Physio/Pharma Flashcards
1
Q
Gerstmann syndrome
A
Difficulty with differentiating between right and left is a hallmark symptom of Gerstmann syndrome and typically results from damage to the left parietal lobe. right-left confusion
2
Q
What part of the brain plays a role in the etiology of seasonal affective disorder (SAD)?
A
The suprachiasmatic nucleus mediates sleep cycles, wake cycles, and circadian rhythms, all of which are affected in seasonal affective disorder.
3
Q
Autosomal dominant disorders
A
Autosomal dominant disorders occur when only one defective copy of an autosomal gene is required to cause a disease. Huntington’s is an example
4
Q
An autosomal recessive disorder
A
An autosomal recessive disorder is defined by the inheritance of two mutated genes. Examples are sickle cell anemia and cystic fibrosis.
5
Q
X-linked disorders
A
X-linked disorders refer to genetic conditions associated with mutations in genes on the X-chromosome. Examples include Rett syndrome and fragile X syndrome.
6
Q
Y-linked disorders
A
Y-linked disorders are conditions associated with genetic mutations on the Y-chromosome. Examples include congenital adrenal hyperplasia and Alagille syndrome.
7
Q
James-Lange theory of emotion
A
My heart is racing, therefore I am scared; The James-Lange theory of emotion states that an autonomic arousal and skeletal action comes before an emotion. More specifically, an event happens, then you appraise it (the cognitive aspect); this leads to an action (the behavioral aspect), which in turn leads to emotions (the feeling aspect).
8
Q
delirium hallmark symptoms
A
Hallmark symptoms include the acute onset of cognitive changes like disorientation, memory deficits, perceptual disturbances, and difficulty shifting attention. While delirium is more common in older adults, it can occur at any age. Once delirium is suspected, the underlying medical cause must be identified and treated.
9
Q
A(n) ____________ seizure is typically seen in children and characterized by periods of inattention, lapses in awareness, and staring.
A
absence; During an absence seizure, also referred to as a petit mal seizure, symptoms can include staring off into space, inattention, lapses in awareness, and repetitive blinking.
10
Q
tonic phase
A
Tonic phase is the beginning of a grand mal seizure where the muscles contract forcefully.
11
Q
Clonic phase
A
Clonic means agitated. This phase of the seizure begins when the person begins jerking, trembling, and/or convulsing.
12
Q
Agraphia, acalculia, finger agnosia, and left-right disorientation are symptoms of which of the following?
A
Gerstmann Syndrome
13
Q
Creutzfeldt-Jakob disease
A
Creutzfeldt-Jakob disease is a rare degenerative brain disease that is characterized by memory loss, behavioral changes, poor coordination, and visual disturbances.
14
Q
Addison’s disease
A
Addison’s disease, also known as hypercortisolism, is an endocrine disorder with symptoms including abdominal pain, weakness, and weight loss.
15
Q
Geschwind syndrome (Gastaut-Geschwind)
A
Geschwind syndrome (Gastaut-Geschwind) is a behavioral syndrome associated with temporal lobe epilepsy and is characterized by circumstantiality (excessive verbal output), hypergraphia (intense desire to write or draw), hyposexuality, emotional volatility, and, in some cases, hyperreligiosity.
16
Q
Chlorpromazine effect
A
Chlorpromazine, generic for Thorazine, is a first generation antipsychotic. Many typical and atypical antipsychotic medications may cause anticholinergic effects like dry mouth, constipation, urinary retention, dry eyes, confusion, and memory difficulties.
17
Q
Fluvoxamine
A
Fluvoxamine, generic for Luvox, is an SSRI. Most common side effects of SSRI’s include restlessness, insomnia, gastrointestinal upset, frequent urination, and sexual dysfunction.
18
Q
Carbamazepine
A
Carbamazepine, generic for Tegretol, is an anticonvulsant used to treat mania. Side effects may include drowsiness, diarrhea, nausea/vomiting, and headache. Although carbamazepine toxicity or overdose can be associated with anticholinergic effects, risk is low in therapeutic doses.
19
Q
analgesic effect
A
pain relief
20
Q
Glutamate
A
Glutamate is an excitatory neurotransmitter that is thought to play a role in the formation of long-term memories. Abnormal glutamate transmission is also associated with schizophrenia, autism spectrum disorder, depression, and obsessive-compulsive disorder.
21
Q
GABA
A
GABA is an amino acid and major inhibitory neurotransmitter that has a calming effect, and insufficient levels of GABA are often associated with anxiety. Gamma-Aminobutyric Acid (GABA) is an inhibitory neurotransmitter. It decreases activity in the nervous system and plays a role in stress, anxiety, and fear.
22
Q
Early memory loss associated with Alzheimer’s disease is believed to be caused by deterioration of neurons in the hippocampus that secrete:
A
Acetylcholine (ACh) mediates motor functions as well as learning processes, and lower levels of ACh in the hippocampus have been linked to decreased alertness in Alzheimer’s patients.
23
Q
Damage to the hippocampus is most likely to interfere with the ability to:
A
convert short-term memory to long-term memory.
24
Q
Eating foods containing tyramine (e.g., cheese, raisins) while taking a monoamine oxidase inhibitor (MAOI) is contraindicated because which of the following can occur?
A
Increased blood pressure
25
Risperidone
Risperidone is a second-generation antipsychotic (atypical antipsychotic) that alleviates symptoms of schizophrenia without producing movement problems.
26
Individuals who have sustained a traumatic brain injury are most likely to _____
experience retrograde and anterograde amnesia and as they recover their memories, they’re more likely to recall remote events first and then slowly recall more recent events; When an individual sustains a head trauma, they tend to suffer from both retrograde amnesia or the inability to recall events that occurred prior to the trauma and anterograde amnesia, difficulty forming new memories. As an individual recovers, they will remember remote memories first, followed by more recent memories leading up to the trauma, and finally, the ability to form new memories.
