Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro Block 2 > Sleep Physiology / Disorders (4) > Flashcards

Sleep Physiology / Disorders (4) Flashcards

0
Q

How does decreasing ambient light cause melanin to be secreted? (Path and which portion of ANS is involved?)

A

Decreasing light causes retinal ganglion cells (contain melanopsin) to fire and send signal to the Suprachiasmic Nucleus, which in turn activates the Paraventricular Nucleus–> activates neurons in the intermediolateral gray zone of upper spinal cord to modulate neurons in the superior cervical ganglia–> activation of sympathetic neurons traveling to pineal gland–> increased synthesis and release of melanin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What is the normal amount of sleep for average adult?

A

7.5 +/- 2 hours

Normal sleep decreases with age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which nucleus is thought of as the “master clock”? Where is it located?

A

Suprachiasmatic Nucleus in the anterior area of hypothalamus–> controls behavioral and physiological circadian rhythms, including the wake-sleep cycle, hormonal secretion, and thermoregulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What time of day does melatonin secretion peak?

A

2:00-4:00 AM (begins rising in early evening as daylight decreases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What two hormones other than melatonin are also involved in rhythmic cycling related to the day/night and/or sleep/wake cycles?

A

Growth hormone and cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What four things are monitored during polysomnography?

A
  1. EEG (brain waves)
  2. Eye movement
  3. Respiration
  4. Oxygen tension (plethysmography sensor)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the different frequencies and waveforms detected in EEG useful for?

A

They can be used to diagnose certain neuro conditionsa nodal so used to identify the various stages of sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What two wave frequencies are typically seen in the normal awake human? What frequency range does each have?

A
  1. Beta (over 13 Hz)

2. Alpha (8-13 Hz)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What usually happens to the amplitude of wave forms as the frequency decreases?

A

Amplitude increases as frequency decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which stage of sleep corresponds to REM sleep?

A

Stage V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What generally happens to EEG frequency as sleep moves from stage I to stage IV?

A

The frequency decreases (so amplitude increases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which stage of sleep is the lightest?

A

Stage I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which stage of sleep is characterized by sleep spindles and K complexes?

A

Stage II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which stage of sleep is most similar to awakefulness, according to EEG?

A

REM sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What kind of waves generally are seen in stage I sleep?

A

Theta waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What characterizes Stage II sleep?

A

Theta waves; are also spindle complexes and K-complex patterns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of waves characterize Stage II and IV of sleep?

A

Delta waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What two types of waves are seen during REM sleep?

A

Theta and Beta waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How many ~ 90 minute cycles of alternating NREM and REm sleep are there per night of sleep?

A

5 to 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which portion of sleep is get progressively longer with each cycle sat he night progresses?

A

REM sleep cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What type of sleep is associated with vivid, bizarre dreams?

A

REM sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why can’t people usually move during REM sleep?

A

Usually have a muscle paralysis, if they don’t, there USA. Problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When do sleep walking and night terrors occur?

A

During slow wave (non-REM) sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

During which type of sleep is there a decrease in overall body metabolism with slower HR, RR, body temp, and BP?

A

Non-REM sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a feature of REM sleep that can differentiates a physiological from a psychological problem?

A

BONERS!!!!!!!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Activity in what three areas of brain may be responsible for the highly emotional content in REM dreams?

A
  1. Amygdala
  2. Parahippocampal gyrus
  3. Anterior cingulate cortex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Inhibition of what two structures may add to the bizarre nature of dreams in REM sleep?

A
  1. Frontal cortex

2. Posterior cingulate cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

______ neurons in the pedunculopontine (PPT) and lateral dorsal tegmental (LDT) tigger the thalamocortical signaling that produces what kind of waves on EEG?

A

Cholinergic; Beta waves–> consistent with arousal and alertness

  • these are inhibited during NREM sleep, which helps facilitate slow wave sleep
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Where in the brain are the PPT and LDT located?

A

Nucleus basalis–> is down just inferior to the genu of corpus callous, in the cortex

Project widely tot eh forebrain and are activated during wakefulness and REM sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What type of NT is the output of the locus ceruleus? Where does it travel to? Where located?

A

LE sends out NE from the lateral tegmental area in the superior Pons to the neocortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

When is the locus ceruleus active?

