Patho Exam 2 Flashcards
Opening at the center of the iris
pupil
In order to see the pupil constricts and dilates to allow the appropriate amount of light into the
_____
retina
Forms the optic nerve, composed primarily of neurons
retina
Converts images the brain can understand as vision
retina
Innermost layer of the eye. Sensory portion of the eye that changes light waves into neuro- impulses that travel to the brain for interpretation
retina
normally yellow circular clearly defined borders
optic disk
responsible for central vision
macula
central region of the macula responsible for sharp vision
fovea
can optic nerve regenerate?
no, you will lose vision
Adaptation of the eye for near vision
accommodation
A reflex direction of the eye toward an object attracting a person’s attention
fixation
condition where pupil accommodates but does not react to light.
Argyll Robertson Pupil
Visual field loss secondary to optic nerve damage
glaucoma
Leading cause of preventable blindness in the United States
glaucoma
Dilates the pupil with _____
myDratics
2 types of glaucomas
Primary open-angle glaucoma (POAG)
Acute angle-closure glaucoma
Significant structural changes occur in glaucoma involve
ciliary muscle, trabecular meshwork, and canal of schlemn.
Contraction of ciliary muscle allows drainage of _____ fluid through the canal of schlemn
aqueous
Relaxation of ciliary muscle causes obstruction of the ____
canal
________ attached to the trabecular meshwork, allows free flow of aqueous humor between the anterior and posterior chambers of eye
The ciliary muscle
Produced in ciliary body
Aqueous Humor
regulates IOP
canal of Schlemn
Ciliary muscles controlled by the ___
ANS
________ stimulation causes the ciliary muscle to relax (enlarge) which can block the
drainage
Sympathetic
________ stimulation causes ciliary muscle to contract which allows drainage
parasympathetic
If outflow from the anterior chamber is impeded, back pressure will develop and
increase ____ ____ ____
Inter ocular pressure (IOP)
Most common form of glaucoma in the United States
primary open-angle glaucoma
Devoid of symptoms until significant and irreversible optic nerve injury has occurred
typically has gradual loss of peripheral vision
primary open-angle glaucoma
Progressive optic nerve damage, with eventual impairment of vision IOP increases as there is a
slow exit through the trabecular meshwork
primary open-angle glaucoma
Primary Open-Angle Glaucoma risk factors
Elevation of intraocular pressure (IOP)
Family history of POAG
Advancing age
African and South American ancestry
treatment of primary open-angle glaucoma
Directed at reducing elevated IOP (the only
modifiable risk factor)
Principal method: Chronic therapy with drugs
Drugs lower IOP by Facilitating ____ ____outflow, and reducing its production
aqueous humor
If drugs are ineffective for glaucoma treatment , surgical intervention is needed to promote outflow of _____
aqueous humor
Cholinergic agents
Acetylcholine (Miochol)
Echothiophate (phospholine iodide)
Beta-adrenergic blocking agents
Timolol (Timoptic)
Mimic parasympathetic action of acetylcholine
Cholinergic/MIoTICS
Block sympathetic nerve endings in the ciliary epithelium causing a decrease in aqueous humor production
beta blockers
pharmacologic form of naturally occurring neurotransmitter
acetylcholine – constricting pupil
direct acting MOA (parasympathomimetics, miotics)
onset, peak, duration of direct acting -Acetylcholine
onset and peak- insant
Duration- 10 mins
Another direct-acting commonly used MIOTIC is called
_____ – a derivative of acetylcholine
pilocarpine
inhibits cholinesterase enzymes which then allows for the pupils to constrict because acetylcholine is not broken down