27
Neurotrophins
Neurotrophins are a class of proteins that induce the survival, development, and function of neurons. Nerve growth factor (NGF) is a type of neurotrophin that cancels the program for apoptosis.
28
catecholamines
NTs - norepinephrine, epinephrine and dopamine - impact personality, mood, memory and sleep
29
catecholamine hypothesis
low norepinephrine leads to depression and high leads to mania
30
peripheral nervous sxs
somatic nervous system + autonomic nervous system
31
autonomic NS
parasympathetic and sympathetic
32
CNS
spinal cord + brain (hindbrain, midbrain, forebrain)
33
hindbrain
pons, medulla, cerebellum
34
midbrain
superior and inferior colliculi, substantia nigra, and reticular formation/RAS
35
forebrain
subcortical cortex (thalamus, hypothalamus, basal ganglia, amygdala, hippocampus) and cerebral cortex (frontal, parietal, temporal, occipital)
36
functional neuroimaging techniques
positron-emission tomography (PET), single proton emission computed tomography (SPECT), and functional magnetic resonance imaging (fMRI) - used to get information on brain activity
37
positron-emission tomography (PET)
PET scan gives information on regional cerebral blood flow, glucose metabolism, and oxygen consumption, which are presumed to correlate with level of neural activity. PET scans are used to assess cerebrovascular disease, Alzheimer’s disease and other forms of dementia, schizophrenia, and other disorders and to identify brain areas that are active during the performance of ordinary tasks and the experience of ordinary emotions.
38
Amino acids
GABA, glutamate, endorphin (peptide)
39
ADOPTION METHOD
The adoption method is a quasi-experimental research design that relies on adopted children as participants to isolate the effects of genetic versus environmental variables.
40
Midbrain
superior and inferior colliculi, substantia nigra, and the reticular formation. The superior and inferior colliculi serve as routes for visual and auditory information, respectively, while the substantia nigra is involved in motor activity and plays a role in the brain’s reward system. The reticular formation extends from the spinal cord through the hindbrain and midbrain into the hypothalamus in the forebrain.
41
damage to dorsolateral area of prefrontal cortex
results in dorsal convexity dysexecutive syndrome, which is characterized by impaired judgment, insight, planning, and organization. Individuals with this syndrome tend to be concrete and perseverative, have trouble learning from experience, neglect their hygiene, have reduced sexual interest, and may be apathetic.
42
damage to orbitofrontal area of prefrontal cortex
produces orbitofrontal disinhibition syndrome, which is also known as pseudopsychopathy. This disorder involves emotional lability, distractibility, poor impulse control, and impaired social insight. People with this disorder may exhibit explosive aggressive outbursts or inappropriate jocularity, engage in unusual or inappropriate sexual behavior, and make lewd comments.
43
damage to mediofrontal area of prefrontal cortex
produces mesial frontal apathetic syndrome, which is also referred to as pseudodepression. The primary characteristics of this
syndrome are impaired spontaneity, reduced emotional negative cognitions, and dysphoria reactions, diminished motor behavior and verbal output, and lower-extremity weakness and sensory loss. People with this syndrome often describe themselves as bored or lacking in motivation and may seem depressed but do not have the vegetative symptoms,
that characteristic of major depression.
44
areas in frontal lobe
primary motor cortex, supplementary motor area, premotor area, brocas area, prefrontal cortex
45
parietal lobe damage
apraxia (inability to perform skilled motor movements in the absence of impaired motor functioning), and somatosensory agnosia (tactile agnosia, asomatognosia, and anosognosia).
46
located in temporal lobe
auditory cortex and wernickes area
47
damage to temporal lobe
auditory agnosia, auditory hallucinations, and other disturbances in auditory sensation and perception
48
occipital lobe damage
apperceptive or associative visual agnosia, visual hallucinations, or cortical blindness; left occipital lobe damage can cause simultanagnosia (inability to see more than one thing or one aspect of an object at a time); while lesions at the junction of the occipital, temporal, and parietal lobes may produce prosopagnosia (an inability to recognize familiar faces).
49
Visual agnosia (apperceptive vs associative)
Apperceptive visual agnosia occurs when a person is unable to perceive objects despite intact visual acuity, while associative visual agnosia occurs when a person is unable to recognize an object that they are focusing on as the result of impaired memory or inability to access relevant semantic knowledge.
50
suprachiasmatic nucleus
The suprachiasmatic nucleus (SCN) is part of the hypothalamus and acts as the body's "biological clock" and is responsible for many of the body's circadian rhythms
51
caudate nucleus
The caudate nucleus is located within the basal ganglia. It is an important part of the brain's learning and memory system
52
split brain visual field questions
Left visual field- right visual hemifield goes to left hemisphere and left hemifield goes to right hemisphere; eg. A split-brain patient staring straight ahead given the word "headband" is flashed in her left visual field only would only see "band"
53
damage to hypothalamus
The hypothalamus is involved in regulating hunger, thirst, sex, sleep, body temperature, movement, and emotional reactions. It also maintains homeostasis through its influence on the autonomic nervous system, pituitary gland, and other endocrine glands. Damage to the hypothalamus can cause very intense emotional reactions (like uncontrollable laughter and/or intense rage or aggression)
54
hemispheres and emotions
The two hemispheres play somewhat different roles in the regulation of emotion. Areas in the right hemisphere mediate negative emotions and damage to these areas can produce indifference, apathy, or undue cheerfulness. Left hemisphere is usually positive emotions.
55
Gerstmann's syndrome
Gerstmann's syndrome occurs with damage to the left parietal lobe. Gerstmann's syndrome is characterized by finger agnosia, right-left confusion, agraphia (an inability to write), and acalculia (an inability to preform simple mathematical calculations).
