all emotions) while cortex produces emotional feelings.
When event is perceived (take test) messages are sent at the same time to hypothalamus which arouses body and the limbic system which causes the subjective feelings.
32
Describe schachter and singers theory of emotion.
Cognitive arousal theory
Combo physical arousal and cognitive attributions for that arousal.
Physical sensations similar for most emotional states.
Specific emotion depends on attribution.
Epinephrine study...environmental cues determine attributions for arousal.
33
How does sexual development occur?
Hypothalamus stimulates pituitary gland which produces gonadotropin hormones. These hormones stimulate sex hormones (from tested or ovaries).
Hypothalamus-pituitary-gonadal axis (HPG) onset during puberty. Genetically and environmentally programmed.
34
What structures of the brain show sexual dimorphism, or sex related differences in physical appearance?
Found in the size, shape, or volume of corpus collision, hippocampus, amygdala, and cerebellum.
May be due to exposure of testosterone and other androgens in prenatal and early postnatal pd.
35
Discuss the 5 sleep stages.
Go through stages every 90 mins
```
1--alpha waves..fast, relaxing
Move to slower theta waves
2- theta waves..light sleep
3-slow, large delta waves..transition
4- large, slow delta waves. Deep sleep
5-REM. paradoxical sleep. Hrate and breathing like awake, difficult to wake. Vivid dreams.
```
Most stage 3, 4 occur early part. REM pds increase in length as nite goes on.
36
What is the pattern of sleep duration over the life span?
First 6 mo.. REM and non REM. during the first 2 or 3 mo..starts with REM.. This reverses.
Total sleep time, stages 3 and 4 sleep, and REM sleep decrease from childhood to adulthood.
Stages 3 and 4; REM continue to decrease through adulthood
Sleep time...newborns...16 hrs
....preadolescents ...10 hrs
Adults...8 or less
Infancy..REM is 50 percent
Adult..REM is 20 percent
Older adults not require total less sleepy than young adults..more trouble falling asleep, wake in nite, experience advanced sleep phase (shift in timing of sleep involves going to sleep earlier and waking earlier)
37
What brain structures are involved in memory?
Hippocampus is involved in memory consolidation (st to ltm)
Amygdala is involved in emotional memories
Prefrontal cortex...working and prospective memory (do in future)
Temporal lobes...stores long term declarative memories.
38
Long term potentiation...first seen in glutamate receptors of hippocampus and later the brain. Hi frequency stimulation of neurons increases sensitivity and structure of dendrites...memories form
Protein synthesis...new ones for LTM and modifyjng pre existing proteins for STM. Administering a drug that blocks protein synthesis or RNA (needed for synthesis) prevents formation of lt memories.
Neural foundations for memory.
39
Papez's circuit was identified as a neural pathway involved in:
A. Fight or flight
B. experience and expression of emotion
C. Onset of puberty
D. Coordination of movement in rt and left sides of body
B. proposed expression of emotion governed by hypothalamus
| Experience of emotion is result of interactions among hypothalamus and other structures.
40
What is the difference between sensation and perception?
Sensation is the receipt of info by sensory receptors and translation of info to nerve impulses sent to brain.
Perception is process of becoming aware of and interpreting what has been sensed.
41
What is the visual pathway?
Light waves enter the eye and pass through cornea (transparent cover), pupil (opening in iris; opens and closes to regulate amt of light), and lens (focus light waves on retina at back of eye with 2 types of photoreceptors.
42
Describe the two types of photoreceptors.
Rods--black, white, grey
Periphery of retina
Sensitive to brightness
Sense stimuli in lo lite
Cones--detect color
Cluster center of eye (fovea)
Fx best in bright lt
Greater visual acuity than
Rods
43
What is the blind spot?
Where the optic nerve leaves the retina. There are no photoreceptors.
44
What visual fields are seen by the left hemisphere optic tract?
Right visual field of both eyes.
Optic tract to rt hemisphere carries signals from left visual field of both eyes.
Signals then travel via each optic tract to lateral geniiculate nucleus in thalamus and primary visual cortex in occipital lobe.
45
Explain the young helmhoktz trichromatic theory and compare it to herings opponent process theory.
Trichromatic theory..3 types of color receptors (cones) that respond to a different primary color..red, blue, green. 1 st level of processing in the retina.
Opponent process theory ...3 types of cells (red/ gn, blue/yellow. Black/white). Overall stimulating pattern produces colors. Explains after images .
Second level of processing.
46
```
In most ppl the right hemisphere is dominant for:
A. Spoken language
B. positive emotions
C. Visual spatial skills
D. All the above
```
```
Right hemisphere
Visual spatial relations
Creativity
Holistic thinking
Negative emotions
```
```
Left hemisphere..usually dominant
Language
Logic
Analytic thinking
Positive emotions
```
47
When split brain patients were shown a pic to the left visual field only. What happened?
Pt could not verbally id object or pick or out from many objects w rt hand. Could pick w left hand.
Show pic to right visual field only. Could verbally identify and pick out object w rt hand. Not able to w left.
48
What is getstmanns syndrome?
Caused by lesions in the left parietal lobe.
Agraphia
Acalculia
Finger agnosia
Left rt disorientation
49
What makes up the hind brain? What are their functions and disorders?
Medulla...regulates vital fx....death
Respiration, cardiovascular activity, sleep, consciousness
Pons..connects 2 parts cerebellum
Relays sensory and motor info
Regulates arousal
Cerebellum..balance, coordination, posture...ataxia, tremors, loss of balance
50
What makes up the midbrain? What are their functions and related disorders?
Reticular activating system...sleep wake cycle, screens incoming sensory info...coma
Substantial niagra..voluntary movement and reward seeking...
Parkinson's
51
What makes up the forebrain? What are their functions and related disorders?
Hypothalamus..homeostasis, motivated behaviors, strong feelings into physical responses....
Hormonal/emotional disturbances
Inability regulate eating, drinking, temp
Thalamus..relays sensory info to cortex (not olfaction)...
Language, memory, motor
Hypo or thalamus?
Mammillary bodies damaged (thiamine due drinking) korsakoffs
Suprachasmic nucleus regulates circadian
Basal ganglia..(caudate nucleus, globus pallidus, putmen)...voluntary movement, outward emotional expression, sensory movement ...
