Basic Science & Pharmacology Flashcards
(175 cards)
1
Q
Definition of prolonged QTc
A
> 460 (prepubertal)
470 (postpubertal men)
480 (postpubertal women)
2
Q
How neurons communicate with each other
A
Neurotransmitters made from amino acids
- -> collected into vesicles by VMAT (vesicular monoamine transporter)
- -> vesicles release neurotransmitters into synaptic cleft
- -> neurotransmitters bind to postsynaptic receptor or presynaptic autoreceptor
- -> stimulation of postsynaptic receptor causes inhibitory or excitatory postsynaptic potential
- -> sum of excitatory and inhibitory postsynaptic potential at axon hillock crosses depolarization threshold
- -> action potential sent down axon
- -> influx of calcium causes vesicular release of neurotransmitter into synaptic cleft
–> monoamines reuptaken by transporter protein or broken down (in synaptic cleft or in presynaptic neuron)
3
Q
Types of CNS cells
A
Pyramidal neurons
Glial cells
4
Q
Definition of glial cells
A
Non-neuron CNS cells
5
Q
Types of glial cells
A
Oligodendocytes
Microglia
Astrocytes
6
Q
Function of oligodendrocytes
A
Akin to Schwann cells in PNS (provide myelin sheath for neurons in CNS)
7
Q
Function of microglia
A
“Macrophages” of CNS (clean up cellular debris)
8
Q
Function of astrocytes
A
Provide nutrients to neurons
Provide structural support for neurons/capillaries
Modulate synaptic activity
Regulate CSF composition
9
Q
Main inhibitory neurotransmitter
A
GABA
10
Q
Role of GABA
A
Main inhibitory neurotransmitter
11
Q
Main excitatory neurotransmitter
A
Glutamate
12
Q
Role of glutamate
A
Main excitatory neurotransmitter (and main neurotransmitter in brain overall; 80% of synapses)
13
Q
Types of monoamines
A
Dopamine Serotonin Norepinephrine Epinephrine Acetylcholine Histamine
14
Q
Types of catecholamines
A
Dopamine
Norepinephrine
Epinephrine
15
Q
Production of dopamine and NE/epinephrine
A
Phenylalanine –> tyrosine –> tyramine –> L-DOPA –> dopamine –> NE –> epinephrine
16
Q
Which molecule causes hypertensive crisis with MAOIs
A
Tyramine
17
Q
Production of serotonin
A
Tryptophan –> 4-HT –> 5-HT (serotonin)
18
Q
Production of melatonin
A
Tryptophan –> melatonin
19
Q
What’s special about tryptophan
A
Produced into serotonin + melatonin
20
Q
What foods are tryptophan found
A
Milk, turkey
21
Q
What does MAO-A do
A
Break down serotonin and NE
22
Q
What does MAO-B do
A
Break down dopamine and histamine
23
Q
Function of dopamine
A
Increase reward seeking
Assign importance to rewarding environmental stimuli
Inhibits prolactin release
24
Q
Where are dopaminergic neurons clustered
A
Ventral tegmental area (midbrain) Substantia nigra (basal ganglia structure in midbrain)
25
Main dopaminergic pathways
Mesolimbic
Mesocortical
Nigrostriatal
Tuberoinfundibular
26
Clinical significance of mesolimbic pathway
Excess dopamine = positive symptoms of schizophrenia
| Main pathway in reward system
27
Clinical significance of mesocortical pathway
Insufficient dopamine = negative symptoms of schizophrenia
28
Clinical significance of nigrostriatal pathway
Insufficient dopamine = extrapyramidal symptoms
29
Clinical significance of tuberoinfundibular pathway
Insufficient dopamine = hyperprolactinemia
30
Where does mesolimbic pathway connect to/from
Ventral tegmental area (VTA; in midbrain) --> nucleus accumbens + amygdala
31
Where does mesocortical pathway connect to/from
Ventral tegmental area (VTA; in midbrain) --> prefrontal cortex
32
Where is ventral tegmental area located
Midbrain
33
Main dopamine receptor
D2 receptor
34
Clinical significance of D2 receptors
Antipsychotics = D2 antagonists
35
Where noradrenergic neurons predominately found
```
Locus ceruleus (dorsal caudal pons)
Lateral tegmental noradrenergic nuclei (in ventral pons and medulla)
```
36
Caudal
Inferior ("cauda equina" = horse tail)
37
Dorsal
Back (dorsum of hand)
38
Where is locus ceruleus located
Dorsal caudal pons (inferior/posterior part of pons)
39