56
damage to what produces (expressive vs receptive) aphasia
Broca's area is the major motor speech area located in the frontal lobe of the brain. Damage to Broca's area causes expressive (Broca's) aphasia which is characterized by difficulties in producing spoken and written language. Wernicke's area is important for comprehension of language and damage to this area causes receptive aphasia (e.g. deficits in language comprehension).
57
cutaneous senses
pressure/touch, warmth, cold and pain
58
dermatomes
The area of the body that is innervated by the dorsal root of a given segment of the spinal cord is referred to as a dermatome.
59
areas of the brain that play a role in memory
temporal lobes, hippocampus, amygdala, prefrontal cortex, thalamus, basal ganglia/cerebellum/motor cortex
60
R/L temporal lobe damage
The temporal lobes are essential for the encoding, storage, and retrieval of long-term declarative memories, with the right and left lobes serving somewhat different functions. Following removal of the right temporal lobe, deficits are found primarily on nonverbal memory tasks (e.g., measures of face-recognition, spatial position, maze-learning, and emotional memory), while removal of the left temporal lobe produces impaired performance on measures of verbal memory (e.g., recall of word lists and stories and recognition of words and numbers).
61
dorsolateral prefrontal cortex and memory
the dorsolateral prefrontal cortex is important for working memory, and impairments in working memory in patients with schizophrenia have been linked to abnormal activity in this area
62
Neural processes of memory
studied in aplysia (slug); 1) long term potentiation (Long-term potentiation (LTP) refers to the greater responsivity of a postsynaptic neuron to low-intensity stimulation by a presynaptic neuron for hours, days, or even weeks after the presynaptic neuron has been barraged by high-frequency stimulation) and 2) protein synthesis (Long-term memory also seems to depend on enhanced protein synthesis during the minutes or hours following learning or training)
63
excess androgren in pregancy
An excess of androgen production is known as adrenogenital syndrome (AGS) or congenital adrenal hyperplasia (CAH). Newborn genetic females with CAH may have an enlarged clitoris, which may be mistaken for a penis; an enlarged vulva, which resembles a bilobed scrotum; and partial or complete fusion of the labia majora. Affected genetic males may have penile enlargement. Both genetic males and females with CAH tend to be taller as children but reach a shorter stature than normal as adults.
64
postconcussional syndrome dx
Major or Mild Neurocognitive Disorder Due to Traumatic Brain Injury - if There is evidence of a traumatic brain injury with at least one of the following – loss of consciousness, posttraumatic amnesia, disorientation and confusion, and/or neurological signs and it occurs immediately after the traumatic brain injury or immediately after recovery of consciousness and continues past the acute post-injury period
65
three major causes of stroke
thrombosis (blockage of an artery by a blood clot), embolism (sudden blockage of an artery by material from another part of the bloodstream), and hemorrhage.
66
primary vs secondary hypertension
Primary (essential) hypertension is diagnosed when high blood pressure is not due to a known physiological cause, while secondary hypertension is diagnosed when elevated blood pressure is related to a known disease. Primary hypertension accounts for about 85 to 90% of all cases of high blood pressure. Untreated, it can lead to cardiovascular disease and is a major cause of heart failure, kidney failure, and stroke.
67
tx for migraines
Treatments include nonsteroidal anti-inflammatory drugs (a combination of acetaminophen, aspirin, and caffeine is particularly effective); drugs that act on serotonin receptors in the smooth muscles that surround cranial blood vessels (e.g., ergotamine, sumatriptan, SSRIs); and beta-blockers. A combination of thermal biofeedback and autogenic training is useful forsome migraine sufferers.
68
hypoinsulinism
Hypoinsulinism produces diabetes mellitus (excessive blood glucose), which, when untreated, causes increased appetite with weight loss, polyuria, polydipsia, increased susceptibility to infection, and apathy, confusion, and mental dullness.
69
Hyposecretion of ADH
diabetes insipidus (excessive water loss)
70
AMYGDALA AND KLUVER-BUCY SYNDROME
The amygdala is a substructure of the limbic system and is involved in the control of emotional activities, including the mediation of defensive-aggressive behaviors and the attachment of emotions to memories. Bilateral lesions in the amygdala and temporal lobes of primates produces Kluver-Bucy Syndrome, which is characterized by reduced fear and aggression, increased docility and compulsive oral exploratory behaviors, altered dietary habits, hypersexuality, and “psychic blindness” (an inability to recognize the significance or meaning of events or objects).
71
ANTICHOLINERGIC EFFECTS
Anticholinergic effects are caused by several drugs including the antipsychotics and tricyclic antidepressants. They include dry mouth, blurred vision, tachycardia (rapid heart rate), urinary retention, constipation, memory impairment, and confusion.
72
APHASIA (BROCA’S, WERNICKE’S, AND CONDUCTION)
Aphasia refers to impairments in the production and/or comprehension of language. (1) Broca’s aphasia is produced by damage to Broca’s area. It involves difficulty in producing written or spoken language with little or no trouble in understanding language and often includes anomia and impaired repetition. (2) Wernicke’s aphasia is caused by damage to Wernicke’s area. It is characterized by an inability to comprehend written or spoken language along with the production of rapid, seemingly effortless speech that is lacking in content and may include anomia, paraphasia, and impaired repetition. (3) Conduction aphasia is produced by damage to the arcuate fasciculus. It does not significantly affect language comprehension but does result in anomia, paraphasia, and impaired repetition.
73
ATYPICAL ANTIPSYCHOTICS
(CLOZAPINE): Clozapine and other atypical (newer) antipsychotic drugs affect receptors for several neurotransmitters including dopamine, serotonin, and glutamate. These drugs are effective for both positive and negative symptoms of schizophrenia and are less likely to produce tardive dyskinesia than the traditional antipsychotics. However, they can produce agranulocytosis and other blood dyscrasias as well as neuroleptic malignant syndrome.