indirect MOA of echothiophate
onset, peak, duration of indirect acting- Echothiophate
onset: 10-30 mins
peak: 24 hours
duration: 7-28 days
for cholinergic drugs, If sufficient amounts enter the bloodstream, _____ effect may occur (most likely with indirect-acting)
systemic
adverse effects of cholinergic drugs:
Hypotension
Bradycardia
Headache
Nausea/vomiting
Diarrhea/ abdominal cramps
Asthma attacks
- increase aqueous outflow
- reduces aqueous humor formation thereby
decreases risk of damage to optic nerve
Timolol Maleate (timoptic) MOA
onset, peak, duration of Timolol Maleate (timoptic)
onset: 15-30 mins
peak: 1-2 hours
duration: 24 hours
side effects of Timolol Maleate (timoptic)
arrhythmia, bradycardia, heart block,
bronchospasm in asthmatic patient
Beta-Adrenergic Blocking Agents local adverse effects are usually _____
minimal
Beta-Adrenergic Blocking Agents systemic adverse effects:
Heart and lungs if absorbed in sufficient amounts (bradycardia, bronchospasm)
timolol Has drug-drug interaction especially with other _____ drugs
cardiac
timolol: Apply light pressure on lacrimal sac for how long after instilling drug to
minimize systemic absorption
1 minute
When applying eye drops, have the patient look up to the ceiling, and place the drop in the _______ ___
conjunctival sac
also known as narrow-angle glaucoma
angle-closure glaucoma
-Develops suddenly and is extremely painful
-No treatment— irreversible loss of vision in 1
to 2 days
angle-closure glaucoma
uses of mydriatics
Adjunct to measurement of refraction
Intraocular examination
Intraocular surgery
adverse effects of mydriatics
Blurred vision and photophobia
Precipitation of angle-closure glaucoma
Systemic effects
A patient is admitted to the hospital for treatment of symptomatic bradycardia and atrioventricular (AV) heart block. What topical medication for the eye should the nurse withhold and discuss with the healthcare provider before administration?
timolol (will slow heart down even more)
middle ear Auditory Ossicles:
malleus, incus, stapes
Bridge for sound to the inner ear.
middle ear
Conducts sound vibrations from outer ear to central hearing apparatus in the _____ ___
middle ear
Protects the inner ear by reducing amplitude of loud sounds.
middle ear
______ __ allows equalization of pressure on either side of TM so it doesn’t rupture.
Eustachian tube
directs sound waves from the auricle to the tymphanic membrane; coated in cerumen (hydrophobic) repels water protects against Fungus/bacteria
external ear
bounded by tympanic membrane
middle ear
parts of middle ear that transmits sound
Malleus, incus, stapes
parts of external ear
Auricle or pinna
inner ear that provides balance houses the apparatus for hearing
Semicircular canals, cochlea
this connects the middle ear with the nasopharynx and allows passage of air
eustachian tube
Normally closed opens with yawning and swallowing.
eustachian tube
Sound transmission to the inner ear impaired
(altered sound transmission through outer and middle ear due to obstruction or trauma)
conductive hearing loss
Results in ability to hear sound but inability to understand speech, can lead to misunderstanding by others, Hearing aids make sounds louder but not clearer
sensorineural hearing loss
Perception of noise without an actual source of sound, ringing of ears
Tinnitus
Age-related hearing loss
presbycusis
More than ___ drugs cause tinnitus, usually caused by ____
200, noise
Determine if a patient can hear a whispered sentence or a series of numbers when whispered from a
distance of 1-2 feet (covering tragus)
whisper test
A sticky liquid secreted by glands in the skin of the ear canal.
protects your ears by trapping outside materials such as dirt particles, dust and bacteria.