Tourette's, OCD, ADHD, Parkinson's, schiophrenia, Huntington's.
Limbic system..
Amygdala..integrate emotional rx, emotions attached to sensory, mediated defensive/aggressive behavior...lack emotional response, kluver-bucy
Hippocampus...memory consolidation...Alzheimer's, dementia
Septum, cingulate cortex
52
What areas make up the frontal lobes? What are the functions and related disorders?
Primary cortex
Premotor cortex
Broca's area aphasia
Prefrontal cortex (damage causes dysexecutive syndrome, pseudo depression, pseudopathology, ADHD, bipolar, schizophrenia)
53
What makes up the temporal lobe?
| What is the function and related disorders?
Auditory processing (receptive), long term memory, and emotion.
Auditory cortex...auditory agnosia, auditory hallucinations,
Wernicke's area aphasia
54
What does the parietal lobe contain and what are the disorders in this area?
Somatosensory cortex..touch, kinesthesia, pressure, pain, temperature, integrates
Somatosensory agnosia
Apraxia (purposeful movement even with normal fx)
Contra lateral neglect..lack interest one side body
Getstmanns syndrome (ageaphia, acalculia, finger agnosia, left rt disorientation.
55
What does the occipital lobe do and what are common disorders?
Visual processing
Cortical blindness
Blind spots
Loss of depth perception
Jx occipital, temporal, parietal causes prosopagnosia
56
What do the different hemispheres of the cerebral cortex do in regard to emotions?
The left or dominant side is associated with positive emotions. Lesions produce depression, anxiety, fearfulness.
The right or nondominant side is associated with negative emotions, such as apathy, indifference, inappropriate euphoria
57
Describe the James Lang theory of emotion.
Arousal is interpreted as emotion.
Afraid because we tremble.
Sad because we cry
58
Describe the cannon bard theory of arousal.
Simultaneous activity (sympathetic nervous system and cortex)
Arousal and emotion same time.
Sympathetic nervous system produces physical arousal (same for all emotions) while cortex produces emotional feelings.
59
Describe schachter and singers theory of emotion.
Cognitive arousal theory
Combo physical arousal and cognitive attributions for that arousal.
Physical sensations similar for most emotional states.
Specific emotion depends on attribution.
Epinephrine study...environmental cues determine attributions for arousal.
60
How does sexual development occur?
Hypothalamus stimulates pituitary gland which produces gonadotropin hormones. These hormones stimulate sex hormones (from tested or ovaries).
Hypothalamus-pituitary-gonadal axis (HPG) onset during puberty. Genetically and environmentally programmed.
61
What structures of the brain show sexual dimorphism, or sex related differences in physical appearance?
Found in the size, shape, or volume of corpus collision, hippocampus, amygdala, and cerebellum.
May be due to exposure of testosterone and other androgens in prenatal and early postnatal pd.
62
Discuss the 5 sleep stages.
Go through stages every 90 mins
```
1--alpha waves..fast, relaxing
Move to slower theta waves
2- theta waves..light sleep
3-slow, large delta waves..transition
4- large, slow delta waves. Deep sleep
5-REM. paradoxical sleep. Hrate and breathing like awake, difficult to wake. Vivid dreams.
```
Most stage 3, 4 occur early part. REM pds increase in length as nite goes on.
63
What is the pattern of sleep duration over the life span?
First 6 mo.. REM and non REM. during the first 2 or 3 mo..starts with REM.. This reverses.
Total sleep time, stages 3 and 4 sleep, and REM sleep decrease from childhood to adulthood.
Stages 3 and 4; REM continue to decrease through adulthood
Sleep time...newborns...16 hrs
....preadolescents ...10 hrs
Adults...8 or less
Infancy..REM is 50 percent
Adult..REM is 20 percent
Older adults not require total less sleepy than young adults..more trouble falling asleep, wake in nite, experience advanced sleep phase (shift in timing of sleep involves going to sleep earlier and waking earlier)
64
What brain structures are involved in memory?
Hippocampus is involved in memory consolidation
Amygdala is involved in emotional memories
Prefrontal cortex...working and prospective memory
Temporal lobes...stores long term declarative memories.
65
Long term potentiation...first seen in glutamate receptors of hippocampus and later the brain. Hi frequency stimulation of neurons increases sensitivity and structure of dendrites...memories form
Protein synthesis...new ones for LTM and modifyjng pre existing proteins for STM. Administering a drug that blocks protein synthesis or RNA (needed for synthesis) prevents formation of memories.
Neural foundations for memory.
66
Papez's circuit was identified as a neural pathway involved in:
A. Fight or flight
B. experience and expression of emotion
C. Onset of puberty
D. Coordination of movement in rt and left sides of body
B. proposed expression of emotion governed by hypothalamus
| Experience of emotion is result of interactions among hypothalamus and other structures.
67
What are the theories of color vision?
Trichromatic theory by young helmholtz...3 types of cones that respond to red, blue, green. Applies to the first level of processing in the retina.
Herings opponent process theory says 3 types of opponent process cells (red-green; blue- yellow; black-white). Applies to the second level of processing that occurs as visual signals pass from retina to visual cortex.
68
What is the auditory pathway?
Ear to auditory canal to eardrum to membrane that vibrates in response to sound waves. Vibs picked up and amplified by ossicles and transmitted to the oval window. Movement here exerts pressure on liquid in cochlea and produces movement in hair cells (auditory receptors). Vibs made to neural activity via auditory nerve is to thalamus, and auditory cortex.
69
What are the components of sound?
Loudness...amplitude if waves. Db
Decibels. Convo is 60
Pitch frequency of sound waves. Measured cycles per sec. Humans range is 20 to 20,000 hertz
Timbre to tone quality and sounds waves complexity. Makes it possible to distinguish between 2 sounds have same loudness and pitch.
70
What is pain effected by?
Not caused by a single stimuli but by several types of stimuli like heat; pain, pressure,....
Sensitivity is affected by past pain experience, presence of anxiety, or depression .
For some, more previous experience , greater sensitivity.
71
What is the gate control theory?
Activation of large myelinated nerve fibers that carry info about touch, pressure, and vibration inhibits transmission of pain by small un myelinated nerve fibers.
Close the gate with massage, heat, cold, info traveling from brain (distraction reduces pain).
