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Physio > Physio final 4-5 > Flashcards

Physio final 4-5 Flashcards

1
Q

mesolimbic dopamine pathway

A

route between VTA, nucleus and limbic system (hippocampus and amygdala)
key pathway to pleasure and reward
substance use

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2
Q

mesocortical dopamine pathway

A

route between VTA/nucleus accumbens and PFC

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3
Q

stress

A

high corticotropin-releasing hormone (CRH)
strengthens the amygdala
weakens the hippocampus and PFC

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4
Q

role of stress and SUD

A

results in:
negative emotional state
lack of executive control = increase risk of relapse
brings back memory of relief/craving

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5
Q

stress studies

A

1/3 of adol. with reported abuse/neglect will develop a SUD before 18
2-4x of those with PTSD develop chemical dependencies
SGM across lifespan = increase risk of TUD and AUD + homelessness = 5x
covid-19 = increased 23% increase in AUD

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6
Q

potential health benefits of moderate drinking

A

small amount still increased risk of CVD-related illness = risks attenuated by healthy lifestyle

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7
Q

Moderate drinking (CDC)

A

females = up to 1 drink/day
males = up to 2 drinks/day

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8
Q

heavy drinking (CDC)

A

females = 8 or more/week
males = 15 or more/ week

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9
Q

binge drinking (CDC)

A

in 2-3 hours
females = 4 or more
males = 5 or more

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10
Q

stimulants impact the brains levels of …
(stimulant pharmacokinetics)

A

epinephrine/norepinephrine
dopamine
serotonin

impact each to varying degree
cause attention, alertness and energy

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11
Q

uses for stimulants (Freud’s Uber Coca)

A

pain management
ADHD
Asthma
Obesity
Narcolepsy

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12
Q

Primary risk factors of stimulants
(stimulant pharmacokinetics)

A

reduced seizure threshold (more likely to have a seizure)
increased BP, HR, HTN = increased risk of stroke and MI
poor appetite, mood swings, anxiety, insomnia
toxic levels = paranoia and psychosis

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13
Q

endocannabinoid system

A

comprises a vast network of chemical signals and cellular receptors that are densely packed throughout our brains and bodies
“Neuromodulation system”
has CB1 and CB2 receptors

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14
Q

CB1 receptor

A

increased in brain and lower concentration in body
wide spread
mediates most of the psychoactive effects of cannabinoids
targets Motor activity, thinking, appetite, STM, pain perception and immune cells

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15
Q

CB2 receptors

A

principally involved in anti-inflammatory and immunosuppressive actions
target: gut, kidney, pancreas, adipose tissue, skeletal muscles, respiratory tract, CNS, cardiovascular

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16
Q

phytocannabinoid

A

biologically active compound found in cannabis
most notable: THC and CBD

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17
Q

THC content

A

< .3% in hemp
> .3% in marijuana

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18
Q

anandamide

A

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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19
Q

Absorption of cannabis
(Pharmacokinetics of Cannabis)

A

inhalation - peak plasma concentration 3-10 mins; bioavailability = 10-35%
oral - peak plasma concentration ~120 mins; bioavailability = 6-20%

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20
Q

distribution of cannabis
(pharmacokinetics of Cannabis)

A

rapidly to well-vascularized organs
accumulates in adipose tissue

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21
Q

metabolism of cannabis
(pharmacokinetics of cannabis)

A

predominately hepatic (liver)
able to cross the placenta; released through breast
excreted through urine, feces and sweat

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22
Q

Primary source of fuel for the brain (and info)

A

glucose

~20% of glucose-derived energy
provides precursors for NT synthesis and apoptosis
glucose levels correlated with thinking, memory and learning

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23
Q

high sugar diet =

A

decreased brain-derived neurotrophic factor (BDNF)
BDNF modulates growth, development and communication between synapses
decreased BDNF = increased risk of neurodegenerative D/O d/t atrophy and small vessel disease

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24
Q

Americans consume ________ lbs of sugar per year

A

156

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25
Q

AMA recommends _______ of sugar per day

A

6-9 tsps

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26
Q

technology addiction/ “internet gaming disorder”

A

teens (13-18) spend about 8.4 hour/day on screens
“like” “re-tweets” “novelty” = increased mesolimbic activation (need to check alerts)

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27
Q

increased use of technology =

A

increased SUD ADHD depression anxiety

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28
Q

role of covid-19 and technology addiction

A

triggers: boredom, isolation, low self-esteem

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29
Q

center of internet and technology addiction

A

digital distraction test
smartphone compulsion test
virtual addiction test

30
Q

ventromedial Prefrontal cortex (VMPFC) controls…

A

impulse control
courage
moral decision making

31
Q

VMPFC

A

interface between emotional response and control of complex bxs
uses emotional reactions to guide behaviors