cerumen
Carbamide Peroxide Otic Solution/Debrox
Ear wax emulsifier, For use in ear only, class: peroxide, soften, loosens and removes cerumen
Contraindications for debrox
-ear drainage
-Tympanic membrane rupture (new/unhealed)
-Significant pain or irritation
t/f: •Hearing loss caused by noise is not reversible
true
Avoidance of continued exposure to noise levels greater than __ dB is essential
70
Salicylates, loop diuretics, cancer chemotherapy drugs, antibiotics
ototoxic substances- drugs
Toluene, carbon disulfide, mercury
ototoxic substances- industrial chemicals
ABX =
antibiotics
DM =
diabetes mellitus
Tx =
treatment
BM =
bone marrow
_____ _____ must be functioning properly to defend against pathogens/foreign substances
immune system
immune response functions:
defense, homeostasis, surveillance
substance that elicits immune response
antigen (on pathogen)
bodys ability to resist disease
immunity
type of immunity that is present at birth, nonspecific response, and first line defense against pathogens
innate
type of immunity that is cell mediated and humoral
acquired/adaptive
immunity that does not produce antibodies, cell destruction through T lymphocytes, destroys pathogens inside cell
cell mediated immunity
immunity that produces antigen-specific antibodies, destroys cells through B cells, destroys pathogens outside cell
humoral immunity
_____ activates the immune system but doesn’t always indicate infection
inflammation
when defense system fails and pathogen takes over
infections
t/f: inflammation is always present with infection; infection is not always present with inflammation
true
_______ response is a sequential reaction to cell injury and removes necrotic material; neutralizes and dilates inflammatory agent
inflammatory
t/f: inflammation mechanism is the same no matter what the cause
true
3 phases of inflammation:
vascular response
cellular response
formation of exudate
response that occurs after injury causing arterioles to vasoconstrict, releasing chemicals and histamine to dilate vessels
vascular response
during vascular response, _____ mediators cause increased capillary permeability
chemical
symptoms of vascular response
redness, heat, swelling
plasma protein
fibrinogen
accumulation of WBC’s, movement of neutrophis and monocytes move to site of injury during what response
cellular
local symptoms of inflammation
redness, heat, pain, swelling, fn loss
systemic symptoms of inflammation
leukocytosis, malaise, nausea/anorexia, fever, increased HR and RR
body reacts to fever by increase of what?
heat production and conservation
bodys method of increasing temp to new set point
shivering
body reaches new set point =
chills decrease
Released cytokines & fever they triggered =
activation of defense mechanisms
fevers are beneficial because they kill _________, increase phagocytosis of ________, and proliferation of __ _______
microorganisms, neutrophils, T cells
healing process 2-3 weeks, no residual damages, predominately neutrophils
acute inflammation
same as acute process but lasts longer (weeks to months)
subacute inflammation
lasts weeks, months, or years, agent repeatedly injures tissues, lymphocytes and macrophages
chronic inflammation
hormones secreted by adrenal cortex, available as exogenous drugs
corticosteroids
inhibition of inflammatory and immune responses; increases BG level and breakdown of proteins to amino acids, stimulate
bone demineralization & stabilize mast cells
corticosteroids MOA
Prednisone is a _______
glucocorticosteroid
glucocorticosteroid; anti-inflammatory or immunosuppressant, avoided in presence of serious infection, can be secreted in breast milk
prednisone
contraindications of prednisone
allergy, serious infections, DM
When give steroids –> causes the endogenous production of hormones
to stop, starts stimulating normal production of endogenous hormones
taper dosing
drug that influences every body system
prednisone
prednisone adverse effects:
moon face, hyperglycemia, psychosis, adrenal suppression, insomnia, nervousness, impaired wound healing
Prednisone: monitor/ caution patient with
DM, gastritis, reflux disease, ulcer disease, cardiac/renal/liver disease
one celled organisms, normal flora; cocci, bacillia or spirochetes
bacteria
gram positive stain ______
purple
gram negative stain ____
red
microorganism that causes disease
pathogen
pathogen invades body, multiplies and produces disease, triggers inflammation and immune responses
infection
assists body to combat infection, most effective if combined with functional defense mechanisms
antibiotics
bacteria are present but not with over signs/symptoms, presence of bacteria on body surface without causing disease
colonization
does colonization require ABX?
