NT Flashcards
1
Q
Monamines
A
Dopamine, Serotonin (5HT), Norepinephrine and Eprinephrine
2
Q
Dopamine is considered what type of pathway
A
“reward” pathway and addiction
3
Q
Dopamine Synthesis
A
tryosine to dopa to dopamine
4
Q
Dopamine Degradation
A
monamine oxidase (MOA) and catechol-O-methyl transferase (COMT)
5
Q
Ganglion
A
Collection of nerve cell bodies outside the CNS
6
Q
Nuclei
A
Collection of nerve cell bodies in the CNS
7
Q
What type of NT is serotonin
A
Monamine
8
Q
Glycine is ________ AA
A
Neutral/Inhibitory GABA
9
Q
Aspartate is ______ AA
A
Excitatory
10
Q
Circle of Willis connects _______ and _______
A
caratoid and basilar arterties
11
Q
The pia mater contains _______ plexuses
A
choroid
12
Q
Midbrain also called
A
Mesencephalon
13
Q
Hindbrain consists
A
Metencephalon (cerebellum & pons) & Myelecephalon (medulla)
14
Q
What part of the brain contains the thalamus and the hyperthalamua?
A
Forebrain
15
Q
Short preganglionic and long post ganglionic neurons
A
Sympathetic
16
Q
Long preganglionic and short post ganglionic neurons
A
Parasympathetic
17
Q
Preganglionic axons neurotransmitter
A
Acetylocholine both branches (cholinergic)
18
Q
Postganglionic axons neurotransmitter
A
Sympathetic - norepinephrine (adrenergic)
Parasympathetic - release acetylcholine
19
Q
Cholinergic Receptors
A
Receptor for Ach
Nicotinic, Muscarinic
20
Q
Medulla also called
A
Myelencephalon
21
Q
What kind of tract is pyramidal (corticospinal)
A
Descending motor tract
22
Q
Pyramidal upper motor neurons arise
A
cortex and descends to cross over and decussate at the medulla (pyramids)
23
Q
Another motor tract
A
extrapyramidal (outside of the pyramidal)
24
Q
They r involved in non-volu expressions of the fine motor & postural control
A
extrapyramidal
25
Synapse with final motor neurons of ventral (gray) horn
extrapyramidal
26
Receptor senses a stimulus (from environment or inside body)
Reflex Arc
27
```
Stressor Reponse (BP, HR, MVO2, EF, CO, Circulating BV) - threat response
Increase Muscle Blood Flow
Bronchodilation (oxygenation)
Liver Glycolysis (lactic acid)
Adipose Lipolysis (FFA)
Distance VIsion
Sexual Climac (2nd phase)
```
Sympathetic Reponses
28
```
Digestion
Anabolism (growth)
Near Vision
Voiding, Defecation
Sexual Excitation (1st phase)
```
Parasympathetic Reponses
29
Parasympathetic end organ receptors
Muscarinic
30
NO
Released by some parasympathetic neurons and gas that causes blood vessel vasodilatated
31
Parasympathetic: Post synaptic neuron release
ACh, NO
32
Sympathetic: Post synaptic neuron release
Norepinephrine (NE)
Epinephrine (EP)
Dopamine (DA)
Acetylcholine (ACh)
33
Dorsal, afferent
Sensory pathway
34
Ventral, efferent
Motor Pathway
35
Brings info to spinal cord
Afferent Sensory neuron
36
Spinal cord sends out ______ to the body to a(n) __________ that accomplishs the action
motor neuron
| effector organ
37
_____ develops from dorsal thickening of ectoderm to form neural plate
CNS
38
With maturity, cerebral maturity suppresses primitive lower brain & spinal cord reflexes
CNS maturity
39
```
Spinal Reflexes
Stepping
Sucking
Rooting
Palmar Grasp
```
Primitive Reflexes
40
Some aging effects of the NS
Decreased # neurons
Degeneration cerebra & cortex tiss, degen of nerve proteins
Loss of brain tiiss, reduced inhibition spinal cord
Reappearance of primitive reflexes
Deficits in taste & Smell
Decreases in Vision
Gait changes - shorter, shuffling, no associated arm swinging
Falls in elderly
41
Pain Neuroanatomy: Actions occurs in body & CNS
effector organ
42
Pain Neuroanatomy
Reflex arc loop system (afferent IN, efferent OUT),
43
Types of nociceptors
Skin - mechanoreceptors, thermal receptors
Joint - mechanoreceptors, silent
Visceral - mechanoreceptors, silent, chemical, thermal
Silent ("deep") - found in skin & deep tiss
44
Tissue injury is painful bc release of chemicals of _______ & includes ________
inflammation
| includes: vasoactive peptides (bradykinins), prostaglandins, histamine, lymphokines, serotonin (5HT), substance P
45
Derived from large molecule in brain called POMC
endorphins & dynorphins (strongest)
46
Inhibit pain transmission w/in CNS
endorphins & dynorphins
47
Spreads pain locally
Substance P
48
Sympathetic NS Activation
ascending pain impulses can't make it 2 higher CNS levels
| Reduce awareness of pain in a crisis to respond in emergency
49
Improves pain tolerance and clinical correlate: reduced tolerance for pain in depressed persons & improved tolerance in ppl given antidepressants
Serotonin
50
Pts do not get use to the pain and CNS response (limbic system) worsens
Chronic Pain