Where is epinephrine released
Adrenal medulla (inner section)
40
Types of adrenergic receptors
Alpha 1 and 2
| Beta 1 and 2
41
Clinical significance of alpha-2 receptors
Autoreceptor for presynaptic adrenergic neurons -->
| Reduce sympathetic and increase parasympathetic activity
42
Clinical significance of beta-2 receptors
Beta-2 agonists = bronchodilators (e.g. Ventolin)
43
Serotonergic neurons predominately found in
Raphe nuclei (in midbrain)
44
Where are raphe nuclei found
Midbrain
45
Location of serotonin receptors
80% GI system
Platelets
2% CNS (raphe nuclei in midbrain)
46
Clinical significant of 5-HT1 receptor
Inhibitory autoreceptor for serotonergic neurons
Modulates anxiety/depression
Triptans = 5HT1 B/D antagonist
47
Clinical significance of 5-TH2A receptor
Atypical antipsychotics = 5HT2 antagonist
| LSD = 5HT2 agonist
48
Clinical significance of 5-HT2C receptor
```
Anxiogenic effects (creates anxiety)
Role in weight gain + T2DM w/ atypical antipsychotics
```
49
Clinical significance of 5-HT3 receptor
Ondansetron = 5HT3 agonist
50
Types of cholinergic receptors
Muscarinic
| Nicotinic
51
Cholinergic neurons predominately found in
Basal forebrain complex
| Mesopontine complex
52
Histaminergic neurons predominately found in
Tuberomammillary nucleus in posterior hypothalamus
53
Where tuberomammillary nucleus found
Posterior hypothalamus
54
Clinical significance of raphe nuclei
Contains most serotonergic neurons
55
Clinical significance of ventral tegmental area
Contains most dopaminergic neurons
| along with substantia nigra
56
Clinical significance of substantia nigra
Contains most dopaminergic neurons
Part of basal ganglia
(along with ventral tegmental area)
57
Clinical significance of locus ceruleus
Contains most adrenergic neurons
| along with lateral tegmental noradrenergic nuclei
58
Clinical significance of lateral tegmental noradrenergic nuclei
Contains most adrenergic neurons
| along with locus ceruleus
59
Clinical significance of tuberomammillary nucleus
Contains most histaminergic neurons
60
Where histamine predominately found
Mostly mast cells
| CNS (in tuberomammillary nucleus)
61
Role of histamine
Allergic reaction (inflammatory mediator)
Modulates sleep-wake cycle (highest during awake state)
Modulates feeding behaviour
62
Types of histaminergic receptors
H1
| H2
63
Clinical significance of H1 receptors
Allergy meds = H1 antagonist
| Antagonism = sedation, weight gain
64
Clinical significance of H2 receptors
H2 blockers = ranitidine (peptic ulcer, GERD)
65
Main glutamate receptor
NMDA receptor
66
Main GABA receptor
GABA A receptor
67
Divisions of nervous system
CNS
| PNS
68
Divisions of CNS
Brain
| Spinal cord
69
Divisions of brain
Cerebrum
Cerebellum
Brainstem
70
Divisions of brainstem
Midbrain
Pons
Medulla
71
Divisions of peripheral nervous system
```
Sensory (afferent) NS
Motor (efferent) NS
- Somatic NS (voluntary movements)
- Autonomic motor NS (involuntary movements)
- Sympathetic NS
- Parasympathetic NS
```
72
Difference betw somatic and autonomic NS
```
Somatic = voluntary movements
Autonomic = involuntary movements
```
73
Structure that connects two hemispheres
Corpus callosum
74
Corpus callosum
Structure that connects two hemispheres
75
Diencephalon
```
-thalamus structures including
Thalamus
Hypothalamus
Subthalamus
Epithalamus
Dorsal thalamus
```
76
4 lobes of brain
Frontal
Temporal (side)
Parietal (upper middle)
Occipital
77
Function of hypothalamus
Regulates homeostasis (temperature, satiety, hunger, BP, perspiration, sexual drive)
Regulates sleep wake cycle (suprachiasmatic nucleus in anterior hypothalamus)
Regulates hormone release from pituitary gland
78
Indentation between frontal and parietal lobe
Central sulcus of Rolando
79
Central sulcus (of Rolando)
Indentation betw frontal lobe and parietal lobe
80
Indentation betw 2 hemispheres
Falx cerebri
81
Falx cerebri
Indentation betw 2 hemispheres
82
Indentation betw temporal lobe and frontal/parietal lobe
