Physio Cumulative Final Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

The Brain Uses:

A
  • 20% of total resting oxygen
  • 15-20% of total blood flow
  • 60% of glucose metabolism
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2
Q

The Brain Energy Division

A
  • Approx. 25% maintaining neurons and glial cells
  • Approx. 75% electrical signaling across the brain’s circuits
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3
Q

Apoptosis

A
  • planned and purposeful neuronal cell death
  • removal of damaged or unneeded neurons
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4
Q

Necrosis

A
  • unplanned and uncontrolled neuronal cell death
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5
Q

Synaptic Pruning

A
  • a natural process that occurs in the brain between early childhood and adulthood
  • the brain eliminates extra synapses
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6
Q

Synapses

A
  • brain structures that allow the neurons to transmit an electrical or chemical signal to another neuron
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7
Q

Difficulties with Synaptic Pruning

A
  • Schizophrenia correlated with less synapses
  • Autism correlated with more synapses
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8
Q

Frontal Lobe

A
  • Executive functions (emotion regulation, planning, reasoning, inhibitory control), personality
  • dominant hemisphere = social conduct
  • Phineas Gage
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9
Q

Prefrontal Cortex

A
  • Seat of planning and strategizing
  • ventromedial PFC - empathy and guilt
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10
Q

Parietal Lobe

A
  • Integrating sensory information including touch, temperature, pressure, and pain
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11
Q

Temporal Lobe

A
  • Processing sensory information, particularly important for hearing, recognizing language, and forming memories
  • Contains the primary auditory cortex
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12
Q

Occipital Lobe

A
  • Visual processing (depth, distance, location)
  • Contains the primary visual cortex
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13
Q

Basal Ganglia

A
  • 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)
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14
Q

Somatic Nervous System

A
  • Made up of spinal nerves and cranial nerves
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15
Q

Spinal Nerves

A
  • mixed nerves that carry sensory information into and motor commands out of the spinal cord
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16
Q

Cranial Nerves

A
  • the nerve fibers that carry information into and out of the brain stem
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17
Q

Autonomic Nervous System

A
  • Consists of the sympathetic division and parasympathetic division
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18
Q

Sympathetic Division

A
  • fight, flight, freeze, fawn
  • controls functions that accompany arousal and expenditure of energy
  • coordinates responses to a stressor
  • aka thoracolumbar system
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19
Q

Parasympathetic Division

A
  • 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
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20
Q

Rate of Absorption and Distribution

A
  • 5L/min blood pumped every minute
  • entire volume of blood supply circulates every minute
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21
Q

Intravenous

A
  • into the vein
  • fastest and most dangerous
  • 30-60 seconds
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22
Q

Intraperitoneal

A
  • into the abdomen
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23
Q

Intramuscular

A
  • into the muscle
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24
Q

Subcutaneous

A
  • under the skin into the fatty tissue
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25
Q

Intracerebral

A
  • bypass the BBB
  • intracerebroventricular
  • into the cerebral ventricles
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26
Q

Oral

A
  • sublingual
  • most common
  • “first pass” metabolism
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27
Q

Intrarectal

A
  • inserted into the rectum
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28
Q

Inhalation

A
  • breathed in through the lungs
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29
Q

Insufflation

A
  • through the nasal passages
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30
Q

Topical

A
  • putting something on your skin (ex. lotion)
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31
Q

Entry of Drugs into the Brain

A
  • 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
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32
Q

Therapeutic Index

A
  • a quantitative measurement of relative safety of a drug
  • commonly used margin of safety
  • lower ratio = more dangerous
  • ideal TI > 10
  • TI = TD50/ED50
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33
Q

Effective Dose 50 (ED50)

A
  • the dose that produces the desired effects in 50% of the individuals
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34
Q

Toxic Dose 50 (TD50)

A
  • the dose that produces toxic effects in 50% of the individuals
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35
Q

Agonist

A
  • a molecule that by binding to the receptor STIMULATES a response
  • more postsynaptic effects
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36
Q

Antagonist

A
  • a molecule that by binding to a receptor BLOCKS or inhibits the response
  • less postsynaptic effects
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37
Q

CDC Moderate Drinking

A
  • females = up to 1 drink per day
  • males = up to 2 drinks per day
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38
Q

CDC Heavy Drinking

A
  • females = 8 or more per week
  • males = 15 or more per week
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39
Q

CDC Binge Drinking

A
  • females = 4 or more in 2-3 hours
  • males = 5 or more in 2-3 hours
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40
Q