72
What is neuropathic pain?
Caused by nervous system trauma, surgery, disease, and drugs. Phantom limb pain example. Cause unknown...think due to damage to neurons in CNS or PNS. Psych factors don't cause it may play role in course and severity.
Drug tx..antidepressants (esp tricyclics like amitryptyline, doxepin, imipramine and SRNI venlafaxine)., opioids, anticonvulsants, topical analgesics.
Some evidence TENS reduces...transcutaneous nerve stimulation.
73
What is synesthesia?
Joining senses
Involuntary perceptual condition in which stimulation of one sensory modality elicits a sensation in another.
60 forms
Involve any of the senses
Most common is grapheme synesthesia in which numbers or letters are associated w specific colors.
May be due to limbic system, increased connectivity between associated regions, mostly think genetic reasons.
May be due to sensory deprivation, drug use, or brain damage.
74
What is psychophysics?
What are the two thresholds for studying it?
Relationship between the magnitude of physical stimuli and psychological stimulation.
Fechners thresholds:
1. Absolute threshold...weakest stimulus person can detect. Defined as intensity at which a physical stimuli is detected 50 percent of the time.
2. Just noticeable difference... Smallest physical difference between two stimuli that is recognized as a difference. This varies due to stimulus type and initial intensity.
75
What are the psychophysical laws?
Webers law...jnd increases in size proportionate to magnitude of the stimulus.
Fechners law...logarithmic relationship between psych sensation and magnitude of physical stimulus. Internal stimulus increases arthmetically and physical increase geometrically.
More accurate for extreme.
Not work for all types of stimuli.
Stevens power law..corrects others
Exponential relationship between psych sensation and physical magnitude. Exponent varies by stimuli. Research using method of magnitude estimation (students assigned numbers to stimul)
76
Whose law says there is a logorithmic relationship between psych sensation and intensity of physical stimulus.
A. Fechner
B. weber
C. Stevens
D. Thorndike
A
77
Which transforms sound waves into neural signals?
A. Ossicles
B. hair cells
C. Eardrum
D. Bipolar cells
B
78
```
Stare at red square shift to rt and see image of ----- square. This supports what?
A. Green, opponent
B. green, trichromatic
C. Blue, opponent
D. Blue, trichromatic
```
A
79
Gate control theory explains:
A. How neurotransmitters reduce the likelihood that an action potential will occur.
B. how certain stimuli can block or modify pain perception
C. Why the magnitude of just noticeable difference differs for different stimuli.
D. How sounds vary in terms if timbre.
B
80
```
Which drug is useful for alleviating neuropathic pain?
A. Lithium
B. clozapine
C. Methylphenidate
D. Amitryptyline
```
D
81
```
Joe sees the number 1 as a green number, 2 as purple, and 3 as red. This condition is:
A. Getstmanns syndrome
B. prosopagnosia
C. Synesthesia
D. Agnosia
```
C
82
What are the structural brain imaging techniques? What do structural techniques do?
Structural techniques identify structural changes due to blood clots, tumors, strokes, degenerative disease, inflammation, infection.
Both..cross sections of brain;
Sensitive to tissue density
```
CT computerized axis tomography
Uses X-rays
Pro..cost less
Quicker images
Don't have to be motionless for a long period of time.
```
```
MRI magnetic resonance imagery
Uses magnetic field & radio waves
Pro...3 dimensional
Better detail
No X-rays
```
83
What are the functional imaging techniques?
Functional imaging gives info about brain structure and activity
PET scan, SPECT, functional MRI
PET..small amounts if radioactive material to see neural activity by measuring blood flow, glucose metabolism, or oxygen consumption. Good to see distribution of NT and id brain dysfx due to stroke, epilepsy, tumor, dementia, etc.
SPECT ....lower resolution PET
FMRI...same as MRI but also gives info on brain activity by detecting changes in blood oxygenation.
84
What is a stroke and discuss the two kinds.
Stroke is a cerebrovascular event...onset of neurological symptoms due to interruption or severe decrease in blood flow to the brain.
Ischemic stroke...most common
.....blocked artery
Hemorrhagic stroke...weakens blood vessel in brain ruptures, leaks
85
What are the risk factors for stroke?
Risk factors: hypertension *
Atherodclerosis
Atrial fibrillation
Other types heart disease. Diabetes
Cigarette smoking
Over 55, male,
Black, family hx
86
What are the symptoms of a stroke that comes from the middle cerebral artery?
Most often involved in stroke.
This artery supplies blood to parts of frontal, temporal, and parietal lobes and the basal ganglia.
Effects...contralateral hemiplegia
And hemiparesis (face and arm).
Contralateral visual field loss both eyes
Aphasia (if dominant hem is affected)
Contralateral neglect
Denial of deficit if nondominant hemisphere is affected.
87
Where is the location of an anterior cerebral artery and what symptoms result?
Frontal and parietal lobe, corpus collosum, caudate nucleus
Effects...contralateral hemiplegia (leg). ..impaired judgement , insight
...personality change
...incontinence
88
Where is the posterior cerebral artery and what are the symptoms?
Supplies blood to thalamus, temporal lobe, occipital lobe
```
Problems...cortical blindness
...visual agnosia
...visual deficits
....language impairments
....memory loss
```
89
Traumatic brain injury can be open or closed (widespread damage, lose cs, blow doesn't penetrate skull) and is classified as mild, moderate, or severe based on what indicators?
Prognosis related to severity and location , age, premorbid, etc
Most recovery first 3 mo to one yr
Many sx indefinitely
Anterograde amnesia (post traumatic) is good predictor of outcome.
Glasgow coma scale GCS,
Post traumatic amnesia PTA
Loss of consciousness LOC
Mild...GCS 13 to 15;
PtA less 1 hr;
LOC 30 min or less or none
Moderate... GCS. 9 to 12
PTA...1 to 24 hours
LOC ...30 mins to 24 hrs
Severe...GCS 8 or less
PTA more 24 hrs
LOC more 24 hrs
90
What is required for a postconcussional disorder?
Significant concussion following head trauma noted by:
Loss of cs, ptraumatic amnesia, and/or post traumatic seizures
Plus impaired attention/memory
And 3 plus sx for at least 3 mo
Fatigue, headache, dizziness, irritability, aggression, anxiety, depression, personality change, apathy.