74
AUTONOMIC NERVOUS SYSTEM (SYMPATHETIC AND PARASYMPATHETIC BRANCHES):
The autonomic nervous system (ANS) is a division of the peripheral nervous system and is involved in the control of visceral functions (e.g., heart rate, blood pressure, respiration, digestion, and sweating). It consists of the sympathetic and parasympathetic branches. The sympathetic branch is involved in the mediation of flight or fight (emergency) reactions. Activation of the sympathetic branch produces increased heart rate, pupil dilation, increased blood sugar, and inhibition of the digestive processes. The parasympathetic branch is involved in the conservation of energy and relaxation. Activation is associated with slowing of heart rate, lowered blood pressure, contraction of pupils, reduction of sweat gland output, and increased activity of the digestive system.
75
BASAL GANGLIA:
The basal ganglia are subcortical structures (caudate nucleus, putamen, globus pallidus, and substantia nigra) that are involved in planning, organizing, and coordinating voluntary movements. Basal ganglia pathology has been linked to Huntington’s disease, Parkinson’s disease, Tourette’s disorder, OCD, and ADHD.
76
BETA-BLOCKERS
(PROPRANOLOL): Propranolol and other beta-blockers block or diminish the cardiovascular excitatory response to the hormones epinephrine and norepinephrine. They are used to treat cardiovascular disorders, glaucoma, and migraine headache and are also useful for reducing the physical symptoms of anxiety. Common side effects of propranolol include bradycardia, nausea, diarrhea, dizziness, decreased sexual ability, and trouble sleeping
77
BRAIN LATERALIZATION/SPLIT-BRAIN PATIENTS:
Although the left and right hemispheres are both involved to some degree in most functions, they tend to specialize. The left (dominant) hemisphere dominates in verbal activities (spontaneous speaking and writing, word recognition, memory for words and numbers); analytical, logical thought; and positive emotional states. The right (non-dominant) hemisphere dominates in visual-spatial activities such as facial recognition, spatial interpretation and memory for shapes and in negative emotions. The specialization of the two hemispheres is referred to as brain lateralization and was initially studied in split-brain patients, whose corpus callosums had been severed to control severe epilepsy.
78
CEREBELLUM AND ATAXIA:
The cerebellum is a large structure on the dorsal aspect of the hindbrain. It is involved in the extrapyramidal control of motor activities (e.g., coordination, balance, posture). Damage can result in ataxia, which is characterized by slurred speech, severe tremors, and a loss of balance.
79
CEREBRAL VENTRICLES/HYDROCEPHALUS:
The ventricles are the four cavities of the brain that contain cerebrospinal fluid. Blockage of the ventricles and a resulting build-up of fluid can cause hydrocephalus.
80
CEREBROVASCULAR ACCIDENT:
Cerebrovascular accident (CVS) is also referred to as cerebral stroke and refers to brain damage that occurs when a blood clot or other obstruction or hemorrhage disrupts the flow of blood to the brain. Common symptoms include contralateral hemiplegia, hemianesthesia involving the face, arm, and leg, and contralateral visual field loss.
81
CONTRALATERAL REPRESENTATION
For most sensory and motor functions, the cortex exhibits contralateral representation, which means that the left hemisphere controls the functions of the right side of the body and vice-versa.
82
CORPUS CALLOSUM
The right and left hemispheres are connected by several bundles of fibers, the largest of which is the corpus callosum. If the corpus callosum is severed, the two hemispheres operate essentially as separate, independent brains.
83
DEPTH PERCEPTION/RETINAL DISPARITY
Depth perception depends on a combination of binocular and monocular cues. Retinal disparity is a binocular cue and refers to the fact that our two eyes see objects in the world from two different views: the closer an object, the greater the disparity of the two images.
84
DOPAMINE HYPOTHESIS:
According to the dopamine hypothesis, schizophrenia is due to overactivity at dopamine receptors either as the result of oversensitivity of the receptors or excessive dopamine levels.
85
EFFECTS OF PSYCHOACTIVE DRUGS:
Terms used to describe the effects of the psychoactive drugs include the following: (1) Agonists produce effects similar to those produced by a neurotransmitter. (2) Inverse agonists produce an effect opposite the effect produced by a neurotransmitter or an agonist. (3) Partial agonists produce effects that are similar to (but less than) the effects produced by a neurotransmitter or an agonist. (4) Antagonists produce no activity in the cell on their own but, instead, reduce or block the effects of a neurotransmitter or agonist.
86
EMOTION (AREAS OF THE BRAIN)
Areas of the brain that have been implicated in the regulation of emotion include the amygdala (which plays a role in the perception and expression of anger, fear, sadness, happiness, and other emotions and attaches emotion to memories), the hypothalamus (which is involved in the translation of emotions into physical responses), and the cerebral cortex. With regard to the latter, the left hemisphere governs happiness and other positive emotions, while the right hemisphere mediates sadness, fear, and other negative emotions.
87
FRONTAL LOBE AND BROCA’S AREA/PREFRONTAL CORTEX:
The frontal lobe occupies the major portion of the cortex and includes the primary motor cortex, supplementary motor area, premotor cortex, Broca’s area, and prefrontal cortex. It is involved in initiative, planning ability, abstract thinking, and other executive functions; personality and mood; and motor functions. Damage to Broca’s area produces Broca’s (expressive) aphasia. Damage to the prefrontal cortex produces personality changes and deficits in higher-level cognitive abilities.
88
GATE-CONTROL THEORY OF PAIN:
According to gate-control theory, there are mechanisms in the spinal cord that mediate (block) the perception of pain.
