Psychiatric disorders/anatomy (BS1 CH8) Flashcards
autonomic nervous system
controls involuntary responses in the body, including things like sweating, blushing, and pupil dilation, is divided into the sympathetic and parasympathetic systems.
sympathetic nervous system
The sympathetic nervous system stimulates the body in the classic “fight or flight” response, mediated by hormones such as epinephrine and norepinephrine. If the body needs to get ready for action, it will dilate the pupils, raise the heart rate, and increase blood flow to skeletal muscles to prepare for sudden action.
parasympathetic nervous system
By contrast, the parasympathetic nervous system is the “rest and digest” system that increases blood flow to the digestive system, slows the heart rate, constricts the pupils, and generally exerts actions opposite to those of the sympathetic nervous system. In turn, the autonomic nervous system is part of the peripheral nervous system, which describes the nervous system throughout the body and is distinguished from the central nervous system, which corresponds to the brain and spinal cord. The peripheral nervous system is also divided into the visceral nervous system, which modulates the digestive system, and the somatic nervous system, which connects to skeletal muscle to allow for voluntary movement.
A group of patients have difficulty focusing on fixed objects when moving across the room or even rotating their heads. What structure is LEAST likely to be damaged in these individuals, based on their symptoms? A. Inferior colliculus B. Medial geniculate nucleus C. lateral geniculate nucleus D. Auditory cortex
B. Medial geniculate nucleus- no In the auditory pathway, the medial geniculate nucleus precedes the inferior colliculus. C.Lateral geniculate nucleus- no, The lateral geniculate nucleus is the point at which visual information enters the brain, part of thalamus. The patients’ troubles could stem from a deficiency of the visual system. D.Auditory cortex D is correct. The auditory cortex is responsible for processing sound information in the temporal lobe after it has passed through the medial geniculate nucleus. It is not mentioned that these patients have trouble perceiving sound. Note that some information is also sent to the inferior colliculus, which helps keep the eyes focused on singular points even when the head is rotating. This key part of the vestibulo-ocular reflex could easily be damaged in these people.
What is one example of adaptation in relation to signal detection? A child living near a bread factory begins to associate the smell of bread with home. B. A resident who spends long hours in fluorescent lighting more frequently looks downwards. C. A man who resides above a bakery stops noticing the smell wafting from below. D. A teacher learns to pause his lecture when he hears the intercom speaker begin to crackle.
C is correct. While the bakery smells might be distracting at first, the man’s brain adapts, allowing him to focus on more relevant stimuli. A- wrong b/c this is not related to adaptation as much as it is to response bias. B- wrong b/c this is a physical habit formed from experience. It does not pertain to the resident’s altered perception of light. D- wrong b/c like B, this is a habit learned from experience and does not describe adaptation
Huntington’s disease
Huntington’s disease is caused by an expanded CAG repeat in the gene that encodes the huntingtin protein on chromosome 4; this causes the progressive atrophy of brain structures. It is unrelated to dopamine.
By blocking norepinephrine reuptake, duloxetine could cause which of the following side effects?
B is correct A.Increased frequency of urination Digestion is promoted by the parasympathetic (“rest and digest”) response, including increased urination/defecation. B. High blood pressure Blocking norepinephrine reuptake would potentiate its effects. Since norepinephrine is a mediator of the sympathetic nervous system response (commonly known as the fight-or-flight response), it may lead to side effects associated with sympathetic activation. High blood pressure, as a consequence of the fight-or-flight response, is a possible outcome.
level 1 disorders
anxiety disorders
depressive disorders
bipolar and related disorders
schizophrenia spectrum and other psychotic disorders
trauma and stressor related disorders
personality disorders
obsessive compulsive disorders
somatic symptom disorders
dissociaive disorders
monoamine hypothesis
of depression predits that the underlying pathophysiological basis of depression is a depletion in the levels of serotonin, norepinephrine and/or dopamine in the CNS
Small molecule neurotransmitters: from chapter 6 BS1
* Amino acids: e.g., glutamate and GABA.
* Biogenic amines: e.g., dopamine, norepinephrine, and serotonin.
* Acetylcholine: binds both ionotropic and metabotropic receptors.
Norepinephrine: involved in arousal and motivation.
Dopamine: involved in reward processing and coordinating movement.