no
infection acquired by person who has not been hospitalized or had a recent procedure
community-associated infection
AKA nosocomial infection, acquired while getting healthcare tx or in hospital
healthcare associated infection
therapy where patient requires immediate ABX
empiric therapy
therapy where lab identifies microorganism, narrow spectrum use
definitive therapy
ABX to prevent an infection in situations with high contamination, prior to surgery (30 mins)
prophylactic/preventative ABX
certain bacteria and fungi that maintain normal fn in organs
normal flora
when normal flora is killed,
bacteria/fungi take over
inference with bacterial cell wall and protein synthesis and replication of DNA/RNA
ABX MOA
do not actually destroy bacteria, inhibits growth of bacteria
bacteriostatic
kill a wide variety of gram pos and some neg bacteria
bactericidal
bacterial infections no longer response to typical ABX treatment
bacterial resistant infections
ABX that contain beta lactam ring in chemical structure, provides mechanism for bacterial resistance
Beta lactam ABX
which ABX was first derived from mold on bread/fruit, bactericidal
penicillins
bind to protein, inhibit peptidoglycan, interferes with cell wall synthesis
PCN MOA
contraindications of penicillin
drug allergy, cephalosporins
semisynthetic ABX, related to PCN
cephalosporins
cephalosporins adverse effects
GI and skin, PCN
inhibit protein synthesis, effective against wide range infections, compete with drugs metabolized in liver
erythromycin
irritates GI tract, stimulates smooth muscle and GI motility, beneficial to patients with delayed gastric emptying
erythromycin
adverse effects of erythromycin
-nausea, vomiting, stomach irritation
-cardiac and liver issues
-tinnitus/hearing loss
inhibits bacterial protein synthesis, binds to magnesium, calcium, metallic ions. forms insoluble complexes
tetracycline (doxycycline)
tetracycline adverse effects
teeth discoloration, effects on fetal development, photosensitivity, upset stomach
non prescription neosporin
neomycin and polymyxin B
hypersensitivity reactions to ABX can occur __ mins or up to days later
30 (delayed responses can occur after 72 hrs)
ADL=
activity of daily living
TIA=
transient ischemic attack
what is the 5th most common death in the US
CVA
2 types of CVA’s
-Ischemic
-Hemorrhagic
Cerebral blood vessels change ________ in response to BP
diameter
During ______ CVA, –> autoregulation
may be impaired
ischemic
our cerebral blood vessels can make changed based on BF
Cerebral autoregulation
non-modifiable risk factors of CVA
gender, age, ethnicity, family history
some modifiable risk factors of CVA
htn, heart disease, diabetes, SMOKING (90%), obesity, sleep apnea, diet, substance abuse
mini stroke with brief episode of neurologic dysfunction, without infarction
transient ischemic attack
how long does a TIA last
<1 hour
which stoke involves a microemboli/temporary clot that temporarily blocks BF
TIA
__ % of strokes are ischemic
87%
Inadequate blood flow to the brain with blockage of a
cerebral artery by a blood clot
ischemic stroke
2 types of ischemic strokes
thrombotic, embolic
most common ischemic stroke, often preceded by TIA, narrowed vessel becomes occluded
thrombotic
thrombotic and embolic strokes result in _____
infarction
Embolus lodges & occludes cerebral artery, Most start as plaque, break off & enter circulation, travels to cerebral circulation & lodges in narrow vessel
embolic stroke
Common causes of embolic stroke
Atrial fibrillation, MI, infective, endocarditis, rheumatic heart disease
less common for embolic stroke:
air and fat emboli (long bone fractures)
ischemic stroke that develops suddenly with no warning signs and develops suddenly, conscious with headache
embolic stroke
Weakened blood vessels rupture and bleeding into the brain/ brain tissue (intracerebral), cells begin to die
Hemorrhagic stroke