51
Pain is dull and poorly localized in this body system
Somatic (bone, ligaments, tendons, muscle, fascia)
52
"Referred" pain, diff to localize, aching
Visceral - internal organs
53
Injury 2 skin with high conce of nerve endings allowing for good localization (lacerations, burns)
Cutaneous
54
Burning, tingling and hypersensitivity 2 touch or cold, lancinating
Neuropathic
55
Burning, itching
Inflammatory
56
Caused by injury 2 body tiss
| Surgical trauma, infection/Inflam
Nociceptive
57
Abnormalities in nerves, spinal cord / brain
Neuropathic
58
Entirely or mostly related to psychological disorder (rare)
Psychogenic
59
Increase painful sensation in reponse to additional noxious stimuli; amplification or pain due to injury or inflammation
Hyperalgesia
60
Pain for stimulus that does not normally produce pain
Allodynia (light touch, sunburn)
61
Constant bombant of 2nd order neurons in dorsal horn, neuron previously carried touch sensation (Abeta) now carrys pain , neuropathich pain syndromes as well as chronic pain that is undertreated
Wind up Pain
62
ABCDE Pain
Ask about pain regularly
Believe report of pain & relief agents
Choose pain control options appropriately
Deliver interventions (timely, coordinated)
Empower pts & family members 2 control course pain management
63
What maintains internal environment
Hypothalamus
64
Part of limbic system
Hypothalamus
65
If 2 cold is stimulated
Thyroid
66
When stimulated produces throxine, which stimlated adrenal medulla, produces nonepine/ epine causing sympathetic activation
Thyroid
67
If 2 hot ______ pathway is shut down and _____ system is more dominant
TRH/TSH and parasympathetic system
68
Active and multiphase process
Sleep
69
To keep awake ______ sends out signals & 2 go 2 sleep ______ must be inhibited
SCN (supra-chiasmatic nucleus)
70
Inhibition of SCN is initiated by _____ production & synthesized by _______
melatonin
| pineal gland
71
Four stages of NREM
1: light sleep & alpha waves (5% of total sleep)
2. Sleep spindles & slower (50% )
3. delta waves & sleep spindles (10%)
4. Only delta waves - deepest (10%)
72
SWS
slow - wave sleep
occurs in stage 3 & 4 NREM
neocortex probably occurs
73
______ memory improved after a deep sleep
Declarative (fact-based)
74
_____ sleep occurs every 90 min after 1st 1-2 hrs deep sleep
REM
75
20-25% Total sleep
REM
76
During increased cerebral blood flow & steroid released
REM
77
Controlled by pontine reticular formation
REM
78
Sleeping pattern of newborns
16-17 hrs, mostly REM
79
Primary sleep disorders
Dyssominia (insomnia) and Pasrasomnia (nightmare)
80
hypocretin/orexin deficiency
narcolepsy
81
10-20 minutes long
narcolepsy
82
Sudden loss of muscle tone
Cataplexy
83
Includes other sym - cataplexy, hallucinations, sleep paralysis
narcolepsy
84
Occur just b4 sleeping (hypnagogic) or right after waking up (hypnopompic)
Hallucinations
85
Breathing related sleep disorders
Sleep apnea syndromess (SAS)
86
Occurs more than 30 times per 8 hrs sleep
Hypopnea/apnea
87
Not related 2 airway blockage
| occurs usually w/other cardia / neurological diagnoses - elderly
Central sleep apnea (CSA)
88
Form of central apnea
| AW obstruction in obese
Pickwickian Syndrome
89
Obstructive and central
Mixed type sleep apnea
90
_____ ppl have 45% greater risk of HTN
sleep apnea syndromes
91
_______ ppl have increased risk of MI and stroke
sleep apnea syndromes
92
Micro sleeps during the day contributing to injury & fatigue
sleep apnea syndromes
93
Treatment includes avoid alcohol & sedatives, wt loss
Oral appliance
+ airway pressure - forcing air thru nasal passages
Surgery
sleep apnea treatments
94
Disorder includes jet lag, shift work, delayed sleep phase
Circadian rhythm sleep disorders
95
Childhood Parasomnias
Nightmare, night terrors. somnabulism (sleepwalking disorder) - during stage 3 or 4 NREM
96
Mental and behavioral health diagnoses looked up in here
Diagnostic & statistical manual
97
Includes variety disorders like Asperger's
Autism
98
diagnosis can b made b4 age 3 sometimes as early as 12-18 months
Autism
99
Assessment scoring tool for Autism
M-CHAT
100
May develop seizure disorder
Autism
101
Seizure disorder
Epilepsy
102
brain waves occur at different frequencies
Epilepsy
103
Diagnosis test of Epilepsy
EEG
104
Type of seizure that is widespread electrical discharge affecting both sides of brain; often genetic
Generalized
105
Type of seizure that is abnormal electrical discharge in only 1 part of brain
Partial
106
Occurs in Asian men
SUNDS syndrome (sudden unexplained nocturnal death syndrome) also Brugada Syndrome
107