91
Describe the deficits with Huntington's disease. Degenerative disease.
Autosomal dominant gene disorder e 50 percent chance of inheriting.
Linked to prob in basal ganglia and cortex (MRI shows reduced volume in bg; PET shows reduced metabolic brain activity)
Glutemate, Ach, GABA, and dopamine abnormalities.
Sx...first signs 30 to 50 yrs
Affective (depression, anxiety, lability). May get wrong dx.
Then personality change, forgetfulness, motor sx
Later athoetosis (slow writhing) and chorea (involuntary rapid, jerking of face, limbs, trunk.
Later dysphasia (diff swallow), immobility, and dementia.
Hi suicidality. ESP if young.
92
Describe Parkinson's disease.
Degenerative disease of movement. Trpb
40 percent comorbidity of depression and in 20 percent of cases depression precedes motor problems by 5 yrs.
Some develop dementia w it.
Lack of dopamine in substantia nigra which affects basal ganglia, thalamus, cortex.
Temporary relief with L-dopa and other drugs.
Sx 4 categories:
Tremor...hands, arms, legs..initial sx
Pill rolling.
Rigidity...neck, arms, legs
Cogwheel rigidity...combo tremor and rigidity..short, jerky movements
Postural instability..unsteady, stoop, gait problems
Bradykinesia..slowness if voluntary movement. Fine and gross. Slow to start and complete. Mask like/blank facial look.
Some get dementia.
93
Describe partial seizures.
They are focal seizures start in a localized area in one side of the brain and affect one side of the body (may spread and bc generalized). 2 types.
Most often due to abnormal electrical activity in one of the lobes, ESP temporal.
Simple partial seizures.no loss of cs
Uncontrollable movements, sensory sx, and/or auditory hallucinations.
Complex partial..may start w an aura, some alteration in consciousness, often include automatisms (involuntary complex movements..lip smack, chew, walk in circles)
Partial seizures most often in Temporal lobe seizures...automatisms, auditory hallucinations, sensory phenomenon, déjà vu, depersonalization, autonomic sx
94
Describe generalized seizures.
Bilaterally symmetric and not focal onset.
Tonic clonic or grand mal
Alteration of cs
Tonic stage...muscles stiffen face and limbs
Clonic..jerky rhythmic in arms and legs
When consciousness returns may be depressed, irritable, confused or have amnesia for events that occurred during the seizure.
Absence seizures...brief loss if cs and vacant stare but few or no other sx (petite mal)
95
Describe migraine headaches.
Throbbing pain on one side of head.
May have nausea, vomiting, dizziness, sensitivity to light, sound..
Classic migraine starts with an aura
Common migraine no aura
Triggered by factors like stress, weather, alcohol, foods and additives
Sx may increase by activity
May relate to low level serotonin that constricts bld vessels in brain.
Tx...no steroidal anti-inflammatory drugs, ergotamine, sumatriptan, ssri , and other drugs act in serotonin receptors; beta blockers; combo thermal biofeedback and auto genic training .
96
Describe tension headaches.
Dull and diffuse mild to moderate pain feels like a tight band around the head.
May be due to sustained contractions if muscles in forehead,scalp, neck. Others unknown cause.
Some evidence serotonin or other NT involved.
Tx..pain relievers, EMG biofeedback
Chronic ones..antidepressants
97
Describe the difference between cluster and sinus headaches.
Cluster..severe nonthrobbing pain that lasts 15 to 90 mins; occurs more than once ea day over several weeks or months.
Unilateral pain.
Usually located behind one eye and may spread.
Tx...oxygen tx, sumatriptan or other triptan, lidocaine or other local anesthetic
Sinus headaches...inflammation that produces a dull throbbing pain can be worsened by sudden movement and cold weather.
Tx..antihistamines, decongestants,antibiotics, corticosteroids
98
```
Nt most associated with voluntary muscle movement is:
A. Norepinephrine
B. serotonin
C. Acetylcholine
D. Dopamine
```
C
99
The ascending reticular activating system produces its effects on motivation by:
A. Channeling sensory input to proper region of cortex
B. providing diffuse facilitation to entire cortex
C. Inhibiting irrelevant input from receptors
D. Providing generalized facilitation to all muscles
B
RAS involved in behavioral arousal. Screens input to the brain and provides diffuse stimulation to entire cortex when important info must be processed.
100
Three classes of antidepressants. Tricyclics include:
A. Fluoxetine, setraline, paroxetine
B. Prozac, Zoloft, Paxil
C. Nardil and parnate
D. Imipramine, clomipramine, amitryptyline
D
A is SSRIs
B brand names for those in b
C. MAOI
101
```
The most widely prescribed anti anxiety drugs are:
A. SSRIs
B. tricyclics
C. Benzodiazepines
D. Barbiturates
```
C
Most widely prescribed anxiolytics include diazepam (Valium), alprazolam (Xanax), clonazepam (klonapin), lorazepam (Ativan ), and triazolam (halcion).
Barbiturates have been replaced for anxiety by the benzodiazepines.
102
What is the difference between agnosia, apraxia, and aphasia?
Agnosia is inability to recognize objects.
Aphasia is impairment in speech functions.
Apraxia is related to movement.
103
Damage to the broca's area of the left hemisphere produces:
A. Apraxia
B. agnosia
C. Aphasia
D. Ageaphia
C
104
```
Trauma to the temporal lobe is associated with:
A. Loss of coordination
B. visual blurring
C. Apraxia
D. Memory loss
```
D
105
In tx of schizophrenia, haloperidol is
A. Most effective for treating positive symptoms
B. most effective for treating negative symptoms
C. Equally effective for both
D. Not effective for any
A. This conventional antipsychotic is most useful for positive sx, such as hallucinations, disorganized speech, and delusions.
106
```
What is one of the effects of estrogen replacement tx?
A. Increased mood swings
B. reduced libido
C. Increase vaginal dryness
D. Increase risk osteoporosis
```
B
ERT may decrease libido , reduce mood swings, reduce dryness and reduce osteoporosis.
107
```
Damage to the suprahiasmatic nucleus can often lead to:
A. Disruptive on if normal breathing
B. reduction of appetite
C. Disruption of circadian rhythms
D. Disruption of memory fx
```
C. Located in the hypothalamus
108
What drug is used to treat enuresis? Tell its generic name.