Bleeding into the subarachnoid space or ventricles
Hemorrhagic stroke
Cause of hemorrhagic stroke where Bulge/ballooning in
blood vessel d/t weakness in the blood vessel wall; can leak and rupture
aneurysm
Abnormal tangle of blood vessels, connection of arteries and veins, Disrupt normal blood flow and oxygen, can weaken and rupture and lead to hemorrhage
Arteriovenous Malformation
(AVM)
One side of the brain controls the ______ side of the body
opposite
Lesion on one side of brain –> affects motor function on opposite side of body =
contralateral
unable to comprehend what is being said
receptive aphasia
inability to produce language
expressive aphasia
inability to communicate
global aphasia
loss of half of your vision
hemianopia
Right half or left half of your vision is missing from each eye, Monitor for diplopia, ptosis, loss of corneal reflex
Homonymous Hemianopsia
during ischemic stroke, In 1 second=
_______ brain cells die
32,000
during ischemic stroke, In 59 seconds=____ million brain cells die
1.9 million
door to needle time=
< or equal to 60 mins
stroke treatment is a multi- ? approach, or supportive therapy
drug
acute care of ischemic stroke
stroke center, treat htn, glycemic control
SBP > 220
DBP > 120
golden hour –>
CT upon arrival, blood glucose, NIHSS, fibrinolytic therapy, surgical intervention, 12 lead EKG and labs
breaks up clots causing stroke
fibrinolytic therapy
acute care of hemorrhagic stroke
antihypertensives, NO anticoagulants or platelet inhibitors, drug therapy, seizure precautions
Any process that stops bleeding
hemostasis
compression at bleeding site
mechanical hemostasis
clamping or cauterization
surgical hemostasis
When hemostasis occurs d/t to physiologic clotting of
blood =
coagulation
Process of Hemostasis
initial injury, vasospasm, platelet plug formation, coagulation
platelet plug formation in order:
adhesion, activation, aggregation, formation
tear in blood vessel, endothelium exposed
hemostasis injury
blood clot
thrombus
thrombus that moves
embolus
Hemostasis involves complex interaction of substances that promote ____ ______
clot formation
each activated clotting factor is a catalyst that amplifies next reaction
coagulation CASCADE
Result of cascade =
large clot forming substance FIBRIN
when platelet plug is not enough, use
coagulation cascade
Blood vessels are damaged by penetration from the outside, thromboplastin released
extrinsic pathway
examples of extrinsic pathway
knife, bullet wound
Clotting response to trauma/internal damage inside the blood vessels of body
intrinsic pathway
Components are present in the blood in inactive forms
intrinsic pathway
Activated when clotting factors come in contact with collage on inside of damaged blood vessels
intrinsic pathway
most powerful enzyme in coagulation process
thrombin
Factor Xa: Prothrombin -> thrombin ->
fibrinogen -> firbin. final product of coagulation:
meshwork (stable clot)
regardless of how clot began, ______ follows the same final common pathway
coagulation
the end of coagulation: converts fibrinogen to ____
fibrin
potent stimulator of platelet adhesion
collagen
antagonizes thrombin
antithrombin
thrombin activates conversion of plasminogen
to _____
plasmin
without thrombin, no ____
clot
reverse of clotting process
fibrinolysis
Breakdown of clots & balances clotting
process
fibrinolytic system
fibrinolytic system starts with activation of ________, then fibrin binds to it
plasminogen
enzymatic protein that breaks down thrombus
plasmin
Drugs that affect coagulation, dangerous and preventative, Used to reverse or maintain hemostasis
anticoagulants
do anticoagulants work on existing clots?
no
Anticoagulants: Contraindications
drug allergy, high risk for bleeding/ active bleeding
drug that Turns off 3 major clotting factors
heparin
Turns off coagulation pathway, Prevents clots from forming, CANNOT lyse clot
heparin
where do we get heparin from?