Alcohol Absorption

A
  • 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
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41
Q

Alcohol Metabolism

A
  • Primarily hepatic (90%)
  • metabolized by alcohol dehydrogenase (ADH) (required B vitamins)
  • acetaldehyde metabolized by aldehyde dehydrogenase –> acetate
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42
Q

Alcohol Excretion

A
  • urine
  • diuretic properties –> decreased nutrients and dehydration
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43
Q

Alcohol Intoxication

A
  • 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
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44
Q

Glucose

A
  • 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
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45
Q

High Sugar Diets

A
  • 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
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46
Q

Stimulants

A
  • Impacts the brain’s levels of epinephrine/norepinephrine, dopamine, and serotonin
  • stimulants impact each to a varying degree (selectivity)
  • cause alertness, attention, energy
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47
Q

Medical Uses of Stimulants

A
  • Freud’s Uber Coca
  • pain management, ADHD, asthma, obesity, narcolepsy
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48
Q

Stimulant Primary Risk Factors

A
  • reduced seizure threshold
  • higher blood pressure, heart rate, hypertension = higher risk of stroke, MI
  • poor appetite, mood swings, anxiety, insomnia
  • toxic levels = paranoia, psychosis
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49
Q

Endocannabinoid System

A
  • comprises a vast network of chemical signals and cellular receptors that are densely packed throughout our brains and bodies
  • a neuromodulation system
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50
Q

CB1 Receptor

A
  • higher in brain and lower in concentration widespread
  • mediates most of the psychoactive effects of cannabinoids
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51
Q

CB2 Receptor

A
  • principally involved in anti-inflammatory and immunosuppressive actions
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52
Q

Most Notable Cannabinoid

A
  • delta-9-tetrahydrocannibinol (THC) and cannabidiol
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53
Q

THC Content

A
  • <.3% = hemp
  • > .3% = marijuana
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54
Q

Anandamide

A
  • 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
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55
Q

Cannabis Absorption

A
  • inhalation: peak plasma concentration 3-10 minutes; bioavailability = 10-35%
  • oral: peak plasma concentration ~120 minutes; bioavailability = 6-20%
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56
Q

Cannabis Distribution

A
  • Rapidly to well-vascularized organs
  • accumulates in adipose tissue
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57
Q

Cannabis Metabolism and Excretion

A
  • predominately hepatic
  • able to cross the placenta; released in breast milk
  • excreted through urine, feces, and sweat
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58
Q

Technology Addiction and Mood

A
  • 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
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59
Q

Mesolimbic Dopamine Pathway

A
  • route between VTA, nucleus accumbens, and limbic system (hippocampus and amygdala)
  • key pathway in pleasure and reward
  • substance use
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60
Q

Mesocortical Dopamine Pathway

A
  • route between VTA/nucleus accumbens and PFC
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61
Q

Stress

A
  • higher corticotropin-releasing hormone (CRH)
  • strengthens the amygdala
  • weakens the hippocampus and prefrontal cortex
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62
Q

Stress Results

A
  • negative emotional state
  • lack of executive control = higher risk of relapse
  • memory of relief/cravings
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63
Q

Ventromedial Prefrontal Cortex (VMPFC)

A
  • 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
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64
Q

Patient E.R.

A
  • 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
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65
Q

Love and the Brain

A
  • 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
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66
Q

Post-Orgasm

A
  • in women: higher oxytocin = feelings of attachment and bonding
  • in men: higher vasopressin = vigilance and need to guard/protect partner
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67
Q

Sleep Cycles

A
  • 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
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68
Q

Daylight Savings Time

A
  • 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
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69
Q

Effects of Sleep Deprivation

A
  • 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
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70
Q

Adenosine

A
  • 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
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71
Q

Melatonin

A
  • 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
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72
Q

Acetylcholine

A
  • pons, basal forebrain, medial septum
  • waking levels: high
  • SWS levels: low
  • REM levels: high
73
Q

Norepinephrine

A
  • locus coeruleus
  • waking levels: high
  • SES levels: low
  • REM levels: low
74
Q

Serotonin

A
  • raphe nuclei
  • waking levels: high
  • SWS levels: decreasing
  • REM levels: low
75
Q

Histamine

A
  • tuberomammillary nucleus
  • waking levels: high
  • SWS levels: low
  • REM levels: low
76
Q

Orexin

A
  • lateral hypothalamus
  • waking levels: high
  • SWS levels: low
  • REM levels: low
77
Q