Serotonin: involved in regulating mood, appetite, and sleep.
bipolar disorder I
mood swings and episodes tend towards manic phase, exgreme energh, insomnia, impuslivity and then manic follwoed by wings into typical depression
MANIC phase
- high energy
- high self esteem
- racing thoughts
- quick talking
- impuslive
- irratibl
Bipolar II disorder
depressed phase
- low energy
- less intense manic episodes
- lack of cocnentraiton
- loss of interest
- helplessness
- sucidal thoughts
to be bipolar need to exhibit both phases, difference which is emphasized more, bipolar II depressd phase predominates
he main difference between bipolar I and II is the severity of symptoms. People with bipolar I disorder experience more severe highs (mania) and may not have depressive episodes. While people with bipolar II experience a less severe high (hypomania), their diagnosis includes depressive episodes.
BD-2 was characterized by more prominent and longer depressions with some hypomania and mixed-features but not mania and rarely psychosis. BD-2 subjects had higher socioeconomic and functional status but also high levels of long-term morbidity and suicidal risk. Accordingly, BD-2 is dissimilar to, but not necessarily less severe than BD-1, consistent with being distinct syndromes.
schziophrenia disorder
delusions, hallucinations
disorganized speech and thoughts
life long condition, symptomsaren’t ncessarily more severe just lasts longe
may involve “negative” symptoms
involve a general detachment from objective reality
*delusions are a belief, like gov trying to control my mind; hallucaination involves sensory/perceptions could be visual or auditory not a belief its a sensory perception
schziophrenia 2
positive symptoms: something they have, a behavior present in the patient that is not present in healthy ppl, for it to be a positive symptom we are saying ti is present*
- psychotic beahviors not seen in healthy ppl
- hallucinations, delusions, disorganized speech or beahvior
negative symptoms: something lacking or something they dont have* somthing expect to see but do not
- disruptions to normal emotions and behaviors, absence of normal patterns
- avolition (loss of motivation to do things) flattened affect, reduced speech/or interactions
cognitive symptoms:
- thought patterns that make it hard to lead a normal life and cause emotional distress, like knowing you have hallucinations, emotional distress cause d by that can really affect daily life why so problematic and included as diagnosis on list of mental disorders
- poor executive funcitoning, rouble focusing or paying attention, problems with working memory
what is going on: abonormalities in neurons and abnormally lwo activity in frontal cortex, makes sense with poor executive functioning, difficulty planning, reasoning making decisions all related to frontal lobe can be an indication of potentially of schizophrenia
2.
Personality disorder clusters
A
milder version of schizophrenia* out of touch with reality
odd/eccentric: think midler versions of schizophrenia*
- paranoid PD manifests the paranoid tendencies
- Schizoid PD manifests the social withdrawal and flattened affect
- Schizotypal PD manifests milder hallucinations and delusions
Cluster B personality disorder
dramatic/erratic: think of these as over-the-top or unstable, issues iwth interpersonal relationships
- antisocial PD is sociopathy, with no regard for right or wrong or other’s rights; think about adolescent, killing neighbor dog and feeling no remorse about it, no real remorse or empathy
- borderline PD is severe abandonment anxiety and emotional turbulence, brandon marshall exhbited and diagnosed it, very quick shift form love to hate, folks tend to be more prone to self harm, highly manuplative struggle to have good relationships
- Histronic PD is overdramatic attention seeking and emotional overreaction; see more in females, often manifests itself as seductive beahvior inappropriately so
- Narcissistic PD is inflated sense of self and lack of empathy, super self centered generally pretty out going but narcissist needs affirmation of other ppl, why they tend ot be pretty charismatic and outgoign wnat to have sense of self reinforced
* antisocial PD can be though of as conduct vs emotional regulation*
Cluster C personality disorder
anxious/fearful: think of these as anxiety or OCD related, world has many risks and dangers response determines; patterns of extreme fear of anxiety
- avoidant PD presents as very extreme shyness and fear of rejection
- dependent PD presents as over-dependence on others to meet needs
- Obsessive-compulsive PD presents as a milder form of OCD
somatic symptoms disorder
- excessive and/or medically unexplained symptoms
- commonly encountered in primary care
to the patient the suffering si real and causes a whole lot of distress when they cannot get a medical explanation to it, mental disorder is most causes symptoms are real; somatic again means related to the body
specific diagnoses: somatic symptom disorder, illness anxiety disorder, conversion disorder, factitious disorder
somatic- main distress physical, in body there is pain
illness anxiety- more like darwin stress is primarily psychological, the term that sort of used to be used is hypochondratic no its too vague so been broken down into different things that may be wrong, somatic symptoms may or may not be present but real distress may be psychological will i die from this illsness? conversion disorder actual cahnge ins ensory or motor function with no discernable cause, temproary blindness like when all parts of hte eye should function correctly nothing functionally wrong with the eye, or temporary paraylsis no one can explain why that is conversion disorder!