Imipramine aka tofranil
109
What med is used to treat OCD? Give generic and category.
Clomipramine or anafranil is an tricyclics antidepressant.
110
What are the TCA's?
Block re uptake of serotonin and norepinephrine.
```
Imipramine/tofranil
Clomipramine/ anafranil
Amitryptyline/elavil
Endepdoxepin/adapin
Sinquan
```
111
What do the tricyclics treat and what are the side effects?
They block reuptake of NE and SE
Supports catecholamine hypothesis that predicts depression is due to lower than normal levels if NT.
```
Major Depression (hopelessness, no pleasure, ESP vegetative sx, like appetite, sleep, energy sx)
Dysthymia
Enuresis (imipramine)
OCD (amitryptyline)
Panic do
Agoraphobia
Chronic pain
```
```
Side effects...often subside weeks or if lower dose
Anticholenergic effects (dry mouth, blurred vision, constipation..)
GI sx
Impaired sexual fx
Drowsie
Weight gain
Confusion and memory probs (ESP old)
Cardiovascular effects
Toxic OD
```
Cautious when given to heart disease or suicidal ppl given toxicity to OD.
112
What is the difference between agonist and inverse agonist and antagonist?
Agonist...effects similar to NT
Inverse agonist..opposite effects of NT or agonist
Antagonist...no activity on own but reduce or block effects of NT or agonist.
113
How does race and ethnicity impact a person's drug response?
Older people have decreased metabolism which can extend te half life of the drug and increase toxicity risk.
Asians and African Americans metabolize certain isoenzymes more slowly than Caucasians. Greater sensitivity to therapeutic and side effects of meds, such as benzodiazepines, neuroleptic a, Li, and some antidepressants.
So start low dose and titrate up.
114
How are the SSRIs different than the TCA's?
```
SSRIs have quicker onset of effectiveness
Fewer and less severe side effects
Safer in overdose
Few or no anticholenergic effects.
Less likely cause sedation
Less likely cause cognitive impairment
Fewer cardiovascular effects
```
115
What are the SSRIs, uses, and side effects?
SSRIs increase SE at synapses.
Fluoxetine / Prozac
Paroxetine/ Paxil
Sertraline/ Zoloft
Major depression, panic, OCD, dysthymia
Social phobia, binging, premature ejaculation
```
Side effects:
Sexual fx
Loss of Appetite
Dizzy
Nausea
Agitation
Headaches
Insomnia
Combo w other drugs that increase SE cause SE syndrome (altered consciousness, agitation, other mental status changes, autonomic changes..sweating, dilated pupil.., tremor, muscle rigidity, akathisia (restless).
```
116
How much does mylenization increase the speed of conduction? What is this type of conduction called?
What disorders are linked to a loss of mylenization?
10 to 100 times
Saltatory conduction
Multiple sclerosis..loss of mylein
117
What are the 4 types of neurotransmitters?
Catecholamines include Dopamine,
Epinephrine, and norepinephrine.
Personality,drive and mood states.
Too much of D in schizophrenia. Too little D in Parkinson's .D involved with movement.
Low Levels of NE with some depression.
Acetylcholine is called a
cholenergic system involved in pns voluntary movement of skeletal muscles.
In brain involved in learning and memory. Alzheimer's deterioration of neurons in brain that secrete Ach.
Mediate sexual behavior and REM.
Serotonin Hunger
Mood states, aggression, arousal, pain, obesity, sleep.personality, temperature, pain
Elevated levels related to schizophrenia.
GABA Optimal levels have a calming effect.
Low levels underly anxiety, Low levels in motor regions of brain
involved with huntingtons chorea....dementia, and jerky movements.
118
What is activated by the sympathetic nervous system?
Mobilizes resources. Gets it ready to expend energy
Increase heart rate
Increase blood flow to extremities.
Inhibits digestive system
Dilates pupils
Conversion of energy stores into glucose.
Occur as unit ready for fight or flight.
119
What measures parasympathetic systems?
Deactivates processes. Conservation of energy. Active during rest and digestion.
More specific in responses
EKG...measures contraction of heart muscle
Galvanic skin response. Electrical conductance of skin
120
Primitative core...basic activities like eating and sleeping. Too if spinal cord.
Old brain...limbic system..hunger, thirst and emotion
New brain..cerebral cortex with higher functions
What is a way to view the brain?
121
What does the septum do which is part of the limbic system.
Part of the limbic system in the forebrain. Mediation of emotions.
Amygdala, septum, and hippocampus are the limbic system.
Inhibition of emotional behavior.
One of brains pleasure center.
Rats will stimulate this over and over. Septal rage syndrome...lesions cause hyper emotionality and vicious attack behaviors.
122
What does the pons do?
Part of the brainstem. Above medulla and connects cerebellum.
Role in relaying sensory and motor information.
Regulates arousal
Sleep
Respiration
123
What is contained in the extra pyramidal system?
Basal ganglia (fine motor and muscle movement), cerebellum, and
Damage to the cerebellum causes ataxia which is like someone who drank too much. Problems with loss of balance, slurred speech, and Tremors.
124
What is the catecholamine hypothesis and what support is there for it?
It says that depression is due to lower than normal levels of norepinephrine.
Tricyclics support it.
125
What is serotonin syndrome? What are the symptoms?
Combining SSRIs with tricyclics or MAOIs or other drug that increases serotonin.
Characterized by altered consciousness, agitation, other mental status changes
Autonomic changes..sweating, dilated pupils
Tremor, muscle rigidity, akathisia (motor restlessness)
Other neuromuscular activities.
126
What drugs can cause a hypertensive crisis? What are the symptoms?
MAOIs combine with other drugs or foods containing the amino acid tyramine can cause a fatal crisis noted by elevated blood pressure, severe headache, stiff neck, nausea, and vomiting, and tychycardia and bradycardia.
Avoid beer, wine, aged cheese, smoked meat, soy sauce, avocados, bananas, eggplant, tomatoes and yogurt.
127
What are the newer antidepressants?
Serotonin-norepinephrine reuptake inhibitors (snris) are venlafaxine (Effexor), duloxetine (Cymbalta), and venlafaxine (pristiq) used for major depression, generalized anxiety and social anxiety do, and panic do.