Disorders of Sleep Stats

A
  • 25% less sleep than earlier generations
  • 20% Americans employed in shift work
  • 40% of adults report falling asleep during the day without meaning to at least once a month
78
Q

Insomnia

A
  • effects 30% of adults
  • 80 million Americans, 40% women, 30% men
  • high comorbidity rate with chronic medical conditions
  • chronic use of sleep-promoting drugs can cause rebound insomnia
79
Q

Primary Insomnia

A
  • difficulty falling asleep after going to bed or after awakening during the night
80
Q

Secondary Insomnia

A
  • inability to sleep due to another mental or physical condition (e.g., pain, medication)
81
Q

Narcolepsy

A
  • orexin-related disorder
  • hereditary component
  • sleep attacks
  • cataplexy
  • sleep paralysis
  • treatment: modafinil, methylphenidate, SSRIs
82
Q

Sleep Attacks

A
  • overwhelming urge to sleep
  • triggered under boring and monotonous conditions
  • lasts 2-5 minutes
  • wake up refreshed
83
Q

Cataplexy

A
  • sudden muscle weakness/paralysis
  • triggered by strong emotional reaction or physical exertion
  • remain fully conscious
  • loss of muscle control due to massive inhibition of motor neurons in spinal cord
84
Q

REM Sleep Behavior Disorder

A
  • lack of muscle paralysis during REM –> acting out dreams
  • can be comorbid with narcolepsy
  • typical onset 60+ years
  • believed to be neurodegenerative
  • treatment = clonazepam
85
Q

Sleep Apnea

A
  • 18 million Americans
  • difficulties sleeping and breathing at the same time higher CO2 = stimulates chemoreceptors –> wake up gasping for air and decreased slow wave activity
  • treated via CPAP and BiPAP: can reverse cognitive deficits with treatment
86
Q

Untreated Sleep Apnea

A
  • significant deficits in attention, memory, and executive functions
  • increase risk of stroke, MI
  • in kids: 2.5x risk of behavioral problems
87
Q

Obstructive Sleep Apnea

A
  • due to narrowing of airway (obesity, enlarged tonsils, hormonal changes)
88
Q

Central Sleep Apnea

A
  • brain does not signal need to breath
89
Q

Broca’s Area

A
  • nonfluent
  • motor
  • frontal lobe
  • speech is slow and broken
90
Q

Wernicke’s Area

A
  • sensory
  • temporal lobe
  • speech is normal and excessive but makes little sense
91
Q

Learning

A
  • acquisition of new information
  • refers to the process by which experiences change our nervous system and our behavior
92
Q

Learning: Stage 1

A
  • Sensory information
  • information is first processed through our senses e.g., echoic memory
  • <1 second
93
Q

Learning: Stage 2

A
  • short term memory
  • meaningful/salient information
  • < 1 minute
  • can support via repetition or chunking (7 +/- 2 Rule)
94
Q

Learning: Stage 3

A
  • long term memory
  • short term memories are converted into long term memories via consolidation
  • can be retrieved across a lifetime
  • increased retrieval i.e., rehearsal = strengthening of memory
  • involves the hippocampus
95
Q

Observational Learning

A
  • aka social learning theory
  • process of learning by watching the behaviors of models
  • occurs via operant conditioning and vicarious conditioning
  • social media
  • violence in video games
96
Q

Prosocial Modeling

A
  • prompts engagement in helpful and healthy behavior
97
Q

Antisocial Modeling

A
  • prompts others to engage in aggressive/unhealthy behavior
  • Bandura Bobo doll - physical aggression
98
Q

Models People are likely to Mimic

A
  • positive perception (liked, high status)
  • shared (perceived) traits
  • stand out
  • familiarity
  • self-efficacy in mimicry
99
Q

Middle Cerebral Artey (MCA) Strokes

A
  • 90% of all strokes
  • largest of the brain arteries
  • supplies most of the outer surface of the frontal, parietal, temporal lobes and the basal ganglia
100
Q

MCA Stroke Symptoms

A
  • contralateral weakness and sensory loss in UPPER extremities
  • homonymous hemianopia (loss of visual field)
  • left MCA stroke = speech deficits
  • right MCA stroke = neglect and poor motivation
101
Q

Anterior Cerebral Artery (ACA) Stroke

A
  • less common
  • feeds deep structures in the brain. frontal, parietal, corpus callosum, and bottom of the cerebrum
102
Q

ACA Stroke Symptoms

A
  • contralateral motor and sensory loss in LOWER extremities
  • poor gait and coordination = clumsy
  • slowed initiation (abulia)
  • flat affect
  • urinary incontinence
103
Q