89
GENERAL ADAPTATION SYNDROME:
According to Selye, the human response to stress is mediated by adrenal-pituitary secretions (e.g., cortisol) and involves three stages: alarm reaction, resistance, and exhaustion. The model predicts that prolonged stress can result in illness or death
90
GENETIC SCREENING METHODOLOGIES:
Genetic screening methodologies are utilized to detect various abnormalities in chromosome structure, protein function, and DNA sequence. There are three main types of genetic testing: cytogenetic, biochemical, and molecular.
91
HIPPOCAMPUS
The hippocampus is a limbic system structure that is important for spatial and explicit memory and the consolidation of declarative memories.
92
HUNTINGTON’S DISEASE:
Huntington’s disease is an inherited degenerative disease that is transmitted by a single autosomal dominant gene and involves emotional, cognitive, and motor symptoms. For many patients, emotional and cognitive symptoms appear first and include depression, apathy, anxiety, antisocial tendencies, and forgetfulness. Early motor
symptoms include fidgeting, and clumsiness, which are followed by facial grimaces and “piano-playing” movements of the fingers. Huntington’s disease is believed to be due to a loss of GABA-secreting neurons and glutamate excitotoxicity in the basal ganglia, especially in the caudate nucleus, putamen, and globus pallidus
93
HYPERTENSION
There are two types of hypertension. Primary (essential) hypertension is diagnosed when high blood pressure is not due to a known physiological cause, while secondary hypertension is diagnosed when elevated blood pressure is related to a known disease. Primary hypertension accounts for about 85 to 90% of all cases of high blood pressure; untreated, it can lead to cardiovascular disease, and it is a major cause of heart failure, kidney failure, and stroke. The prevalence of hypertension is related to age, race, and gender. Older adults have higher rates than younger adults, and African Americans have higher rates than Whites. Although the rates are generally higher for men, among older adults and African Americans, they are higher for women.
94
HYPER-AND HYPOTHYROIDISM:
Hyperthyroidism is caused by hypersecretion of thyroxine by the thyroid gland and is characterized by a speeded-up metabolism, elevated body temperature, accelerated heart rate, increased appetite with weight loss, nervousness, and insomnia. Hypothyroidism is caused by hyposecretion of thyroxine and involves a slowed metabolism, slowed heart rate, lethargy, lowered body temperature, impaired concentration and memory, and depression.
95
HYPOGLYCEMIA
Hypoglycemia (low blood glucose) is caused by excessive secretion of insulin by the pancreas and is characterized by hunger, dizziness, headaches, blurred vision, palpitations, anxiety, depression, and confusion.
96
HYPOTHALAMUS AND SUPRACHIASMATIC NUCLEUS:
The hypothalamus consists of a cluster of nuclei that control the autonomic nervous system and endocrine glands, mediate basic drives, and regulate emotional expression. The suprachiasmatic nucleus (SCN), which is located in the hypothalamus, is involved in regulation of the body’s circadian rhythms.
97
LEARNING AND MEMORY (AREAS OF THE BRAIN):
Areas of the brain involved in learning and memory include the following: (1) The temporal lobes are essential for the encoding, storage, and retrieval of long-term declarative memories. (2) The hippocampus is responsible for the consolidation of long-term declarative memories (transferring information from short-term to long-term memory). (3) The amygdala plays a key role in fear conditioning, learning about rewards and punishments, and adding emotional significance to memories. (4) The prefrontal cortex has been implicated in short-term memory, episodic memory, and prospective memory. (5) The thalamus is involved in processing information and transferring it to the neocortex.
98
LEARNING AND MEMORY (NEURAL MECHANISMS):
Neural mechanisms that are believed to mediate long-term memory include long-term potentiation and protein/RNA synthesis. (1) Long-term potentiation (LTP) is a physiological process involving the modification of nerve synapses, especially at glutamate receptors in the hippocampus. (2) Inhibiting the synthesis of protein or RNA at the time of learning prevents the formation of long-term memories.
99
MAOIs AND HYPERTENSIVE CRISIS:
The MAOIs are antidepressants that work by inhibiting the enzyme monoamine oxidase, which is involved in deactivating dopamine, norepinephrine, and serotonin. The most dangerous side effect is hypertensive crisis, which can occur when an MAOI is taken in conjunction with barbiturates, amphetamines, antihistamines, or certain other drugs, or with foods containing the amino acid tyramine (e.g., aged cheeses and meats, beer, red wine, chicken liver, avocados, bananas, fava beans). Symptoms of a hypertensive crisis include severe headache, stiff neck, rapid heart rate, nausea, vomiting, sweating, and sensitivity to light.
100
MEDULLA
The medulla is a hindbrain structure that controls the flow of information between the spinal cord and brain and regulates a number of vital functions including breathing, heartbeat, and blood pressure.
101
MENOPAUSE/HORMONE REPLACEMENT THERAPY:
The decreased estrogen levels that accompany menopause produce a variety of emotional and physical symptoms including hot flashes, fatigue, mood swings, nausea, vaginal dryness, and loss of bone mass. Hormone replacement therapy (HRT) alters estrogen levels only or both estrogen and progesterone levels and is effective for eliminating hot flashes, mood swings, and vaginal dryness and reduces the risk for bone loss.
102
METHYLPHENIDATE:
Methylphenidate (Ritalin, Concerta, Metadate) is a psychostimulant drug used to treat ADHD in children and adults. Common side effects include decreased appetite, insomnia, dysphoria, and growth suppression.
103
MIGRAINE HEADACHE:
A migraine headache is a recurrent vascular headache characterized by severe throbbing pain, usually on one side of the head. Triggers include certain foods, alcohol, bright lights, and relaxation following physical or psychological stress. A migraine may be preceded by an aura (classic migraine) or gastrointestinal or other symptoms (common migraine).