A

During wakefulness

*but unlike cholinergic input (PPT and LDT) is nearly completely in REM sleep (some activity NREM sleep)

31
Q

What three circuits send out dopaminergic input to cortex?

A
  1. Mesostriatal (from SN to the striatum)
  2. Mesolimbic (to cingulate cortex, amygdala, hippocampus–> limbic structures)
  3. Mesocortical (to prefrontal cortex)
32
Q

What are dopaminergic inputs to the cortex important for?

A

Full wakefulness

34
Q

What type of input is sent from the dorsal and medial raphe nuclei to the cortex?

A

Serotonin

35
Q

What kind of output comes out of the tuberomammillary nucleus to the cortex?

A

Histaminergic

36
Q

When are histaminergic neurons active?

A

During wakefulness

  • less so in NREM sleep and lower still in REM sleep; blocking these receptors increases both NREM and REM sleep
37
Q

What five nuclei are found in the hypothalamus involved in sleep/wake cycles?

A
  1. Suprachiasmatic nuclei
  2. Paraventricular nuclei
  3. Tuberomammillary nuclei
  4. Lateral hypothalamic area
  5. Ventrolateral preoptic nucleus (VLPO)
38
Q

What two substances are involved in signaling from the lateral hypothalamic nuclei?

A

Orexin and hypocretin

39
Q

What type of neurons are found in the VLPO? What dot hey generally serve to do?

A

Has GABAergic neurons (and galanin neurons)—> inhibit all nuclei involved in wakefulness (PPT, LDT, locus ceruleus, SN, raphe nuclei, tuberomammillary nucleus, and lateral hypothalamic area)

*reciprical innervation to these nuclei; have feedback inhibition and allow for rapid change from sleep to wake state

40
Q

What do lesion so f the VLPO lead to?

A

Insomnia

41
Q

What is a somnogen? 3 examples?

A

Endogenous sleep-promoting chemicals that may accumulate during wakefulness and promote sleep onset

*adenosine, cytokines, melatonin

42
Q

What two cytokines are thought to promote sleep?

A
  1. IL-1B

2. TNF

43
Q

When are serotoninergic circuits active?

A

During wakefulness

  • less active during NREM sleep and almost totally silent during REM sleep; is the basis for using TCAs and SSRIs in sleep disorders
44
Q

In what two nuclei are REM-ON cells located that are responsible for the awake-like EEG patterns during REM sleep?

A
  1. Pedunculopontine nucleus (PPT)
  2. Laterodorsal Tegmental nucleus (LDT)

*removal of GABAergic inhibition of these neurons increases as sleep goes from I-IV, resulting in increasing cholinergic (Ach) transmission until REM–> Ach activates the thalamus and other higher cortical areas, resulting in the EEG patterns resembling the awake state

45
Q

What is responsible for the atonic or paralyzed state seen in REM sleep?

A

REM-On cells activate glycine-releasing neurons in the medullary brainstem that inhibit anterior horn cells in the spinal cord–> atonic state

*these neurons activated to release glycine by glutaminergic REM-On cells

46
Q

Where are REM-Off cells located (what nucleus)? How do they work to counteract activation of REM-On neurons?

A

Locus ceruleus–> set of NE neurons that, when activated, cause inhibition of REM-on cells to terminate REM sleep

*thus the two REM-On nuclei (located in PPT and LDT nuclei) and the REM-Off nuclei in/near the locus ceruleus work in a switch-like fashion to initiate or terminate REM sleep

47
Q

During wakefulness, two _______ nuclei and 4 ______ nuclei are active and responsible for maintaining the aroused state.

A

Two hypothalamic nuclei and 4 brainstem nuclei

48
Q

What does a Multiple Sleep Latency test measure?

A

the EEG-defined sleep latency, or the time it takes to fall asleep (confirmed by EEG) measured during 4-5 daytime naps

49
Q

What is scale called that is the self-reported tendency to fall asleep in 8 different situations?

A

Epworth sleepiness scale

50
Q

What is Obstructive Sleep Apnea?

A

repetitive blockage of the respiratory pathway during sleep causing apneic periods

51
Q

How long must apneic periods in OSA last? By what percent does oxyhemoglobin desaturate?

A

at least 10 seconds; O2 sats drop by at least 4%

52
Q

In what sex in OSA more common in? What condition icncreases incidence?