Post Stroke Depression

A
  • 1/3 survivors
  • 6x higher risk of depression 2-3 years post stroke
  • more common in left frontal and basal ganglia strokes
  • adversely effects functional recovery
  • more risk factors = premorbid depression and social isolation post stroke
  • psychopharmacologic treatment is key
104
Q

Post Stroke Anxiety

A
  • 1/4 meet GAD criteria post stroke
  • less common
105
Q

Post Stroke Psychosis

A
  • more common in right-temporo-parietal-occipto area lesions, seizures, and subcortical atrophy
  • pseudobulbar affect = 10-15% post stroke patients
  • hypomanic symptoms = 1%
106
Q

BE FAST

A

Balance
Eyes

Face
Arms
Speech
Time

107
Q

Tissue Plasminogen (tPA)

A
  • can be administered within 4.5 hours
  • helps to restore blood flow to brain regions affected by a stroke, thereby limiting the risk of damage and functional impairment
  • after that time, has hemorrhagic effect
108
Q

Deficiency of Vitamin D

A
  • depression/negative emotions
  • nearly 40-50% of men and women in the Denver metro area are deficient in vitamin D
  • the more melanin your skin has, the harder it is to synthesize vitamin D
  • concurrent use with anti-depressant supportive
109
Q

Magnesium Deficiency

A
  • with stress can increase agitation, anxiety, sleeplessness, headaches, and apathy
  • can treat restless leg syndrome
  • slow response time to reach steady state via oral supplementation (30+ weeks)
110
Q

Omega-3 Fatty Oils

A
  • add on treatment for depression (strong evidence)
  • for ADHD (some evidence)
111
Q

Alpha Diversity

A
  • A measure in microbial ecology of “species” diversity, specifically the diversity WITHIN a sample
112
Q

Beta Diversity

A
  • a measure in microbial ecology of species diversity, specifically, the diversity BETWEEN samples
113
Q

Dysbiosis

A
  • disruption of the gut microbial diversity and community structure, typically due to reductions in beneficial bacteria and overgrowth of harmful bacteria and overgrowth of harmful bacteria, yeast, and or parasites
114
Q

“Old Friends” and a Failure of Immunoregulation

A
  • one factor contributing to increases in chronic inflammatory disorders in high-income countries is thought to be failing immunoregulation, attributable to reduced exposure to microbial environment within which the mammalian immune system co-evolved
115
Q

Old Friends and Psychiatric Disorders

A
  • some psychiatric disorders in developed countries might be attributable to failure of immunoregulatory circuits to terminate ongoing inflammatory responses
116
Q

TBI Sex and Age Breakdown

A
  • females: peak at ages 15-24 and 75+
  • males: extreme peak at ages 15-24 and slight peak at 75+
117
Q

Diffuse Axonal Injury (DAI)

A
  • the shearing (tearing) of the brain’s long connecting nerve fibers (axons) that happens when the brain is injured as it shifts and rotates inside the bony skull
  • damage to white matter
  • changes are microscopic
  • can lead to disorders of consciousness
  • difficult to see on CT scan, or MRI
  • can occur without other visible damage
118
Q

Grades of Diffuse Axonal Injuries

A
  • Grade 1: mildest form
  • Grade 2: moderate form
  • Grade 3: severe form
119
Q

Mild TBI

A
  • unconscious for < 30 minutes
  • Glasgow coma scale: 13-15
  • post-traumatic amnesia: <24 hours
120
Q

Moderate TBI

A
  • unconscious for 30 minutes to 24 hours
  • glasgow coma scale: 9-12
  • post-traumatic amnesia: 1-7 days
121
Q

Severe TBI

A
  • unconscious for 24 hours
  • Glasgow coma scale: 3-8
  • post-traumatic amnesia: >7 days
122
Q

Glasgow Coma Scale Limitations

A
  • substance use
  • administered drugs
  • intubation
  • injury to eye
  • hemiplegia
  • language
123
Q

Non-Injury Risk Factors that can influence TBI Outcomes

A
  • pre-injury psychiatric status and conduct issues/incarceration
  • age at injury
  • level of education
  • stable employment 6 months prior to pre-injury
  • marital status
  • other non-neurological injuries sustained
124
Q

Loss of Consciousness in Subarachnoid Hemorrhage

A
  • transient intracranial circulatory arrest
  • the ‘percussive blood pressure impact of the hemorrhage increase ICP (intracranial pressure) and therefore reduces CPP (cerebral perfusion pressure)
125
Q