104
MOLECULAR GENETIC METHODS:
Molecular genetic methods are used in behavioral genetics research to classify genes responsible for genetic influence.
105
MOOD STABILIZING DRUGS (LITHIUM, ANTICONVULSANT DRUGS):
Mood stabilizing drugs are used to alleviate mania and mood swings in Bipolar Disorder and include lithium and anticonvulsants (e.g., carbamazepine). Lithium is usually the drug-treatment-of-choice for classic Bipolar Disorder, while an anticonvulsant drug may be more effective for patients who experience rapid mood swings or who have dysphoric mania.
106
MULTIPLE SCLEROSIS:
Multiple sclerosis (MS) is a progressive disease of the nervous system that involves a degeneration of the myelin that surrounds nerve fibers in the central nervous system. Common initial symptoms are optic neuritis, motor impairments, sensory abnormalities, and fatigue. Additional symptoms that arise as the disease progresses include tremors, speech problems, mood symptoms, and cognitive impairment.
107
NALTREXONE
Naltrexone (ReVia, Vivitrol) is an opioid antagonist that blocks the craving for and reinforcing effects of alcohol and is used to treat Alcohol Abuse and Dependence. Side effects include abdominal cramping, nausea, vomiting, insomnia, nervousness, headache, and joint and muscle pain.
108
NARCOTIC-ANALGESICS:
The drugs classified as narcotic-analgesics (opioids) have both sedative and analgesic properties. Medically, the narcotic-analgesics are used for the same reasons they were used centuries ago — i.e., as analgesics, treatments for diarrhea, and cough suppressants. Chronic use of a narcotic-analgesic results in tolerance and psychological and physical dependence. Withdrawal symptoms resemble those associated with a bad case of the flu.
109
NEUROIMAGING TECHNIQUES:
Neuroimaging techniques make it possible to study both the structure and function of the living brain. Computed tomography (CT) and magnetic resonance imaging (MRI) are structural techniques. Positron-emission tomography (PET), single proton emission computed tomography (SPECT), and functional magnetic resonance imaging (fMRI) provide information on the functional activities of the brain.
110
NEUROLEPTIC MALIGNANT SYNDROME:
Neuroleptic malignant syndrome (NMS) is a rare, but potentially fatal side effect of the antipsychotic drugs. It involves a rapid onset of motor, mental, and autonomic symptoms including muscle rigidity, tachycardia, hyperthermia, and altered consciousness. To avoid a potentially fatal outcome, the drug must be stopped as soon as symptoms of NMS develop.
111
NEURON (ACTION POTENTIAL AND ALL-OR-NONE PRINCIPLE):
The neuron (nerve cell) is a specialized cell that is directly involved in mental processes and behavior. Messages within a neuron are transmitted from a neuron’s dendrites to the end of its axon through an electrical process called conduction. With sufficient stimulation from other cells, a cell becomes depolarized (the interior of the cell becomes less negative), which triggers an action potential – i.e., an electrical impulse that travels quickly through the cell. The all-or-none principle predicts that an action potential will always be of the same magnitude regardless of the amount of stimulation received by a neuron as long as the minimal level of stimulation (the threshold) has been reached.
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NEUROTRANSMITTERS (ACETYLCHOLINE, DOPAMINE, SEROTONIN, GABA):
Neurotransmitters are chemical substances that are released from axon terminals, diffuse across synapses, and excite or inhibit receptor sites on postsynaptic nerve cells. (1) Acetylcholine mediates neuromuscular transmission, parasympathetic arousal, and memory (e.g., memory loss in Alzheimer’s dementia). (2) Dopamine is involved in inhibitory motor regulation and motivational/emotional functions. Insufficient dopamine in the basal ganglia is believed to underlie Parkinson’s disease; excessive activity at dopamine receptors has been linked to schizophrenia and Tourette’s disorder. (3) Serotonin ordinarily inhibits behavior and is involved in the regulation of mood, hunger, arousal, sleep, temperature, and pain and in the Bipolar and Depressive Disorders, schizophrenia, and OCD. (4) GABA is the most common inhibitory neurotransmitter and is believed to be involved in anxiety, sleep, and seizures. Low levels of GABA in the motor region are associated with Huntington’s disease.
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OCCIPITAL LOBE AND VISUAL AGNOSIA/PROSOPAGNOSIA:
The occipital lobe contains the visual cortex. Damage to the occipital lobe can result in visual agnosia (inability to recognize familiar objects), color agnosia, word blindness, and/or scotomas (blind spots). Lesions at the junction of the occipital, temporal, and parietal lobes can produce prosopagnosia (inability to recognize familiar faces).
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PAPEZ’S CIRCUIT:
Papez’s circuit was proposed as a brain mechanism (circuit) that mediates the experience and expression of emotion. It includes the hippocampus, mammillary bodies, anterior nuclei of the thalamus, and cingulate gyrus.
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PARIETAL LOBE AND APRAXIA/ANOSOGNOSIA/GERSTMANN’S SYNDROME:
The parietal lobe contains the somatosensory cortex. Depending on its location, damage to the parietal lobe can cause apraxia (inability to perform skilled motor movements in the absence of impaired motor functioning), anosognosia (inability to recognize one’s own neurological symptoms or other disorder), or Gerstmann’s syndrome, which involves a combination of finger agnosia, right-left confusion, agraphia, and acalculia.
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PARKINSON’S DISEASE:
Parkinson’s disease is a progressive degenerative disease characterized by tremor, muscular rigidity, akathisia, akinesia, and speech difficulties; and it may eventually include dementia. Symptoms are temporarily relieved by L-dopa, a dopamine agonist. Parkinson’s disease is believed to be due to degeneration of dopamine-containing cells, especially in the substantia nigra.
