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Patho 1 > 4 - Brain > Flashcards

4 - Brain Flashcards

1
Q

The central driving component of the excitatory system is the _______

A

reticular substance of the pons and mesencephalon

a.k.a. the bulboreticular facilitory area

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2
Q

Signals from the reticular excitatory area pass to _______

A

the thalamus, and the thalamus sends signals on to the cerebral cortex

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3
Q

Are the following hormones excitatory or inhibitory?

Norepinephrine

Dopamine

Serotonin

A

Excitatory

Both

Inhibitory

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4
Q

Where are the neurohormones primarily located:

Norepinephrine

Serotonin

Dopamine

A

virtually every area of the brain

midline structures

basal ganglion regions

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5
Q

Identify which neurohormone is associated with the following structures:

Locus ceruleus

Substantia Nigra

Raphe Nuclei

Reticular Excitatory Area Giant Cells

A

Norepinephrine

Dopamine

Serotonin

Acetylcholine

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6
Q

What is the limbic system?

A

the entire neuronal circuitry that controls emotional behavior and motivational drives

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7
Q
A
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8
Q

What is the most obvious area that causes natural sleep?

A

Raphe Nuclei

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9
Q

What are two endogenous substances that induce sleep?

A

muramyl peptide

delta sleep-inducing peptide

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10
Q

what causes narcolepsy?

A

defects in orexin signalling

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11
Q

Which brain waves are associated with very deep sleep?

A

Delta

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12
Q

Generalized tonic-clonic (grand mal) seizures are characterized by:

A

sudden loss of consciousness in all areas of the brain

Seizure activity transmitted down the brain results in tonic and spasmodic (clonic) muscle activity

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13
Q

How long does a generalized seizure usually last?

A

3-4 minutes

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14
Q

What is the usual cause of generalized seizure?

A

Usually unknown

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15
Q

What are 5 epileptogenic factors?

A

Strong emotional stimuli

alkalosis from overbreathing

drugs

fever

loud noises/flashing lights

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16
Q

What are petit mal seizures?

A

Absence seizures

Most common in children

Usually disappear by age 30

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17
Q

Describe the function of the adrenal medulla

A

preganglionic sympathetic nerve fibers pass without synapsing from the spinal cord, through the sympathetic chains, and then through the splanchnic nerves all the way to the adrenal medulla

The adrenal medulla contains secretory cells that are actually embryologically nervous tissue, which is why they secrete epinephrine and norepinephrine as a hormone into the blood supply

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18
Q

What percentage of parasympathetic nerve fibers are within the vagus?

A

75%

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19
Q

In parasympathetic fibers, where are pre and post ganglionic fibers found?

A

The preganglionic fibers pass all the way to the organs they end on,

the postganglionic neurons are located in the walls of the organs they end on

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20
Q

Which fibers are cholinergic?

Which are adrenergic?

A

acetylcholine

adrenergic (short for adrenaline)

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21
Q

All preganglionic neurons are _______

A

cholinergic

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22
Q

Most of the postganglionic sympathetic neurons are _______

Most of the postganglionic parasympathetic neurons are ____

A

adrenergic

cholinergic

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23
Q

Acetylcholine is caused a _____ transmitter

Norepineprhine is called a _____ transmitter

A

parasympathetic

sympathetic

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24
Q

Where does acetylcholine synthesis occur?

A

terminal endings and varicosities

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25
Where does norepinephrine synthesis occur?
begins in terminal nerve endings, completed inside the secretory vessicles
26
\_\_\_\_\_\_\_ is converted into norepinephrine in secretory vessicles
dopamine
27
In the adrenal medulla, norepinephrine is converted \_\_\_\_\_\_\_
about 80% is converted into epinephrine
28
When secreted into the blood, norepinephrine and epinephrine remain active for \_\_\_\_\_\_\_\_
10-30 seconds, decline to extinction over a couple/several minutes via the liver
29
Acetylcholine activates two types of receptors:
muscarinic nicotinic
30
Describe muscarinic receptors
use G proteins as their signaling mechanisms found on all effector cells that are stimulated by postganglionic cholinergic neurons
31
Describe nicotinic receptors
ligand-gated ion channels Found at the synapses between preganglionic and postganglionic neurons
32
Which lasts longer: direct sympathetic stimulation or hormonal sympathetic stimulation?
hormonal is 5-10x more long lasting
33
Complete cessation of blood flow to the brain causes unconsciousness after how long?
5 - 10 seconds
34
Which four arteries form the circle of willis?
Carotids (2) Vertebrals (2)
35
What is the Virchow-Robin Space?
an extension of the subarachnoid space that penetrating vessels travel through
36
What is the average normal blood flow through the brain?
750-900ml/min 2% of bodyweight receives 15% of CO!
37
What effect on cerebral blood flow occurs when CO2/H levels are ELEVATED?
increased blood flow
38
How does CO2 cause vasodilation?
Converted to carbonic acid then bicarb and H H causes direct vasodilation of the cerbreal vessels
39
Do other substances that increase the acidity of the brain have the same effect of CO2 increases?
Yes Your brain will respond to H+ concentration, regardless of origin A lactic acidosis will still cause increased respiration/cerebral blood flow
40
What is the role of astrocytes in cerebral blood flow?
couples neuronal activity with cerebral blood flow
41
Cerebral autoregulation is effective between _________ mmHg of arterial MAP
60-150
42
What causes seizures in pre-eclampsia?
cerebral blood flow autoregulation is impaited leads to pressure-dependent increases in cerebral blood flow Disrupts/damages vascular endothelium causes brain edema and even seizures
43
Which uses more blood: gray or white matter?
Gray matter about 4x as many capillaries are in gray matter
44
Brain capillaries are way less ______ than systemic capillaries
leaky supported on all sides by glial feet, which provide structural support and prevent stretching/trauma
45
What is the average amount of CSF?
150ml
46
What "valve" controls flow of CSF and therefore CSF pressure?
The Arachnoid Villi
47
48
What is the neuromatrix theory?
Gate control ++ patterns of nerve impulses drawn from a multitude of factors Stimuli may trigger the patterns but do no produce them
49
What is the role of serotonin and norepinephrine in pain modulation?
Contribute to pain inhibition in the medulla, but excite peripheral nerves
50
51
what part of the brain is responsible for temperature management?
hypothalamus
52
What happens in the brain when heat is needed?
TSH-RH released from hypothalamus stimulates anterior pituitary to release TSH acts on thyroid to stimulate release of thyroxine thyroxine acts on adrenal medulla adrenal medulla releases epinephrine
53
How is heat distributed?
the circulatory system
54
Term infants produce heat primarily through:
metabolism of brown fat
55
What causes a fever
temporary resetting of the hypothalamic thermostat in response to pyrogenic cytokines and exogenous pyrogens
56
Where do exogenous pyrogens and pyrogenic cytokines come from?
exogenous pyrogens are released by rupture of the microbe's cell wall pyrogenic cytokines are released by phagocytic cells as they destroy microbes within the host
57
What is the final common step for fever generation?
Production of PGE2 acts on warm centers in the hypothalamus to reset the temp goal
58
Why do people feel hot when a fever breaks?
The set point in the hypothalamus is returned to normal the hypothalamus starts executing measures to reduce heat, including peripheral vasodilation, sweating, flushed skin the person suddenly feels hot, throws off the covers and stretches out
59
Higher body temperatures decreases serum levels of \_\_\_\_\_\_\_, which are needed for bacterial replication