Hunt and Hess Grade I through V

A
  • Grade I: asymptomatic or minimal headache/neck stiffness
  • Grade II: Moderate to severe headache, neck stiffness
  • Grade III: drowsiness, confusion
  • Grade IV: stupor, moderate to severe hemiparesis
  • Grade V: deep coma
126
Q

Hemiplegia

A
  • Paralysis affecting one side of the body
  • face, arm, trunk, leg
127
Q

Hemiparesis

A
  • implies a lesser degree of weakness than hemiplegia
128
Q

Neglect

A
  • failure to attend to, respond to, and/or report stimulation that is introduced contralateral to the lesion
  • most often seen with non-dominant parietal association are lesions
  • affects contralesional side
  • persistent neglect is a negative functional outcome predictor
129
Q

Agnosia

A
  • acquired inability to associate a perceived unimodal stimulus with meaning
  • disorder of recognition (not naming!)
130
Q

Anasagnosia

A
  • denial of deficit
131
Q

Prosopagnosia

A
  • impaired ability to recognize faces
132
Q

Tumors

A
  • a mass of cells whose growth is uncontrolled and that serves no useful function
  • can be malignant (cancerous) or benign
133
Q

Tumors Damage Brain Tissue by:

A
  • compression
  • infiltration
  • malignant can compress and infiltrate
  • benign tend to only compress
134
Q

Primary Brain Tumor

A
  • start in the CNS
  • most commonly seen in those under 15 and above 65 y/o
135
Q

Secondary Brain Tumor

A
  • metastasize in brain
  • most common brain metastases are from lung and breast cancer
136
Q

Grading of CNS Tumors

A
  • Grade 1: low proliferative potential, possibility of cure after surgical resection
  • Grade 2: infiltrative, low proliferative potential
  • Grade 3: histological evidence of malignancy
  • Grade 4: histological evidence of malignancy, prone to necrosis
137
Q

Gliomas

A
  • most common primary brain tumor type (33%)
  • tumor of the glial cells
  • astrocytoma
  • meningioma
138
Q

Astrocytoma

A
  • tumor of the astrocytes
  • can be low grade or high grade
139
Q

Glioblastoma Multiforme

A
  • grade 4 astrocytoma
  • most aggressive tumor form
  • average survival rate from diagnosis approx. 2 years
  • higher incidence in white individuals
140
Q

Meningioma

A
  • tumor of the meninges, usually benign and slow growing
  • encapsulated
141
Q

Tumor Treatments

A
  • surgical resection
  • radiation
  • chemotherapy
142
Q

Seizures

A
  • a period of sudden, excessive activity of cerebral neurons
  • epilepsy chronic disorder of recurrent seizures
  • can be partial/focal or generalized
143
Q

Partial/Focal Types of Seizures

A
  • simple partial: no major change in consciousness
  • complex partial: cause of loss of consciousness
144
Q

Generalized Types of Seizures

A
  • Tonic-clonic (Grand Mal)
  • Absence (petit mal)
  • Atonic
145
Q

Tonic-Clonic/Grand Mal Seizures

A
  • most severe form of seizure
  • include convulsions
  • typical stages: aura, tonic, clonic, postictal
146
Q

Tonic Phase

A
  • stiffening of muscles
147
Q

Clonic phase

A
  • jerking or twitching
148
Q

Absence “petit mal” Seizures

A
  • sudden lapse in consciousness
  • staring blankly into space
  • eyelid fluttering
  • lip smacking
  • involuntary hand movements
149
Q

Atonic Seizures

A
  • aka “drop seizures”
  • sudden loss of muscle control = collapse or fall
  • different to cataplexy in narcolepsy due to loss of consciousness
150
Q

Seizure First Aid

A
  • STAY with the person until they are awake and alert after the seizure
  • keep the person SAFE
  • turn the person onto their SIDE if they are not awake and aware
  • call 911 is seizure lasts longer than 5 minutes
151
Q

Depression: Hedonic Tone/Responsiveness

A
  • trait or genetic predisposition underlying one’s baseline range and lifelong ability to feel pleasure
  • dysfunction of mesolimbic and mesocortical pathways
  • loss of 40%-90% of glial cells
  • LOW hedonic tone = increase of anhedonia, depression, and dysthymia
152
Q

Schizophrenia Risk and Development

A
  • 46% concordance rate
  • 10x risk African and Caribbean migrants
  • Men>women
  • mutation in 21 of the 23 chromosomes
  • older paternal age
  • atypical prenatal development
  • poor social adjustment and academic performance
  • deficient psychomotor functioning
153
Q