Used assess / evaluate coma
Glasgow Coma Scale (GCS); peds & adult versions
108
Early death (neuro-endocrine failure) resulting
Dementias
109
ABCs of Dementia
Activity (Function)
Behavior
Cognition - memory & Lang, new info & problem solving, perception, abs thinking
110
Types of dementia
Alzheimer
Lewy-body
Vascular
111
Lewy body dementia
associated with abnormal lewy bodies seen on histology, seen alone or with things like parkinson's
112
vascular dementia
multi-infarct dementia
| caused by same risk factors as any CV disease
113
Other conditions that may cause dementia include
slow viruses (mad cow), tumors, underactive thyroid, alcoholism
114
Deep tendon reflexes (DTR)
In: suddenly stretched by tap w/finger or rubber hammer; mechanoreceptons (spindle fibers in muscle) send afferent (sensory) info 2 spinal cord
Out: spinal cord sends efferent (motor) impulses to muscle via gamma neurons & muscle contracts
115
Brain ________ deep tendon reflexes
inhibits
| y can accentuate reflex during an exam by reinforcement
116
W/in the CNS
UMN lesion
117
UMN lesion
mild weakness, disuse atrophy muscles, accentuated deep tendon reflexes, hypertonia, spasticity
118
Brain ______ spinal cord reflexes
Suppresses
119
Brain unable 2 suppress spinal cord reflexes
Disinhibition
120
Outside CNS
LMN lesion
121
Autosomal Dominant abnormality, ultimately leads to death of neurons & imbalance in basal ganglia w/overactive dopaminergic pathways
Sym: progressive chorea & dementia
starts in adulthood
tx - antagonize dopamine 2 slow progression; no cure
Huntington's Disease
122
(genetic)
| brain degeneration
Parkinson's Disease
123
associated w/depression & development of Lewy Body type dementia
decreased dopamine in basal ganglia
Parkinson's Disease
124
Any focal neurologic deficits on clinical exam (temp or permanent)
Traumatic Brain Injury (TBI)
125
Types of TBI
Diffuse Axonal Injury (DAI) brainstem contusion
Focal Injury (contusions)
Coup Injury
Contre-Coup Injury
126
Shaken baby sydrome; MVA r examples of TBI
Diffuse Axonal Injury (DAI)
127
Type of TBI - blunt (closed) or open (penetrating) trauma
| Most deaths from head trauma
Focal Injury
128
Blow to frontal skull
Coup injury
129
blow to occipital skull & brain strikes inner liner shaped frontal bones on rebound, causing frontal damage also
Contre-Coup
130
Pathophysiology - decreased dopamine, inhibitory (dopaminergic) neurons - imbalance of too much cholinergic and GABA influence; lack of dopamine causes disinhibition - may see constant baseline increased muscle activity leading to rigidity temor
Parkinson's
131
AKA abusive head trauma (ABT)
shaken baby syndrome
132
Long term complications include: deafness, blindness, seize disorder, mental retardation & cerebral palsy
shaken baby syndrome
133
Symptoms lasting less than 24 hrs
Transient Ischemic Attack (TIA)
134
Types of stroke
Ischemic (thrombotic - blood clot)
Hemorrhagic (intracranial bleed)
Embolic (traveling clot from another location n body)
Cryptogenic (hidden)
135
85-90% of strokes in adults
| often due to atherosclerosis in carotid vessels
Ischemic (thrombotic - blood clot)
136
5-10% of strokes
Hemorrhagic (intracranial bleed)
137
Rare Stroke
Embolic (traveling clot from another location n body)
138
Very few (<5%)
not obvious causes
includes embolic strokes
Cryptogenic
139
FAST
Face - face look uneven
Arm - 1 arm hanging down
Speech - Slurred speech
Time - Call 911 now
140
Strokes n infants
intraventricular hemorrhage (IVH) and hypoxic-ischemic encephalopathy (HIE); low blood pressure
141
Childhood Stroke
Usually due to trauma or blood disorders - sickle cell anemia
142
Disorders of the neuromuscular junction
Degenerative Disease
| Rare Syndromes - Lambert-Eaton, pseudochilnesterase deficiency, myasthenia gravis)
143
Autoimmune attack against ACh receptors on skeletal muscle
Myasthenia Gravis
144
Male:Female ration 2:3
| My include thymus disorders
Myasthenia Gravis
145
Transmitted my mother; lasts 1-10 weeks, treat supportively until abates
Progressive reduced muscle strength with repeated muscle use, the improvement after rest
sym start once # of AChR is 30% of normal
Myasthenia Gravis
146
Demylenating Disorder - loss of myelin around neurons in the CNS
MS
147
Over accumulation of neurotransmitter glumate in CNS causing excito-toxicity of anterior horn cells in spinal cord
ALS (Lou Gehrigh's Disease)
148
Neurons that would normally innervate skeletal muscle die and lose of lower motor neuron (LMN) function with muscle paresis;
eventually loses ability to speak, swallow and breathe
ALS (Lou Gehrigh's Disease)