Side effects...sleep, nausea, GI, sexual dysfx, headache, and increased bld pressure.
Norepinephrine-dopamine reuptake inhibitors (ndris) for depression and smoking cessation.
Bupropion (Wellbutrin, zyban)
Side effects...dry mouth, agitation, insomnia, itching, rash, decreased appetite.. Can aggravate preexisting seizures, psychosis, and cause anaphylaxis (allergic rx)
128
What are the names for the mood stabilizer lithium? What is it used for and give side effects.
Lithium is tx of house for classic bipolar (mania without rapid cycling). Reduces mania and levels swings.
Appears to effect ne, d, se
```
Lithium carbonate (eskalith, lithonat, duralith)
Lithium citrate (cibath)
```
Side effects: metallic taste
Fine motor tremor
Wt gain
Nausea, diarrhea
Fine hand tremor
Mild cognitive impairment (confusion and disorientation)
Toxicity (vomit, ab pain, diarrhea, tremor, slurred speech and can lead to seizure, coma, death)
129
What antiseizure meds are used to treat psychological sx? How do they work, what sx do they treat and what are their side effects?
Carbamazepine (tegretol) and valproic acid (depakote) are two antiseizure meds that act on SE levels.
Used for dysphoric mania
Mania with rapid cycling
Side effects: nausea, vomit, lethargy, tremor, ataxia, visual disturbances,
Slight risk of liver failure w both
Agranulocytosis (low white bld cell) and aplastic anemia w carbamazepine.
130
What are the traditional antipsychotics?
What are the uses?
Phenothiazines (Thorazine and mellaril)
Butyrophenones (haloperidol)
Used for: schizophrenia
Psychotic sx (in other do)
Tourette's
Acute mania
131
Discuss the dopamine hypothesis.
Thought that an excess of dopamine causes schizophrenia.
Antipsychotics work by blocking dopamine receptors in brain.
Support bc amphetamines and other dopamine elevating drugs can induce psychosis who don't have schizophrenia or worsen in those who do.
However, other research found it is more complex and may involve an imbalance of dopamine and other nt , like NE and SE.
132
What are the side effects if the traditional antipsychotics?
Disadvantage is they tx positive sx but little effect on negative sx (flat affect, anhedonia, withdrawal).
Anticholenergic effects
(Dry mouth, blurred vision, gi, sexual prob, urine retention, tachycardia)
Extrapyramidal sx
Parkinsonism, dystopia, akathisia, tardive dyskinesia (abnormal involuntary movements, chewing..)
Neuroleptic malignant syndrome
Rare, life threatening
Rigid, fever,sweat, unstable bld pressure, altered mental status, autonomic dysfx. Occur anytime. Often first weeks. Rapid onset.
Discont drugs ASAP or fatal.
133
23 yr old gets tardive dyskinesia after taking a traditional antipsychotic for months. If gradually withdrawn, expect:
A. Increase sx temporary before decrease
B. increase permanently
C. Not be affected
D. Remit immediately
A. Gradual withdraw leads to gradual reduction in sx. Temporary increase before decrease.
134
Common lithium side effect, ESP with older people:
A. Impaired visual spatial perception
B. fine hand tremor
C. Verbal articulation problems
D. Shuffling gait
B...side effects more common in older peeps and occur at lower doses.
135
```
Treatment of OCD most likely includes:
A. Phenelzine
B. lithium
C. Clomipramine
D. Clozapine
```
C
136
```
Eating foods with tyramine while taking maoi should be avoided because doing so can cause:
A. Neuroleptic malignant syndrome
B. hypertensive crisis
C. Agranulocytosis
D. Severe rebound effect
```
B...includes elevated bld pressure, severe headache, stiff neck, nausea, vomiting, blurred vision, confusion
137
```
All are SSRIs but:
A. Clomipramine
B. sertraline
C. Fluoxetine
D. Paroxetine
```
A...anafranil is a tricyclics
138
```
Which antidepressant is least likely to cause cognitive impairment?
A. Imipramine
B. clomipramine
C. Fluoxetine
D. Amitryptyline
```
C. Only ssri
139
```
What is a dopamine antagonist?
A. Propranolol
B. fluoxetine
C. Mathylphenidate
D. Haloperidol
```
D. Traditional antipsychotic that blocks dopamine receptors .
140
Severe side effects occur. March type of med with below problems:
1. Agranulocytosis. Aplastic anemia
2. Hypertensive crisis
3. Liver damage
4. Serotonin syndrome
5. Li toxicity
6. Aggravate preexisting seizure, psychotic do or allergic rx
7. Cautious if suicidality or heart do
8. Neuroleptic malignant syndrome
1. Antiseizure
2. maoi plus tyramine
3. Antiseizure meds
4. SSRIs
5. Lithium
6. Ndris
7. Tricyclics
8. Traditional antipsychotics, no traditional antipsychotics
141
What are the newer antipsychotics, how do they work
Atypical affect different dopamine receptors as well as SE, NE, and glutamate receptors
Drugs include:
Clozapine (clozaril), risperidone (risperdal), olanzapine (zyprexa) and ariprazole (abilify)
142
What are the uses of the at typical antipsychotics and the side effects?
Schizophrenia
Other do with psychotic sx
Advantages..help pos and neg sx
Less likely cause extra pyramidal
Often help where other meds don't
Side effects: anticholenergic
Sedation, wt gain
Neuroleptic malignant syndrome
Clozapine...agranulocytosis (so last resort)
143
What is true about atypical (newer) antipsychotics?
A. less likely than traditional antipsychotics to affect negative sx, more likely produce tardive dysk
B. less likely than traditional to affect negative sx, just as likely tardive dysk
C. More likely to affect negative and less likely affect tardive dysk
D. More likely affect negative and just as likely affect tardive dysk
C
144
```
Which would be most useful for alleviating sx of moderate to severe alcohol withdrawal?
A. Benzodiazepines
B. ssri
C. Li
D. Naltrexone
```
A
145
```
11 ur old taking methylphenidate for ADHD. Most likely have which side effects?
A. Dry eyes, blurred vision
B. insomnia, decrease appetite
C. Numbness arms and legs
D. Increase appetite, wt gain
```
B
146
What are the benzodiazepines and what are their uses?