Schizophrenia Minor Physical Anomalies

A
  • high-steepled palate
  • partial webbing of two middle toes
  • especially wide or narrow-set eyes
154
Q

Schizophrenia Disease Burden

A
  • 20% reduction in life expectancy
  • 40% of deaths attributable to suicide
155
Q

Anxious Apprehension

A
  • more activation in left frontal lobe i.e., Broca’s
156
Q

Anxious Arousal

A
  • higher activation in right temporal lobe i.e., increased sensitivity to environmental sounds and noises
157
Q

Prion Disease

A
  • occur when prion protein, found throughout the body, begins folding into an abnormal three-dimensional shape
  • damaged prion protein destroys brain cells, leading to a rapid decline in thinking and reasoning
  • aka transmissible spongiform encephalopathies
158
Q

Creutzfeldt-Jakob Disease

A
  • most common
  • “mad cow disease” epidemic of the 1980s and 1990s
  • causes severe mental deterioration and dementia - 8 month average
159
Q

Kuru Disease

A
  • from eating contaminated human brain tissue
  • traditional practice of Fore people of New Guinea
  • cannibalism of deceased loved ones
  • 10-50 year incubation period
160
Q

Parkinson’s Disease

A
  • caused by the degeneration of dopamine neurons in the substantia nigra that send axon to the basal ganglia –> deficiency of automatic, habitual motor responses
  • 95% of cases are sporadic
161
Q

Parkinson’s Disease Symptoms

A
  • dystonia = rigidity –> cognitive wheel test
  • Bradyskinesia and slowed reaction times = falls
  • shuffling gait
  • face masking
  • tremors (pill roller tremor)
162
Q

Parkinson’s Disease Treatments

A
  • L-Dopa: time limited , side effects of hallucinations and delusions
  • deprenyl - slows Parkinson’s progression
  • intentional lesioning of the pathway
  • deep brain stimulation
163
Q

Huntington’s Disease

A
  • inherited disease resulting in degeneration of the basal ganglia
  • results in: chorea (involuntary jerking movements), dystonia, slurred speech and swallow difficulties
164
Q

Amyotrophic Lateral Sclerosis (ALS)

A
  • degenerative disorder that attacks spinal cord and cranial nerve motor neurons –> brain and muscle connection loss
  • 90%; 10% inherited
  • mutation on chromosome 21
165
Q

ALS Symptoms

A
  • progressive weakness and muscular atrophy - eventual loss of speech, swallow with paralysis
  • eye movements spared
  • death typically caused by respiratory failure - typically within 24 months
166
Q

Multiple Sclerosis (MS)

A
  • an autoimmune demyelinating disorder
  • at scattered locations within the CNS, the person’s immune system attacks myelin sheaths, leaving behind hard patches of debris called sclerotic plaques
  • damage occurs in white matter
167
Q

MS Risk Factors

A
  • females > males
  • living far from the equator
  • black or white race
  • smoking
168
Q

MS Symptoms

A
  • fatigue
  • vision problems
  • bladder/bowel dysfunction
  • spasms
  • slowed processing speed
169
Q

Meningitis

A
  • inflammation of the meninges caused by viruses or bacteria
170
Q

Meningitis Causes

A
  • virus
  • bacteria
  • fungus
  • parasite
171
Q

Meningitis Symptoms

A
  • stiff neck
  • headache
  • Altered Mental Status
172
Q

Meningitis Etiology

A
  • spread of middle-ear infection to the brain
  • head injury
  • embolus that has dislodged from bacterial infection in the heart
173
Q

Brudzinski’s Sign

A
  • flexion of the hips and knees in response to neck flexion
174
Q

Kernig’s Sign

A
  • resistance to extension of leg while the hip is flexed
175
Q

Memory Test Impairments for Vascular Dementia

A
  • semantic memory
  • visuo-spatial/perceptual skills
  • slowed processing speed
  • with cuing/recognition paradigm can recall information
176
Q

Memory Test Impairments for Alzheimer’s Disease

A
  • episodic memory
  • language
  • cueing/recognition does not help
177
Q

Akathisia

A
  • a feeling of muscle quivering, restlessness, and inability to sit still, sometimes a side effect of antipsychotic or antidepressant medication
178
Q

Bradyskinesia

A
  • slowness of movement
179
Q

Tardive Dyskinesia

A
  • repetitive, involuntary movements, such as grimacing and eye blinking