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POSTCONCUSSIONAL SYNDROME
When using the DSM-5-TR, a person with postconcussional syndrome would receive a diagnosis of Major or Mild Neurocognitive Disorder Due to Traumatic Brain Injury when the following criteria are met: (a) The person’s symptoms meet the criteria for Major or Mild Neurocognitive Disorder. (b) There is evidence of a traumatic brain injury with at least one of the following – loss of consciousness, posttraumatic amnesia, disorientation and confusion, and/or neurological signs (e.g., seizures, visual field cuts, hemiparesis). (c) The neurocognitive disorder occurs immediately after the traumatic brain injury or immediately after recovery of consciousness and continues past the acute post-injury period.
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PRACTICAL CLINICAL TRIAL (PCT):
PCTs are randomized studies designed to evaluate the effects of interventions in typical community conditions.
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PSYCHOPHYSICAL LAWS (WEBER’S LAW, FECHNER’S LAW, STEVENS’S POWER LAW):
The psychophysical laws attempt to predict the relationship between perception and sensation. (1) Weber’s Law states that the just noticeable difference in stimulus intensity is a constant proportion of the initial stimulus intensity. (2) Fechner’s law states that physical stimulus changes are logarithmically related to their psychological sensations. (3) Stevens’s Power Law proposes that the magnitude of a sensation is equal to the physical magnitude of the stimulus producing the sensation raised to a certain power (exponent) which varies, depending on the specific sensation being measured
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QUANTITATIVE GENETIC METHODS:
Quantitative genetic methods are used in behavioral genetic research to determine the net effect of genetic and environmental influences on various traits.
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RETICULAR ACTIVATING SYSTEM:
The reticular activating system (RAS) is a network of nerve fibers involved in wakefulness, arousal, and consciousness.
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SECONDARY SEX CHARACTERISTICS/HYPOTHALAMIC-PITUITARY-GONADAL AXIS:
At puberty, an increase in gonadal hormones influences the emergence of secondary sex characteristics and the development of the reproductive system. Although the mechanisms that trigger the development of the secondary sex characteristics are not well understood, it occurs when the hypothalamus secretes chemicals that stimulate the anterior pituitary gland, which then releases the gonadotropic hormones that stimulate testosterone and sperm production by the testes or ovulation and estrogen production by the ovaries. This system is referred to as the hypothalamic-pituitary-gonadal axis.
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SEDATIVE-HYPNOTICS
(BENZODIAZEPINES): The sedative-hypnotics include the barbiturates, anxiolytics, and alcohol. These drugs are generalized CNS depressants, and their effects, for the most part, are dose dependent. At low doses, these drugs reduce arousal and motor activity; at moderate doses, they induce sedation and sleep; and at high doses, they can produce anesthesia, coma, and death. The benzodiazepines are a type of anxiolytic. Their side effects include drowsiness, ataxia, slurred speech, and other signs of CNS depression; abrupt cessation can cause rebound hyperexcitability. The benzodiazepines are the most commonly prescribed anxiolytic and are used to alleviate anxiety and treat sleep disturbances, seizures, cerebral palsy, and alcohol withdrawal. Common side effects include drowsiness, dizziness, lethargy, slurred speech, and impaired psychomotor ability. They can also produce paradoxical agitation, impaired sexual functioning, confusion, and sleep disturbances.
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SEIZURES (TONIC-CLONIC, ABSENCE, AND PARTIAL)
There are two main types of seizures. (1) Generalized seizures are bilaterally symmetrical and do not have a focal onset. Included in this category are tonic-clonic and absence seizures. Tonic-clonic (grand mal) seizures include a tonic stage in which the muscles contract and the body stiffens; a clonic stage that involves rhythmic shaking of the limbs; and post-seizure depression or confusion with amnesia for the ictal event. Absence (petit mal) seizures are brief attacks involving a loss of consciousness without prominent motor symptoms. (2) Partial seizures begin in one side of the brain and affect one side of the body, at least initially but sometimes spread and become generalized seizures.
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SEXUAL DIMORPHISM:
Sexual dimorphism refers to sex-related differences in physical appearance, and the research has confirmed that the human brain is sexually dimorphic. Studies using structural brain imaging techniques have found sex-related differences in the size of specific regions of the brain including the corpus callosum, hippocampus, and SCN.
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SLEEP (STAGES, EFFECTS OF AGE)
Sleep is divided into five stages on the basis of EEG (electroencephalogram) pattern. During stage 1, alpha waves are replaced by theta waves. The stage 2 EEG record consists primarily of theta waves that are interrupted by bursts of sleep spindles and K complexes. Large, slow delta waves appear during stage 3; and in stage 4, the “deep sleep” stage, delta waves dominate the EEG record. The fifth sleep stage is characterized by the presence of rapid eye movements and, consequently, is known as REM (dream) sleep. Sleep patterns vary with age. In newborns, the sleep period begins with REM sleep which gradually changes to NREM (non-REM) sleep, but this pattern begins to reverse by about three months of age. In addition, total sleep time, stage 4 sleep, and REM sleep all decrease from childhood to adulthood
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SOMATIC NERVOUS SYSTEM:
The somatic nervous system (SNS) consists of sensory nerves that carry information from the body’s sense receptors to the CNS and motor nerves that carry information from the CNS to the skeletal muscles. The SNS governs activities that are ordinarily considered voluntary.
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SPINAL CORD (QUARDRIPLEGIA AND PARAPLEGIA):
The spinal cord carries information between the brain and the peripheral nervous system, coordinates activities of the left and right sides of the body, and controls simple reflexes that do not involve the brain. It consists of 31 segments, which are divided into five groups. From the top of the spinal cord to the bottom, these are: cervical, thoracic, lumbar, sacral, and coccygeal. Damage at the cervical level ordinarily results in quadriplegia (loss of sensory and voluntary motor functioning in the arms and legs), while damage at the thoracic level causes paraplegia (loss of functioning in the legs).
