Module 7

Question 1

What are the two non-NMDA glutamate receptors?

Answer 1

AMPA and Kainate

Question 2

What Is the difference between an ionotropic and metabotropic receptor?

Answer 2

Ionotropic are direct ion channels with a fast transient response
Metabotropic receptors utilise a second messenger system and has a slower and longer
lasting response

Question 3

What ions can block the NMDA receptor?

Answer 3

Magnesium and zinc

Question 4

What glutamate receptor initiates depolarisation in the glutamate neuron?

Answer 4

AMPA

Question 5

What is the primary intracellular cause of the degenerative effects of excitotoxicity?

Answer 5

Elevated calcium

Question 6

What cells are responsible for the majority of glutamate reuptake?

Answer 6

Glial cells

Question 7

What cells are responsible for the production of glutamate in the CNS?

Answer 7

Glial cells

Question 8

List 4 causes of excitotoxicity?

Answer 8

Hypoglycaemia, infection, excitotoxins, excessive trigeminal afferentation, activated
microglia, cortisol, decreased GAD

Question 9

What are the four brainstem Nuclei of the vagus?

Answer 9

NA, NTS, DMN X, CNV

Question 10

What Nuclei control the parasympatheitics of the heart?

Answer 10

NA, DMN X

Question 11

What infections are associated with the vagus?

Answer 11

HSV1-7, Puumala, Coxsackie, Parainfluenza, California encephalitis

Question 12

Name three vagal reflexes

Answer 12

Gag, oculocardiac, carotid sinus

Question 13

What is the best method for Vagal assessment?

Answer 13

HRV

Question 14

What nosode is associated with the GAG reflex?

Answer 14

HSV7

Question 15

List three methods to stimulate vagus

Answer 15

Gargling, singing, gagging, coffee enema, ST36

Question 16

How does the vagal stimulation alter central function?

Answer 16

Vagus fires to the NTS which fires to the LC. The LC activates the ARAS

Question 17

What must be fixed before Vagal stimulation will have an effect?

Answer 17

Aberrant trigeminal input, HPA

Question 18

Describe the benefits of vagal stimulation when mesencephalon function is normal

Answer 18

Inhibition of aberrant cortical function
Parasympathetic output increase
Increased mesencephalic GABA levels

Question 19

TMJ dysfunction drives which area of the brainstem?

Answer 19

Mesencephalon

Question 20

Which spinal structure is most commonly affected by TMJ Dysfunction?

Answer 20

C1

Question 21

Provide 4 non-TMJ findings that can be used to assess TMJ function

Answer 21

Face length, C1, inferior zygoma, Temporalis tenderness, Marching with rotation,
Shoulder/Hip ROM

Question 22

Which two words can be used to assess the central resting position?

Answer 22

Mississippi, Sixty-Six

Question 23

Which SIj is often associated with TMJ dysfunction?

Answer 23

Opposite side of TMJ involvement

Question 24

Provide 3 ways mesencephalon function can be calmed?

Answer 24

Correct the TMJ, Reduce light input, Reduce Sound Input, Andrographis

Question 25

Tetrahydrobiopterin (BH4) can be recycled using which three substances?

Answer 25

Folate, NADH, Vitamin C

Question 26

BH4 deficiency has what affect on Ammonia and Peroxynitrite?

Answer 26

Can lead to elevation in both

Question 27

Nitrotyrosine inhibits which important enzyme required for Ammonia elimination?

Answer 27

Glutamine Synthetase

Question 28

How is peroxynitrite formed?

Answer 28

NO contact with Super oxide free radical or hydrogen peroxide

Question 29

What affect does high ammonia have on brain function?

Answer 29

Neuroexcitation and neuronal death