Physio Cumulative Final Flashcards
The Brain Uses:
- 20% of total resting oxygen
- 15-20% of total blood flow
- 60% of glucose metabolism
The Brain Energy Division
- Approx. 25% maintaining neurons and glial cells
- Approx. 75% electrical signaling across the brain’s circuits
Apoptosis
- planned and purposeful neuronal cell death
- removal of damaged or unneeded neurons
Necrosis
- unplanned and uncontrolled neuronal cell death
Synaptic Pruning
- a natural process that occurs in the brain between early childhood and adulthood
- the brain eliminates extra synapses
Synapses
- brain structures that allow the neurons to transmit an electrical or chemical signal to another neuron
Difficulties with Synaptic Pruning
- Schizophrenia correlated with less synapses
- Autism correlated with more synapses
Frontal Lobe
- Executive functions (emotion regulation, planning, reasoning, inhibitory control), personality
- dominant hemisphere = social conduct
- Phineas Gage
Prefrontal Cortex
- Seat of planning and strategizing
- ventromedial PFC - empathy and guilt
Parietal Lobe
- Integrating sensory information including touch, temperature, pressure, and pain
Temporal Lobe
- Processing sensory information, particularly important for hearing, recognizing language, and forming memories
- Contains the primary auditory cortex
Occipital Lobe
- Visual processing (depth, distance, location)
- Contains the primary visual cortex
Basal Ganglia
- Part of the limbic system
- Controls motor control, as well as other roles such as motor learning, executive functions and behaviors, and emotions
- substantia nigra (produces dopamine, high concentration in basal ganglia)
Somatic Nervous System
- Made up of spinal nerves and cranial nerves
Spinal Nerves
- mixed nerves that carry sensory information into and motor commands out of the spinal cord
Cranial Nerves
- the nerve fibers that carry information into and out of the brain stem
Autonomic Nervous System
- Consists of the sympathetic division and parasympathetic division
Sympathetic Division
- fight, flight, freeze, fawn
- controls functions that accompany arousal and expenditure of energy
- coordinates responses to a stressor
- aka thoracolumbar system
Parasympathetic Division
- rest and digest
- involved with increases in body’s supply of stored energy
- coordinates rest and relax responses after the body has been stressed
- aka craniosacral system
- vagus nerve responsible for the calming following a stressful situation
Rate of Absorption and Distribution
- 5L/min blood pumped every minute
- entire volume of blood supply circulates every minute
Intravenous
- into the vein
- fastest and most dangerous
- 30-60 seconds
Intraperitoneal
- into the abdomen
Intramuscular
- into the muscle
Subcutaneous
- under the skin into the fatty tissue
Intracerebral
- bypass the BBB
- intracerebroventricular
- into the cerebral ventricles
Oral
- sublingual
- most common
- “first pass” metabolism
Intrarectal
- inserted into the rectum
Inhalation
- breathed in through the lungs
Insufflation
- through the nasal passages
Topical
- putting something on your skin (ex. lotion)
Entry of Drugs into the Brain
- drugs exert effects only at their sites of action
- mostly on or in cells of the CNS
- most important factor in determining the rate is lipid solubility
- lipid soluble materials pass through the BBB most rapidly
Therapeutic Index
- a quantitative measurement of relative safety of a drug
- commonly used margin of safety
- lower ratio = more dangerous
- ideal TI > 10
- TI = TD50/ED50
Effective Dose 50 (ED50)
- the dose that produces the desired effects in 50% of the individuals
Toxic Dose 50 (TD50)
- the dose that produces toxic effects in 50% of the individuals
Agonist
- a molecule that by binding to the receptor STIMULATES a response
- more postsynaptic effects
Antagonist
- a molecule that by binding to a receptor BLOCKS or inhibits the response
- less postsynaptic effects
CDC Moderate Drinking
- females = up to 1 drink per day
- males = up to 2 drinks per day
CDC Heavy Drinking
- females = 8 or more per week
- males = 15 or more per week
CDC Binge Drinking
- females = 4 or more in 2-3 hours
- males = 5 or more in 2-3 hours
Alcohol Absorption
- GI tract = 20% stomach and 80% small intestine
- food inhibits absorption by causing oxidation of alcohol and closing the pyloric sphincter
- irritates gastric mucosa –> slowed absorption
- impacts vitamin absorption
Alcohol Metabolism
- Primarily hepatic (90%)
- metabolized by alcohol dehydrogenase (ADH) (required B vitamins)
- acetaldehyde metabolized by aldehyde dehydrogenase –> acetate
Alcohol Excretion
- urine
- diuretic properties –> decreased nutrients and dehydration
Alcohol Intoxication
- consuming ETOH faster than liver can break it down
- 1 standard drink per hour
- 80% of individuals with AUD have thiamine deficiency due to lower vitamin absorption and higher thiamine use by ADH
Glucose
- primary source of fuel for the brain
- ~20% of glucose-derived energy
- is necessary (provides precursors for NT synthesis and apoptosis)
- glucose levels correlated with thinking, memory, and learning
High Sugar Diets