```
Treat: anxiety
Insomnia
Muscle spasms
Seizures
Moderate to severe alcohol withdrawal
```
```
Enhance GABA (inhibitory NT)
Diazepam (Valium)
Alprazolam (Xanax)
Clonazepam (klonapin)
Lorazepam (Ativan)
Triazolam (halcion)
```
147
What are he side effects of the benzodiazepines?
| What are some disadvantages?
```
Most common..drowsie, sedation
Motor...ataxia, in coordination
Cognitive..anterograde amnesia
..poor concentration
Anticholenergic effects
Sexual dysfunction
Paradoxical effects ...anxiety, aggressive, excitability
Older ppl..confusion, disorientation
```
Disadvantages: addictive
Chronic use..wdrawl, depend, tolerance...rebound anxiety even greater than original
Severe withdrawal (seizure, hallucinations, coma) can occur if abruptly stop after high dose for long time.
Combo with alcohol or other CNS depressant can be fatal.
148
What are the barbiturates and their uses?
Barbiturates exert effects on GABA receptors in RAS, medulla, cortex.
Thiopental (Pentothal)..general anesthetic
Amobarbital (Amytal)..acute management of agitated patients
Secobarbital (Seconal)..short term tx for insomnia
149
What are the side effects to the barbiturates?
Many are the same as for the benzodiazepines..
Drowsie, confusion, ataxia, cognitive, paradoxical excitement
Regular use leads to dependence, tolerance, withdrawal
Combo w alcohol can be lethal...potentiating effects
150
What is the azaspirone?
Pat prescribed is buspar for generalized anxiety do
Reduces anxiety wo prominent sedative or muscle relaxant effects
Doesn't lead to abuse, dep, wdrawl
Effects on anxiety via d, ne, se
```
Side effects:
Nausea
Dizzy
Headaches
Lt headedness
```
151
What are the narcotics, their uses, and side effects?
Mimick body's natural analgesics, endorphins/enkephalins. Include natural opioids and heroine and methodone. Plus:
Oxycodone/percodan/OxyContin
Hydrocodon/Vicodin
Meperidine/Demerol
```
Uses: preop med(relax, sedate)
Acute and chronic pain
For heroine detox...
Methadone/dolophine/ methodose
(Decrease cravings and wdrawl )
```
Side effects: dry mouth, dilation, nausea, hypotension, cough suppression, respiratory depression
OD...death
Chronic..depend, toler, wdrawl
Eventually use just to keep from wdl
Wdrawl..cold or flu like. Later pain, vomit, hi bp...
152
What are the psychostimulants, their uses, and side effects?
Mimic or potentiate The action of NE and D
```
ADHD and narcolepsy
Methylphenidate (Ritalin/concerta)
Pemoline (cylert)
Amphetamine-dextroamphetamine (adderall)
Even low dose ..decrease motor and impulsivity and increase attention in those wout ADHD
```
Drug of abuse..cocaine, methamphetamine
```
Side effects: insomnia
Wt loss/decrease appetite, stomachaches
Dysphoric mood
Growth suppression can be reversed with drug holidays
Exacerbate tics
```
153
What are the norepinephrine reuptake inhibitors?
Block reuptake of NE
Atomixetine (strattera)
First non stimulant okd for ADHD in 6 year old plus
```
Side effects: decrease appetite
Dizzy
Fatigue
Irritability
Sexual dysfx
May increase suicidal thoughts/ax in children and adults.
```
154
What are the beta blockers? What do they do and what are their side effects?
Inhibit sympathetic nervous system
Slows heart rate and bld pressure
Propranolol (inderal)
```
Traditionally used: hypertension
Cardiac arrhyhmias
Migraines
Essential tremor
Physical sx of anxiety (not worry,..)
```
```
Side effects: bradycardia
Hypotension
Sexual dysfx
Fatigue, nausea, dizzy
Depression
Vision changes
```
Abrupt withdrawal avoided...arrhythmia etc
155
What are the anti alcohol drugs? How do they work and what are their side effects?
Tx alcohol ABUSE and dependence
Disulfiram (Antabuse)..inhibits alcohol metabolism causes development of nausea and vomiting, short breath, tychardia
Naltrexone (reVia, vivitrol)...opiod receptor antagonist and reduces pleasure able effects and craving for alcohol.
156
What are cognitive enhances and what are they used for?
Slow down memory loss and cognitive sx of Alzheimer's.
Cholinesterase inhibitors that inhibit the breakdown of acetylcholine
Tacrine Hydrochloride/cognac no longer used due to liver problems.
Donepezil hydrochloride/aricept..approved mild, moderate, severe
Rivastigmine/exelon and galant amine/razadyne...mild and moderate
Side effects: nausea, diarrhea, wt loss stomach prob
157
What makes up the basal ganglia and what does it do?
Caudate nucleus
Globus pallidus
Putamen
Involved in:
Control of voluntary movement motor/outward expression of emotion
Sensorimotor learning
```
Abnormalities linked to:
Tourette's
Huntington's
Parkinson's
Schizophrenia
Mood prob
OCD
ADHD
```
158
What is ataxia?
Slurred speech, severe tremors, loss of balance.
Occurs when damage to cerebellum
Side effect of many meds
159
Name NT and what involved in:
Acetylcholine: voluntary movement
Learning and memory. Sex and sleep. Alzheimer's and normal memory loss.
Dopamine: mood, movement, learning, reinforcing effects of stimulants, nicotine, and opiates.
Depression, schizophrenia, Tourette's, ADHD, Parkinson's, Huntington's
Serotonin..anxiety, mood, memory, aggression, pain, sleep, appetite, sex (pass mama)
Too little...OCD, PTSD, depression, aggression, and bulimia.
Too much...schizophrenia, autism, anorexia (appetite)
GABA...inhibitory...abnormal levels impact anxiety, motor.
Disorders of sleep, eat, anxiety, and seizures. Parkinson's and Huntington's.
Anti anxiety drugs increase GABA.
Glutamate...excitatory...
Learning and memory
Long term potentiation..form memories.
Abnormal levels..anxiety, mood, schizophrenia
Over activity..seizures, stroke, traumatic brain injury, Alzheimer's, Huntington's, Parkinson's.
160
What do wernicke's, brocas and conduction aphasia have in common?