A

More common in men; obesity causes a higher incidence

53
Q

There is a strong association between obstructive sleep apnea, ________ ________, and ___________.

A

Heart disease and Hypertension

54
Q

What causes sleep apnea?

A

Complex pathological interactions of pharyngeal muscles, tongue, and soft tissues——> airway obstruction

55
Q

__% of men and __% of women have obstructive sleep apnea (aged 30-60)

A

4%; 2%

56
Q

What are some symptoms of sleep apnea?

A
  1. excessive daytime fatigue
  2. snoring
  3. heartburn
  4. memory loss
  5. irritability/ depression
  6. Morning headache
  7. SOB
  8. Nocturia
  9. impotence
57
Q

What are some signs of OSA?

A
  1. Nasal obstruction
  2. Macroglossia
  3. Tonsillar/ Adenoid hypertrophy
  4. Reflux laryngitis
  5. Shirt collar size over 17 inches
  6. HTN
  7. CHF
  8. Pitting edema of lower ext
  9. Enlargement of hands and feet (acromegaly)
58
Q

Narcolepsy is defined as excessive daytime sleepiness with one or more of what 4 symptoms?

A
  1. Sleep attack/ intrusion–> irresistible daytime sleep onset
  2. Cataplexy–> abrupt loss of muscle tone during waking hours
  3. Sleep paralysis–> persistent REM after wakening
  4. Hypnogogic hallucinations–> dreams persist after awakening
59
Q

When do 90% of people usually have onset of narcolepsy (ages)?

A

Usually by 2nd-3rd decade of lfe

60
Q

Secondary Narcolepsy can be seen with what 4 conditions?

A
  1. Multiple Sclerosis
  2. Pituitary tumors
  3. Vascular malformations
  4. Stroke
61
Q

Does narcolepsy have a familial tendency?

A

Yes–> 1st degree relatives have a 1-2% increased risk

62
Q

What two symptoms do over 90% of narcolepsy patients have?

A
  1. Excessive daytime sleepiness
  2. fragmented nocturnal sleep
  • ~80% have cataplexy, hypnogogic hallucinations, and/or sleep paralysis, so the excessive daytime sleepiness and other tetrad of symptoms pretty common
63
Q

Narcolepsy is due to loss of neurons in what area of brain?

A

loss of hypocretin/ orexin secreting neurons in the lateral posterior hypothalamus

64
Q

What two HLA genes may predispose to automimmune attack on neurons involved in narcolepsy?

A

DQ1 or DQB1*0602

65
Q

What lab test ca be useful in confirming narcolepsy in addition to clinical symptoms and polysomnography?

A

CSF fluid will be low in hypocretin-1 in 90% (10% have normal level, so not entirely specific)

66
Q

How long is sleep latency in Mean Sleep Latency Test for narcoleptics?

A

Less than or equal to 8 mins (remember this test is done during the day, so indicates definite excessive daytime sleepiness)

67
Q

What two drug classes can be used to treat the cataplexy in narcolepsy?

A

tricyclic antidepressants or SSRIs

68
Q

What is insomnia?

A

Difficulty falling asleep or remaining asleep

69
Q

What is the difference between transient insomnia and chronic insomnia?

A

Chronic—> insomnia lasting over 6 weeks; anything less than 6 is classified as transient

  • Transient affects up to 50% of adults and Chronic up to 25%, so insomnia is very common
70
Q

What are some causes for the failure to maintain sleep seen in insomnia?

A
  1. OSA
  2. Aging
  3. Depression
  4. REM sleep disorder
  5. CNS degenerations
  6. Medication side effects
71
Q

What is loss of atonia/paralysis during REM sleep, leading to physical acting out of dream states, including verbalization, punching, kicking, jumping from bed?

A

REM Sleep Behavior Disorder

72
Q

What is the cause of Primary REM Sleep disorder?

A

idiopathic or associated with the alpha-synucleinopathies (Parkinson’s, Lewy Body Dementia, Multisystems Atrophy, Progressive Supranuclear Palsy)

73
Q

What three conditions may cause a secondary REM Sleep Behavior disorder?

A
  1. EtOH withdrawal
  2. TCA use
  3. SSRI use
74
Q

Treatment for REM Sleep Behavior disorder?

A

Clonazepam

75
Q

In what age and sex is REM Sleep behavior most common in?

A

Most common in adult males over 50

Neuro Block 2 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions