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WEEK 7 SEM 4 > The ageing brain > Flashcards

The ageing brain Flashcards

1
Q

What is the function of the frontal lobe?

A 
executive behaviour
complex decision making
emotions
interaction on social level 
impulsivity
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2
Q

What is the function of the parietal lobe?

A

Sensory processing
reading
writing

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3
Q

What is the function of the temporal lobe?

A

language (esp left hemisphere)
memory
auditory and visual combined

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4
Q

What is the function of the occipital lobe?

A

visual processing

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5
Q

What are the physical/structural changes of the brain?

A

atrophy
neurofibrillary tangles
plaques
oxidative stress
cerebral blood flow and homeostatic regulation
Ventriculomegaly (the size of the ventricles increases)

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6
Q

What are the chemical changes in the brain?

A

changes in neurotransmitters

blood brain barrier changes

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7
Q

What is atrophy?

A

loss of neurons and the connections between them

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8
Q

At what age is your brain mass its max?

A

25

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9
Q

Does the loss of neurones (atrophy) happen througout the brain?

A

no
pre-frontal cortex and striatum are most affected
hippocampus, temporal lobe and cerebellum are also affected
grey matter and white matter lose at different rates

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10
Q

What does the pre-frontal cortex do?

A

planning, cognitive complex behaviour, expression, decision making, social behaviour

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11
Q

What does the striatum do?

A

initiates voluntary movements

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12
Q

What does the hippocampus do?

A

short term, long term and spatial memory

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13
Q

What is the cerebellum involved with?

A

motor fine tuning

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14
Q

What do you see in a CT scan of a patient with atrophy?

A

less solid matter (more black on scan bc more CSF)
More black around the cortex
widened sulci
The ventricles are bigger- ventricular megaly just because you are losing bits of the brain

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15
Q

Which part of the brain is protected from atrophy?

A

OCCIPITAL LOBE

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16
Q

What happens to grey and white matter?

A

grey matter decreases when reach childhood

white matter increases until 40 then decreases

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17
Q

What is lost more: white or grey matter?

A

white matter

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18
Q

What are neurofibrillary tangles?

A

collection of hyperphosphorylated tau protein

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19
Q

what do tau proteins do?

A

stabilise microtubules

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20
Q

What are plaques?

A

deposition of beta amyloid

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21
Q

What do tangles and plaques lead to?

A

reduced synaptic transmission

22
Q

What is oxidative stress?

A

Oxidative stress is when you don’t have enough antioxidants to soak up the free radicals and so the free radicals cause inflammation
When you are older, the BBB becomes more permeable, the antioxidant levels become reduced and so more free radicals can cause the damage

23
Q

What is cerebral white matter lesion known as?

A

leukoaraiosis

24
Q

What happens in cerebral white matter lesions?

A

chronic ischaemic changes
Associated with vascular risk factors
Possibly related to small vessel strokes of episode of hypoperfusion related to loss of autoregulation

25
Q

What happens to cerebral flow and homeostatic regulation?

A

old age- blood flow to brain reduces by 5-20%
narrower arteries
bp fluctuates
reduction in homeostasis

26
Q

What happens to acetylcholine levels in the ageing brain and what does it cause?

A

reduces- causes cognitive impairment

27
Q

What happens to dopamine levels in the ageing brain and what does it cause?

A

reduces- causes reduced arm swing and increased rigidity

28
Q

What happens to serotonin levels in the ageing brain and what does it cause?

A

reduces- causes depression and changes in circadian rhythm

29
Q

What happens to the blood brain barrier in the ageing brain?

A

increased permeability
reduced transport of glucose, proteins and hormones
bbb is more susceptible to hypoglycaemia

30
Q

What do all the changes in the ageing brain lead to?

A
  • difficulty learning new things
  • difficulty retrieving information
  • slower processing speed
  • problem solving ability declines
  • reasoning about unfamiliar things declines
  • attending to & manipulating own environment can be more difficult
31
Q

What are the 2 types of stroke?

A

ischaemic or haemorrhagic

32
Q

What are treatments for stroke?

A

thrombolysis

thrombectomy

33
Q

What is parkinson’s?

A

neurodegenerative disease

death of dopamine producing cells in the substantia niagra

34
Q

What are the symptoms of parkinson’s?

A

tremor
rigidity
bradykinesia

35
Q

What is the most common dementia?

A

alzheimer’s

36
Q

What causes alzheimer’s?

A

AMYLOID PLAQUES

NEUROFIBRILLARY TANGLES

37
Q

What are amyloid plaques in dmeentia?

A

beta amyloid (A)
the parent protein for this is called amyloid precursor protein (APP)
genetic support for amyloid plaques
genes which interact with APPe.g. presenilin 1 and 2, or patients with increased number of chromosome where the APP gene lies (e.g. patients with Down syndrome) have a higher chance of developing dementia at an earlier age

38
Q

What are neurofibrillary tangles in dementia?

A

formation of intra neuronal (inside neurones) tangles of hyper-phosphorylated tau protein
this protein becomes extracellular (leaves the neurone) when the neurone dies and disrupts communication between other neurones
these tangles are seen in excess amounts in patients with alzheimers dementia in the temporal lobe

39
Q

How is alzheimer’s treated?

A 
- acetylcholinesterase inhibitors (enzyme that breaks down acetylcholine)
rivastigmine
galantamine
donepezil
- NMDA receptor antagonist
memantine
40
Q

What is delirium?

A

‘acute confusional state’

‘acute brain failure’

41
Q

What are the 3 types of delirium?

A

hyperactive-hypoactive-mixed

42
Q

What is cognitive reserve?

A

it is the amount of damage a brain can take before cognitive functions go down

43
Q

What are risk factors for delirium?

A

65+
fractured femur neck
dementia
severe illness

44
Q

How do you assess for delirium?

A

4AT
Abbreviated Mental Test Score
Montreal Cognitive Assessment

45
Q

What is the 4AT test?

A

1) Alertness
2) AMT 4 (Age, DOB, Place, Year)
3) Attention (Months of the year backwards)
4) Acute change or fluctuating course

46
Q

What are the causes of delirium?

A

MAIN ONES:
1. Reduction in Ach and increase in dopamine
2. Theory that mediated by acute stress response:
Increased Cortisol
Increased Sympathetic activation
Elevated Cytokines

  • infection
  • urinary retention
  • constipation
  • pain
  • cardiovascular/respiratory problems
  • metabolic problems
  • neurological problems
  • medications
  • drug/alcohol withdrawal
  • surgery and general anesthesia
  • environmental factors like change in environment
47
Q

What is diencephalon?

A

mid brain and contains structures such as thalamus and hypothalamus

48
Q

What does the brainstem do?

A

conducts information from spinal cord to brain
origin of cranial nerves
has cardiorespiratory control
controls level of consciousness

49
Q

can any parts of the brain make neurones?

A

well technically no but some studies show hippocampus

50
Q

Which lobe is commonly affects by age related changed?

A

medial temporal lobe

51
Q

With ageing, which memories are preserved and which ones decline?

A

procedural (motor skills), primary and semantic memory (general facts) are well preserved.
episodic (memory of events) and working memory (holding and processing) and executive function (planning and managing tasks) are most affected and a decline is seen in these.

52
Q

Which type of delirium is most common?

A

Hypoactive delirium is most common! Hyperactive makes up only about 20%.

WEEK 7 SEM 4 (7 decks)

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