lungs or intestinal mucosa of pig
t/f: heparin is weight based
true
Large molecule only given IV, low molecular heparin just into really small molecules
unfractionated heparin
small structure, easier to target specific, more predictable outcome, injectable only
LMWH
DVT Prophylaxis –>
subq
Inhibits vitamin K synthesis, inhibits production of certain clotting factors
warfarin
Foods high in Vitamin K may ↓
______ ability to prevent clots
warfarin’s
toxic effect of anticoagulants
hemorrhagic
S/S of anticoag toxicity:
hematuria, melena, petechia, ecchymoses,
gum/mucus membrane bleeding
warfarin is synthesized in
liver
May take liver __ hours to resynthesize clotting
factors to reverse warfarin
36
heparin antidote
protamine sulfate
main anticoag AE
bleeding!
warfarin Antidote
vitamin K
Measure blood clotting time, if number is HIGHER, blood clot takes ______, if number is LOWER, ____
longer, quicker
Prevent clot formation, Prevent platelet adhesion at the site of blood vessel injury, Occurs before clotting cascade
antiplatelets
Collagen is stimulator of
platelet adhesion
After adhesion –>
stimulators from activated plts are released
stimulators tell platelets to _____, causing platelets to adhere
aggregate
Affect cyclooxygenase pathways, Final enzymatic pathway that operates within platelets & on cell
walls
final platelets
Inhibits cyclooxygenase in platelet, Inhibits enzyme so can’t regenerate –> prevents formation of thromboxane A2 (TXA2), TXA2 causes blood vessels to constrict & platelets to aggregate
aspirin
_____ Result = vessels dilate, prevent platelets from
aggregating and form a clot
aspirin
contraindications of aspirin:
thrombocytopenia, active
bleeding & allergy
fibrinogen attaches to receptors on platelet, Platelet will be able to aggregate now since it received the signal, inhibits activation of this receptor, Platelet does not
receive signal to clot
Clopidogrel
(Plavix)
Reduce risk of thrombotic stroke, TIA
prophylaxis, prevention of thrombosis
clopidrogel
KAVA is a sedative and ______
anxiolytic (acute liver failure)
St.John’s wort (natures prozac)
makes birth control uneffective
acute onset, reversible, minutes to hours
-Systemic syndrome characterized by decreased attention span (inattention), doesn’t recognize confused thinking
delerium
symptoms of delerium
hyperactive, with agitation, combative, hallucination, delusional, OR hypoactive, with inability to focus
or concentrate
emotional problems of delerium
fear, depression, euphoria, perplexity
Up to ___% of older adults hospitalized for medical conditions have delirium at some point in hospitalization
60%
Most common surgical complication among older adults, 15-25% after major elective surgery, 50% after high-risk procedures
delerium
Disorder characterized by a decline from previous level of
function in 1 or more cognitive domains:
Attention
Executive function
Language
Learning
Memory
Social cognition
dementia
devastating, progressive memory loss, impaired thinking, Neuropsychiatric symptoms, Inability to perform routine tasks of daily living
Alzheimers disease
Sixth leading cause of death in the United
States
Alzheimers disease
degeneration of neurons, early in hippocampus (memory), later in cerebral cortex (speech, perception, reasoning)
Alzheimers (pathopshysiology)
Degeneration of cholinergic neurons & deficiency of acetylcholine, Beta amyloid plaques form outside neurons and in the cerebral cortex, Presence of neurofibrillary tangles with twists inside of the neurons
Alzheimers
what gender is a risk factor for alzheimers
female
sundowning is common with what disease
Alzheimers
although the treatment of AD is to reverse cognitive decline, and there are no to do so, 3 cholinergic inhibitors approved for the treatment of Alzheimer’s dementia are:
Donepezil, galantamine, and rivastigmine
what happens if we lose acetocholyine in our brain
lose cognitive function
AD patients lose __% of their aceticholyine
90%
Acetylcholinesterase Inhibitors, AD drug
-Therapeutic Use: improves memory w/ mild to moderate AD by enhancing effects of acetylcholine in neurons in cerebral cortex not yet damaged – does not reverse disease
donepezil (aricept)
cholinergic toxicity (donepezil) symptoms: leads to dumbells
Circulatory collapse, Hypotension,
- SLUDGE – Salivation, Lacrimation, Urination,
Diarrhea, GI distress, Emesis
DUMBELLS (cholinergic toxicity) stands for:
diarrhea, urination, miosis, bradychardia, emesis, lacrimation, lethargy, salivation
Largest category of psychiatric problems, second only to HTN as chronic clinical condition
depression
__% of the U.S. population will experience
some form during their lifetime
30
Incidence of depression is twice as high in which gender?