1. impaired fluency
2. Impaired verbal prosody
3. Impaired comprehension
4. Impaired repetition of verbal tasks
4
161
Pt has OCD, multiple motor and one vocal tic. Neurological basis for pts problem is in the:
1. Temporal lobes
2. Amygdala
3. Prefrontal cortex
4. Basal ganglia
4.
162
Circadian clock is located in the hypothalamus and is responsible for sleep-wake patterns. Circadian clock is the:
1. Pineal gland
2. Suprachiasmic nucleus
3. Substantia nigra
4. Reticular activating system
2. This signals the pineal gland which is also in the hypothalamus to produce melatonin which causes temp to drop and sleepiness.
RAS filters incoming sensory info and can activate a person to a state of alert wakefulness. Consists of cells in the medulla, pons, hypothalamus, and thalamus.
163
Thalamus is best described as
1. Master endocrine gland
2. Seat of cs
3. Relay station for all but olfaction
4. House of somatosensory cortex
3.
164
What is the master endocrine gland?
Hypothalamus (along with the pituitary)
Temp regulation, sleep-wake cycle, general arousal, movement
165
What functions are critical to:
Frontal lobes
Brain stem
Limbic system
Frontal lobes...personality, emotionality, inhibition, planning and initiative, abstract thinking, judgement, higher mental fx
Brain stem..pons, meduLla, RAS
Limbic...amygdala hippocampus,..
Memory and emotion
166
```
Parkinson's due to loss of cells in:
Substantia nigra
Basal ganglia
Caudate nucleus
Hippocampus
```
1.
Basal ganglia is made up of sub nigra and caudate nucleus which is best answer as well as low in dopamine.
167
```
Nt involved in voluntary movement
Ach
SE
Ne
GABA
```
Ach
SE..mood do, sleep onset, sex, aggression
Ne..mood
GABA..anxiety, epilepsy, schizophrenia
168
```
Damage to the temporal lobe is likely to effect which type of memory function?
Short term explicit memory
Long term explicit memory
Short term implicit memory
Long term implicit memory
```
2. Generally long term memories that are explicit...cs recollection of facts and autobiographical events.
Damage..can remember for short of of time but can't hold onto info or consolidate it.
Left damage results in impaired memory for verbal material
Right impaired recall of nonverbal such as music and drawings
169
```
Right hemisphere plays an important role in:
Language
Logic
Abstract thinking
Visuospatial organization
```
Right...perceptual, visuospatiial, artistic, musical, intuitive
Left...language, rational, analytical, logical, abstract
170
Describe the divisions of the central and peripheral nervous system.
CNS contains has brain (forebrain, midbrain, hindbrain) and spinal cord (31 segments w 5 grps: cervical (quad); thoracic (paraplegia), lumbar, sacral, coccygeal.
PNS has somatic and ANS.
Somatic regulated sensory and voluntary motor activity by relaying it from sensory to CNS and from CNS to skeletal muscles.
ANS regulates involuntary. Has sympathetic and parasympathetic nervous system (body relax, conserve energy, controls daily processes)
171
What is the neuron made of?
Nerve cell that is the info processing unit of nervous system.
Cell body..nucleus, mitochondria, and special structures for protein synthesis.
Dendrites respond to stimuli from other neurons and take info to cell body.
Axon...carrys info away from cell body. Terminal button at end of ea branch.
FYI..conduction, electrochemical process info received and processed in a nerve. Before signal, at rest (inside cell negatively charged, outside positively charged). When enough stimulation, less neg on inside Nd it becomes depolarized. This causes an action potential. Speed determined by larger axon diameter and thicker myelin greater speed.
172
What stops synaptic transmission?
Reuptake...terminal buttons take excess nerurotransmitter and store it for later
Enzymatic degradation..enzymes around synapse break down nt that is removed via waste.
173
Dc the three hormones in the endocrine system and related diseases.
Thyroxine
Insulin
Cortisol
Thyroid gland releases thyroxin which controls metabolism. Under secretion is hypothyroidism and over is hyperthyroidism or Graves' disease (speed metabolism, increase appetite, wt loss, accelerated he, nervous, heat intolerance, insomnia, decreased attn span)
Pancreas secretes insulin.
Undersecretion causes diabetes mellitus.
Over secretion causes hypoglycemia (hunger, weak, headache, visual prob, palpitations, anxiety, depression, confusion)
Cortisol by adrenal cortex regulates bld glucose.
Undersecretion is Addison's disease (muscle weakness, fatigue,
Low bp, decrease appetite, irritable, darkening of skin, depression).
Over secretion cause cushings disease (obesity, hypertension, poor concentration/memory, decrease libido..).
174
Paper circuit was originally identified as a neural pathway in:
Fight or flight
Experience and expression of emotion
Onset of puberty
Coordination of movement in rt and left sides of the body
B. said expression of emotion due to hypothalamus
Experience of emotion result of intx of hypothalamus and other structures.
Later found more related to memory.
175
What are the three structures involved in the physical expression of emotion? What is the fx of each.
Hypothalamus...physical expression of emotion thru effects on ANS and pituitary.
Amygdala attaches emotional content to memory, ESP fear and anxiety..mediating defensive/aggressive behaviors and recognizing fear in facial expressions
Cerebral cortex
Left side..positive emotion
Lesion means catastrophic rx w severe depression, anxiety, fear
Right side..negative emotion
Lesions mean indifference rx w apathy and sometimes inappropriate euphoria.
176
What impact does REM deprivation have?
Like from barbiturate use, drug use
Alters sleep patterns
Increase anxiety, irritability
Impair cognitive functioning
Effects disappear when sleep
Rem rebound...more time in rem on subsequent nights
177
```
Research on RNA suggests it plays a role in:
Creativity
Memory formation
Deductive reasoning
Language
```
B
Protein synthesis and long term potentiation are the neural mechanisms linked to the formation
Of memories.
178
What are the causes of color blindness?
Often genetic defect..x chromosome...males more likely
Injury
Disease impacts retina, optic nerve,..
Most common type distinguish red from green.
179
```
Which most useful for alcohol withdrawal?
Benzodiazepines
Ssri
Lithium
Naltrexone
```
A. Best for with drawl
Last one is used to decrease pleasure able effects of alcohol and cravings.
Antabuse or disulfiram inhibits alcohol metabolism and causes sx.