factitious disorder= munchasusen or munchausen by proxy*term doesnt apply in DSM 5 but how it is refered to the one where symptoms are either falsified where patient is actually falsifyign evidence of the symptoms or sometimes munchausen by proxy caregiver intentionally inflicting harm on child to get attention* lke feeding kid poison to get htemn sick to get all this attentio
dissociative identiy disorder
-disruptions and/or discontinuities in core identity
-abnormal itnegration of consciousness, identity and emotion etc.
specific diagnoses:
dissocaitive identiy dsiorder
(dissoctaive amneisa- gap, period of time cannot remember often defense mechanism of brain shutting down becuase somethign was so traumatic)
depersonalization/ derelaization disorder
depersonalization= out of body, numb am I relaly even here? out of body experiment
derealization=(external world, dream like I am here i am not feeling lke I am fuzzy or numb but objects in external world feeling that way) environment feels dream like
the person knows this isnt accurate so its that awareness that causes the person to be so uncomfortable*
personality disorders in general
maladaptive, inflexible behavior patterns
neurodevelopment disorder
difficulty with social interactions
difficulty understanding emotions of others
natural inclinatin for rote, repetitive activities
= autism
what makes it a neurodevelopmental disorder* vs neurocognitive, its developmenbtal so manigests itself early in developmetn typically, usually hard ot reat, behaviorla therapy can be done to really help with these things
characterized by intellecutal disability it is a spectrum and there are a lot of really ridiculously intellgient ppl on that spectrum
- manifest early in development, early onset usually before grade school
- appear as deficits generally difficult ot treat
characterized by intellectual disbaility, communication orders; not often intellectual disability often communication disorder
ALSO ADHD* (motor restlessness, impusivlity, hard time concentrating, distractiability) other diagnoses less likely to be tested, intellectual disability and tourette’s syndomr
alzheimer’s disease
these are 2 abnormal structures in the brain associated with Alzheimer’s disease:
- amyloid plaques: clumps of proteins fragments that accumulate outside of cells
- neurofibrillary tangles: clumps of altered proteins inside cells
its destruction and death of nerve cells that causes memory failure, personality changes, problems carrying out daily activities and other symptons of alzheimer’s disease
most pl develop some but those with A’s disease develop way more, specifically develop first in areas particualrly important for memory then expanding to other areas of the brain, older people in genreal will show some of thsi ppl with alzheimer’s will show far more
problematic becuase it inhibits/ play cirtical role in blocking communication among the nerve cells and really disrupting processes cells need to surive, root of problem is destruction adn death of nerve cells causing memory failure adn personality changes all these symptoms of althzimers its destruction of nerve cells, see impaird memory, then impared judgement, difficulty finding, progression can last anywhere from 2-20 years, average is 8 years for severe decline
parkinson’s disorder
another neurocgonitive disorder like alzheimer’s
another role in whats going on in the brain
if alzheim’er is tyupically manifesting itself in problems with memory, the most characteristic symptom of parkinson’s is muscle control, someone shaking a lot** can certainly be an indication before parkinson’s its a problem with motor function and muscle control causing you to shake involutnarily! here again something at play in the brain seems to be assocaited with abnormally low doapime levels, that finding is enouraing in a way suggesting that maybe if that problem can be addressed maybe there is hope to move in the right direction to treat this, movement disorder is also caused by death of cells the death of cells generate dopamine*
- dopaminergic neurons in the substantia nigra of the basal ganglia die off, mkaing it harder to contorl movements, one on each side of mem,brane we see cells have been killed off here
-dopamine is involved in sending messages to areas of the brain that control coordination and movement- if we see reduction in dopamine levels will see parksinon, chronic and progression disorders like alzhemiers, not like one day you do not have parkinson’s and hte next day you do see gradual decline as conditions worsen, about 50-80% of parkinson’s patient eventually see some sort of dimentia as disease progresses starts out as motor function then majority of cases it manifests itself as some sort of dementia
- dopamine levels progressively drop, so symptoms gradually become more severe
- abnormal aggregates of proteins called Lewy bodies develop inside neurons
alzhimer’s what is the problem with muscle control
Lewy body dementia- almost reverse of parkinson’s earlier symptoms are congitive and the later syumptoms are motor funcitoning, with parksinson’s its motor function first