twice as high in women than men
to get diagnosed with depression, symptoms must be present
most of the day, nearly every day, for at least 2 weeks
Insufficient amount of brain neurotransmitters such as Norepinephrine, Serotonin or Dopamine
- Decreased Serotonin permits it to occur
- Decreased Norepinephrine causes it
depression
Biochemically derived from Tryptophan, Primarily in the GI tract (90%) with remainder in the CNS serotonergic
neurons (parasympathetic cholinergic
receptors)
serotonin
Primarily used to relieve symptoms of
depression, Can also help patients with anxiety disorders
antidepressants
Most commonly prescribed antidepressants
selective serotonin reuptake inhibitors
Most widely prescribed SSRI in the world, primarily for major depressions, Produce selective inhibition of serotonin reuptake, Produce central nervous system (CNS) excitation
fluoxetine (prozac)
adverse effects of SSRI
-Withdrawal syndrome
-Neonatal effects when used during pregnancy
-Extrapyramidal side effects
- Bleeding disorders
- Sexual dysfunction
-Weight gain
Begins 2 to 72 hours after treatment, Altered mental status, resolves spontaneously after
discontinuing the drug
serotonin syndrome
Toxicity – Serotonin Syndrome
SHIVERS:
shivering
hyperreflexia and myoclonus
increased temp
vital sign instability
encephalopathy
restlessness
sweating
conditions that affect a
person’s thinking, feeling, mood,
or behavior
mental illness
examples of mental illness
Depression, anxiety, bipolar
disorder, schizophrenia, etc
More than __%, 1 in ___ will be
diagnosed with a
mental illness/disorder
at some point.
50%, 1 in 5
Amino acid neurotransmitter in brain
Gamma-Aminobutyric Acid (GABA)
Excitatory neurotransmitter, excessive amount = restlessness, nervous tension, anxiety
Glutamate
GABA is ____ while glutamate is ____
inhibitory, excitatory
GABA= promotes sense of ___
calm
Unpleasant state of mind; sense of dread and fear (anticipated or past experiences)
anxiety
drugs with Goal to decrease anxiety by reducing
overactivity in the CNS
anxiolytic drugs
Benzodiazepine receptor blocker, reverse effects of benzos, may cause withdrawal symptoms or seizures
flumazenil
State in which person lacks conscious awareness
sleep
wakes up or almost wakes up; interrupting continuous sleep
fragmented
sleeps recommended amount; does not feel refreshed and alert the next day
nonrestorative
Brain controls changes between sleep & waking, Forebrain & brainstem interact to regulate this
sleep wake cycle
Maintained by network of arousal systems from brainstem & forebrain, promoted by neurotransmitters
wake behavior
In hypothalamus –> sleep promoting neurons
sleep behavior
sleep is stimulated by neurotransmitters and _______
peptides
Hormone made by pineal gland, Release signals the time for sleep, Secretion is linked to the environmental light/dark cycle
melatonin
Synchronizes genetic clocks within individualized cells, master clock of body, in hypothalamus, regulates 24h sleep wake cycle
superchiasmatic nucleus (SCN)
Biologic rhythm pattern in 24 hours, Synchronized to environmental light & day periods, Through specific light detectors in retina
circadian rhythms
Pattern of nighttime sleep, Recorded using brain waves, eye movement, & muscle tone: NREM and REM
sleep architecture
difficulty falling and staying asleep, waking too early and feeling unrefreshed, dissatisfaction with sleep quality
insomnia