32
Q

patient E.R and VMPFC

A

bilateral damage of the VMPFC
excellent social judgement in VERBAL responses to hypothetical situations, expansive reasoning shared
real-life situation = unable to prioritize between trivial and important decisions

33
Q

courage = _________ VMPFC activation

A

increased

34
Q

impulsive/emotional murderers = _____________ VMPFC activation
vs
calculating/careful people = ________ brain patterns

A

decreased

typical

35
Q

antisocial PD = _______________________ in VMPFC

A

decreased 11% of gray matter

36
Q

photos of romantic partners =

A

increased caudate nucleus (processing visual information and controls movement)
increased ventral Tegmental area (mediates reward system) = increased hyper-focus

37
Q

increased cortisol and adrenalin (Love on the brain)

A

increased HR, sweating, anxiety, nervousness
decreased appetite, concentration
dilated eyes

38
Q

“love is blind”

A

decreased PFC activation d/t fight or flight = reduced judgement and increased risk taking

39
Q

post-orgasm brain chemicals

A

in women = increased oxytocin = feelings of attachment and bonding
in men = increased vasopressin = vigilance and need to guard/protect partner

40
Q

sleep cycles last …

A

approximately 90 minutes
alternating between REM and NREM

41
Q

________ predominates first half of night

A

slow wave sleep (SWS)

42
Q

_______ predominates second half of sleep

A

REM

43
Q

hypnogram

A

tool that measures sleep cycle and sleep waves

44
Q

______% increase in myocardial infarction (after daylight savings)

A

24

45
Q

________% increase in traffic accidents (after daylight savings)

A

6

46
Q

____________ mood disturbance and suicide (after daylight savings)

A

increased

47
Q

_________________ is attributed to impact of sleep deprivation on frontal lobe fxing

A

volatility in the stock markets

48
Q

effects of sleep deprivation

A

extensive sleep deprivation is fatal

49
Q

fatal familial insomnia

A

inherited neurological
progressive insomnia
results in damage to portions of the thalamus
death after 12 months

50
Q

potential etiology; effects on sleep deprivation

A

sleep destroys free radicals and prevents their damaging effects

51
Q

adenosine (inhibitory)

A

by product of ATP
steadily increases throughout the day producing the “sleepy feeling” at night
caffeine blocks adenosine receptors = decreased sleepy feely BUT increased fatigue
sleep deprivation = decreased glycogen stores and increased adenosine = sleepiness
accumulation of adenosine = increased delta sleep

52
Q

melatonin is produced by ________ and is a response to ______________

A

pineal gland
evening/darkness about 2 hours before normal sleep time

53
Q

_________ is converted into melatonin

A

serotonin

54
Q

exogenous melatonin

A

take ~1-2 mg 30 - 1 hour before bedtime
light (especially blue light) negates the effects

55
Q

melatonin and dementia

A

contraindicated

56
Q

sleep apnea

A

18 million Americans
difficulties sleeping and breathing at the same time
increased CO2 = stimulates chemoreceptors = wake up gasping for air and decreased slow wave activity

57
Q

2 types of sleep apnea

A

obstructive sleep apnea = narrowing of airways (d/t obesity, enlarged tonsils, hormonal changes)

central sleep apnea = brain does not signal the need to breath

58
Q

sleep apnea untreated

A

significant deficits in attention, memory and executive fxing
increased risk of stroke
(in kids) 2.5x risk of behavioral problems

59
Q

tx for sleep apnea

A

CPAP, BiPAP
can reverse cognitive deficits with tx

60
Q

REM sleep behavior D/0

A

lack of muscle paralysis during REM = act out dreams (move around a bunch during sleep)
can be comorbid with narcolepsy
typical onset = 60+ years
believed to be neurodegenerative
tx = clonazepam

61
Q

drugs that are used to treat symptoms of cataplexy will _________ the symptoms of REM sleep behavior DO

A

worsen!

62
Q

Narcolepsy

A

orexin-related neurological disorder
missing >85% orexin producing neurons
hereditary component
sleep attacks = overwhelming urge to sleep
cataplexy
sleep paralysis
tx = modafinil, SSRIs

63
Q

cataplexy

A

sudden muscle weakness/paralysis seen in narcolepsy

64
Q

_________ % less sleep than earlier generations

A

25

65
Q

___________% Americans employed in shift work

A

20

66
Q

________% of adults report falling asleep during the day without meaning to at least once a month

A

40

67
Q

Insomnia

A

effects 30% of adults
80 million Americans (40% women, 30% men)
2 types (primary, secondary)
high comorbidity rates with chronic medical conditions
chronic use of sleep-promoting drugs can cause rebound insomnia (20-80%)

68
Q

primary insomnia

A

difficulty falling asleep after going to bed or after awakening during the night

69
Q

secondary insomnia

A

inability to sleep due to another mental or physical condition (i.e. pain, medication

70
Q

acetylcholine has to be

A

high when awake
drops for slow wave sleep
increases in REM

Physio (11 decks)

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