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SSRIs:
(FLUOXETINE): The selective serotonin reuptake inhibitors (SSRI’s) are antidepressant drugs that exert their effects by blocking the reuptake of serotonin at nerve synapses. Side effects include gastrointestinal disturbances, sexual dysfunction, insomnia, anxiety, headache, and anorexia. In comparison to the TCAs, the SSRIs are less cardiotoxic, safer in overdose, and less likely to produce cognitive impairments. Fluoxetine (Prozac) is one of the most widely prescribed antidepressants, but its use is surrounded by controversy due to evidence linking it to an increased risk for suicide.
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SYNESTHESIA:
Synesthesia (“joining senses”) is a rare condition in which the stimulation of one sensory modality triggers a sensation in another sensory modality. For example, a person with synesthesia might hear a color or taste a shape.
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TARDIVE DYSKINESIA:
Tardive dyskinesia is a potentially irreversible extrapyramidal side effect associated with long-term use of traditional antipsychotic drugs. Symptoms include rhythmical, stereotyped movements of the muscles of the face, limbs, and trunk (similar to Huntington’s chorea). In some cases, symptoms are alleviated by a GABA agonist or by gradual withdrawal of the drug.
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TEMPORAL LOBE AND WERNICKE’S AREA:
The temporal lobe contains the primary auditory cortex and Wernicke’s area. Damage can result in auditory agnosia, cortical deafness, impairments in long-term memory, and/or Wernicke’s (receptive) aphasia.
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THALAMUS AND WERNICKE-KORSAKOFF SYNDROME:
The thalamus is a “relay station” for all of the senses except olfaction and is also involved in language and memory. Wernicke-Korsakoff syndrome is due to a thiamine deficiency that causes atrophy of neurons in certain areas of the thalamus and the mammillary bodies of the hypothalamus and is usually the result of chronic alcoholism. It begins with Wernicke’s encephalopathy, which is characterized by mental confusion, abnormal eye movements, and ataxia; and is then followed by Korsakoff’s syndrome, which involves severe anterograde amnesia, retrograde amnesia, and confabulation.
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THEORIES OF COLOR VISION (TRICHROMATIC AND OPPONENT PROCESS)
There are two theories of color vision. According to the trichromatic theory, there are three types of color receptors that are each receptive to a different color (red, blue, or green). All other colors are produced by variations in the activity of these three receptors. The opponent-process theory postulates three bipolar receptors: red-green, yellow-blue, and white-black. According to this theory, some cells are excited by red and inhibited by green, and so on; and the overall pattern of stimulation of these cells produces the various colors that we perceive.
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THEORIES OF EMOTION (JAMES-LANGE, CANNON-BARD, COGNITIVE APPRAISAL)
The various theories of emotion differ in terms of their emphasis on the role of peripheral and central factors. (1) James-Lange theory stresses the importance of peripheral factors and proposes that emotions represent perceptions of bodily reactions to sensory stimuli. (2) Cannon-Bard theory places greater emphasis on the brain mechanisms that mediate emotion. It proposes that emotional and bodily reactions to stimuli occur simultaneously as a result of thalamic stimulation of the cortex and the peripheral nervous system. (3) Lazarus’s cognitive appraisal theory proposes that emotions are universal but that there are differences in how emotion-arousing events are interpreted or appraised. It distinguishes between three types of cognitive appraisal – primary, secondary, and re-appraisal.
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THERAPEUTIC DRUG MONITORING (TDM)
TDM is the practice of measuring drug concentration levels in a patient’s bloodstream at designated intervals to optimize dosages.
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TRADITIONAL ANTIPSYCHOTICS
The traditional antipsychotic drugs (e.g., phenothiazines) are used for the management of schizophrenia and other psychoses. They are most effective for positive symptoms (delusions, hallucinations, agitation, thought disorders). Side effects include anticholinergic, extrapyramidal effects, and neuroleptic malignant syndrome. These drugs exert their beneficial effects primarily by blocking dopamine receptors, and their effectiveness provides support for the dopamine hypothesis which attributes schizophrenia to overactivity at dopamine receptors.
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TRAUMATIC BRAIN INJURY (POSTTRAUMATIC AMNESIA, RETROGRADE AMNESIA):
Traumatic brain injury (TBI) refers to an injury to the brain that is caused by an external force and involves temporary or permanent impairments in cognitive, emotional, behavioral, and/or physical functioning. It can be due to a closed-or open-head injury. A closed-head injury usually causes an alteration or loss of consciousness followed by anterograde and retrograde amnesia. Anterograde amnesia is referred to as posttraumatic amnesia, and its duration is a good predictor of recovery. Retrograde amnesia affects recent memories more than remote mem
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TRICYCLICS
(IMIPRAMINE, CLOMIPRAMINE) The tricyclic antidepressants (TCAs) are believed to work by blocking the reuptake of norepinephrine, dopamine, and/or serotonin. They are most effective for alleviating somatic, vegetative symptoms. Side effects include anticholinergic effects, confusion, drowsiness, weight gain, and cardiovascular symptoms. Imipramine has also been found useful for treating enuresis, while clomipramine is an effective treatment for Panic Disorder, Agoraphobia, Bulimia Nervosa, and OCD
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TWIN METHOD
A method used in behavioral genetic research that relies on identical or fraternal twins as subjects.
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TYPE A BEHAVIOR PATTERN
People exhibiting the Type A behavior pattern are highly competitive and achievement-oriented, have a sense of time urgency, and tend to be hostile, easily irritated, and impatient. A number of studies have confirmed that, of the Type A characteristics, cynical or antagonistic hostility is most strongly associated with health problems, especially coronary heart disease in males.