- less brain-derived neurotrophic factors (BDNF)
- BDNF modulates growth, development and communication between synapses - decreased synapses = higher risk of neurodegenerative disorders due to atrophy and small vessel disease
- Americans consume 156lbs of sugar per year
- AMA recommends 6-9 teaspoons per day
Stimulants
- Impacts the brain’s levels of epinephrine/norepinephrine, dopamine, and serotonin
- stimulants impact each to a varying degree (selectivity)
- cause alertness, attention, energy
Medical Uses of Stimulants
- Freud’s Uber Coca
- pain management, ADHD, asthma, obesity, narcolepsy
Stimulant Primary Risk Factors
- reduced seizure threshold
- higher blood pressure, heart rate, hypertension = higher risk of stroke, MI
- poor appetite, mood swings, anxiety, insomnia
- toxic levels = paranoia, psychosis
Endocannabinoid System
- comprises a vast network of chemical signals and cellular receptors that are densely packed throughout our brains and bodies
- a neuromodulation system
CB1 Receptor
- higher in brain and lower in concentration widespread
- mediates most of the psychoactive effects of cannabinoids
CB2 Receptor
- principally involved in anti-inflammatory and immunosuppressive actions
Most Notable Cannabinoid
- delta-9-tetrahydrocannibinol (THC) and cannabidiol
THC Content
- <.3% = hemp
- > .3% = marijuana
Anandamide
- an endocannabinoid (neuromodulator) found in the endocannabinoid system
- THC mimics anandamide –> effecting the endocannabinoid system
- THC much more potent than anandamide
- effects energy, mood, appetite, and perception of time
Cannabis Absorption
- inhalation: peak plasma concentration 3-10 minutes; bioavailability = 10-35%
- oral: peak plasma concentration ~120 minutes; bioavailability = 6-20%
Cannabis Distribution
- Rapidly to well-vascularized organs
- accumulates in adipose tissue
Cannabis Metabolism and Excretion
- predominately hepatic
- able to cross the placenta; released in breast milk
- excreted through urine, feces, and sweat
Technology Addiction and Mood
- teens aged 13-18 spent about 8.4 hours a day on screens
- “likes,” “re-tweets,” “novelty” = higher mesolimbic activation
- more use = higher SUD, ADHD, depression, anxiety, poor coping
Mesolimbic Dopamine Pathway
- route between VTA, nucleus accumbens, and limbic system (hippocampus and amygdala)
- key pathway in pleasure and reward
- substance use
Mesocortical Dopamine Pathway
- route between VTA/nucleus accumbens and PFC
Stress
- higher corticotropin-releasing hormone (CRH)
- strengthens the amygdala
- weakens the hippocampus and prefrontal cortex
Stress Results
- negative emotional state
- lack of executive control = higher risk of relapse
- memory of relief/cravings
Ventromedial Prefrontal Cortex (VMPFC)
- interface between emotional responses and control of complex behaviors
- using emotional reasons to guide behaviors
- courage = higher activation
- impulsive/emotional murderers = less activation
- antisocial personality disorder - less 11% of gray matter in VMPFC
Patient E.R.
- bilateral damage of the VMPFC
- excellent social judgement in verbal responses to hypothetical situations, expansive reasoning shared
- real life situations was unable to prioritize between trivial and important decisions
Love and the Brain
- photos of romantic partners = higher caudate nucleus, higher ventral tegmental area
- higher cortisol and adrenalin
- increased HR, sweating, anxiety, nervousness
- decreased appetite, concentration
- dilated eyes
- less PFC activation
Post-Orgasm
- in women: higher oxytocin = feelings of attachment and bonding
- in men: higher vasopressin = vigilance and need to guard/protect partner
Sleep Cycles
- each cycle lasts approximately 90 minutes
- alternates between REM and NREM
- SWS predominates first half of the night
- REM predominates second half of the night
Daylight Savings Time
- 24% increase in myocardial infarction
- 6% increase in traffic accidents
- increased mood disturbances and suicide
- volatility in the stock markets attributed to impact of sleep deprivation on frontal lobe functioning
- American Academy of Sleep Medicine says to abolish daylight savings time
Effects of Sleep Deprivation
- extensive sleep deprivation is fatal in rats
- inherited neurological disorder, fatal familial insomnia, is a progressive insomnia that results in damage to portions of the thalamus and death after 12 months
- potential etiology: sleep destroys free radicals and precents their damaging effects
Adenosine
- astrocytes store glycogen for “emergency energy”
- adenosine is a by-product (ATP –> adenosine)
- accumulation of adenosine produces increased delta sleep
- adenosine increases steadily during day producing sleepy feeling at night
- sleep deprivation = lower glycogen stores and higher adenosine = sleepiness
Melatonin
- produced by the pineal gland in response to evening/darkness about 2 hours before normal sleep time
- serotonin is converted into melatonin
- exogenous melatonin = take 1-2 mg 30 to 1 hour before bedtime
- light, especially blue light negates melatonin effects
- contraindicated in older adults with dementia and those with dementia