iron, zinc, copper
60
RLS is more common in \_\_\_\_\_\_
women individuals with iron deficiency
61
\_\_\_\_\_\_\_ is a cofactor in dopamine production
iron
62
What kind of virus causes pink eye?
viral conjunctivitis
63
Which three cranial nerves are involved in ocular movement?
oculomotor trochlear abducens
64
What is strabismus?
deviation of one eye from the other when a person is looking at an object weak or hypertonic muscle in one of the eyes
65
What is myopia?
nearsighted, difficulty seeing objects that are far away axis of the eyball is too long
66
what is hyperopia?
farsightedness, difficult seeing things that are near axis of the eyeball is too short
67
What kind of lens corrects myopia Hyperopia?
concave convex
68
What is presbyscusis?
Loss of hearing in old age
69
Which cranial nerves are involved in olfaction?
Olfactory Trigeminal
70
pupils are helpful in evaluating which part of the CNS?
brainstem
71
A large dose of _______ will fully dilate and fix pupils
anticholinergics atropine and scopolamine
72
Overdosing on opioids will exhibit what pupillary changes?
Pinpoint pupils
73
What does vomiting without nausea indicate?
direct involvement of the central neural mechanism
74
Vomiting often accompanies CNS injuries that:
1. involve the vestibular nuclei, esp with diplopia 2. impinge directly on the fourth ventricle 2. produce brainstem compression 2/2 increased ICP
75
What is the difference between brain death and cerebral death?
Irreversible cessation of function of the ENTIRE brain (including brainstem). Cerebral death is the death of the cerebral hemispheres but not the brainstem and cerebellum
76
Damage/dysfunction in what area causes aphasia?
Left cerebral hemisphere (Broca's and Wernicke's Area)
77
Aphasia is usually associated with CVAs that involve with artery?
Middle cerebral artery (or one of its branches)
78
What is agnosia?
defect of pattern recognition can't tell what a safety pin is by feeling it, but can by seeing it or vice versa Lots of varieties
79
What is the difference between expressive aphasia and dysarthria?
Expressive aphasia involves cognitive inability to form words dysarthria is more to do with the physical inability to form words 2/2 nerve dysfunction. It's not cognitive
80
What causes Alzheimer's?
Acculumation of neuritic plaques containing a core of abnormally folded amyloid beta and tau proteins intraneuronal tangles degeneration of basal forebrain cholinergic neurons leads to loss of acetylcholine
81
What diseases cause seizures?
Anything that alters the neuronal environment
82
What is the tonic phase of a seizure?
muscle contraction with increased muscle tone excitation of the subcortical, thalamic, and brainstem areas
83
What is the clonic phase of a seizure?
alternating contraction and relaxation of muscles begins when inhibitory neurons in the cortex react to the cortical excitation
84
What qualifies as status epilepticus? (3)
1. continuous tonic clonic seizures lasting more than 5 minutes 2. rapidly recurring seizures before the person has fully regained consciousness 3. a single seizure lasting more than 30 minutes
85
What is an optimal cerebral perfusion pressure?
70-90
86
What is the ideal MAP for a patient with altered cerebral flow?
90
87
What are the three types of cerebral edema?
vasogenic (most common, increased permeability) cytotoxic (usually ischemia/hypoxia) interstitial (noncommunicating hydrocephalus)
88
What is the difference between communicating and non-communicating hydrocephalus?
noncommunicating (obstructive): obstruction within the ventricular system communicating (nonobstructive): impaired reabsorption of CSF
89
What is the most common cause of communicating hydrocephalus?
Subarachnoid hemorrhage
90
What are the hallmark pathologic features of Parkinson's?
loss of dopaminergic pigmented neurons in the substantia nigra degeneration of the basal ganglia with formation of Lewy bodies
91
What do "amyotrophic" and "lateral" refer to in ALS?
amyotrophic: refers to the progressive muscle wasting (lower motor neuron component) Lateral: refers to the scarring of the corticospinal tract in the lateral column (the upper motor neuron component)
92
What are the two pyramidal tracts?
Corticospinal Corticobulbar
93
Which two types of motor dysfunction comprise the extrapyramidal motor syndromes?
basal ganglia motor syndromes cerebellar motor syndromes

Patho 1 (17 decks)

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