Lateral sulcus (aka Sylvian fissure, lateral fissure of Sylvius)
83
Sylvian fissure
Indentation betw temporal lobe and frontal/parietal lobe
| aka lateral sulcus, lateral fissure of Sylvius
84
Composition of primitive reflex arc
Sensory neuron directly synapses on motor neuron
85
Divisions of spinal nerves
```
C1-8
T1-12
L1-5
S1-5
Coccygeal nerve
```
86
Difference betw L and R hemisphere
R hemisphere = more emotionally adept
| L hemisphere = more analytical
87
Which side stroke more likely to get depression
L hemisphere stroke (R hemisphere more emotionally adept = still intact)
88
Basic functions of frontal lobe
Voluntary motor control (motor strip)
| Executive functions
89
Definition of executive functions
Higher order cognition
| Executing goal-directed activity
90
Types of executive function skills
```
"SOAP ME"
Sequencing
Organizing (incl time management)
Abstract thinking (including perspective taking)
Attention
Planning
Motivation / initiation of tasks
Emotion regulation / impulse control
```
91
Components of frontal lobe
Motor strip
Supplemental motor area
Broca's area
Prefrontal cortex
92
Components of prefrontal cortex
Dorsolateral prefrontal cortex (top)
Medial prefrontal cortex (aka ventromedial prefrontal cortex; ventral = bottom)
Orbitofrontal prefrontal cortex (bottom lateral)
Anterior cingulate cortex
93
Types of frontal lobe syndromes
"SOAP ME"
Disorganized = SOAP
Apathetic = M
Disinhibited = E
94
Disorganized frontal lobe syndrome associated with what lesion
"*SOAP* ME" = top
| Dorsolateral prefrontal cortex
95
Dorsolateral prefrontal cortex associated with which frontal lobe syndrome
Dorsolateral PFC = top most = "*SOAP* ME"
| Disorganized
96
Apathetic frontal lobe syndrome associated with what lesion
"SOAP *M*E" = middle outer = medial prefrontal cortex
97
Medial prefrontal cortex associated with which frontal lobe syndrome
Medial PFC = middle = "SOAP *M*E"
| Apathetic
98
Disinhibited frontal lobe syndrome associated with what lesion
"SOAP M*E*" = bottom = orbitofrontal prefrontal cortex
99
Orbitofrontal prefrontal cortex associated with what frontal lobe syndrome
Orbitofrontal PFC = bottom most = "SOAP M*E*"
| Disinhibited
100
Basic functions of parietal lobe
Process sensory information (somatosensory cortex)
Attention
Visuospatial
101
Basic functions of temporal lobe
Memory/learning
| Processing auditory information
102
Basic functions of occipital lobe
Processing visual info
103
Lesion of movement disorders
Basal ganglia
104
Role of basal ganglia
Smooth out voluntary movements
105
Neurotransmitters associated with basal ganglia
Dopamine
| Acetylcholine
106
Nigrostriatal pathway connects to/from
Substantia nigra (basal ganglia structure in midbrain) to dorsal striatum
107
Components of basal ganglia
```
Caudate nucleus
Putamen ("caudate head rests head on pillow")
Globus pallidus external and internal
Substantia nigra (in midbrain)
Subthalamus
```
(Claustrum, amygdala)
108
Location of substantia nigra
Basal ganglia structure in midbrain
109
Location of lesion in Parkinson's disease / parkinsonism
Substantia nigra (think nigrostriatal pathway)
110
Corpus striatum
Caudate nucleus + putamen + globus pallidus + internal capsule
111
Striatrum
Caudate nucleus + putamen
112
Lenticular nucleus
Putamen + globus pallidus
113
Clinical significance of caudate nucleus
Part of basal ganglia
Inadequate activity = OCD, tic disorders
Lesion = Huntington's
114
Location of lesion with Huntington's disease
Caudate nucleus
115
Location of lesion with Wilson's disease
Globus pallidus
| think Wilson's disease aka hepatolenticular i.e. lenticular nucleus = globus pallidus + putamen
116
Clinical significance of globus pallidus
Part of basal ganglia
| Lesion = Wilson's disease, CO poisoning
117
Pathway responsible for maintaining arousal
ARAS (ascending reticular activating system)
118
Function of ascending reticular activating system
Maintaining arousal
119
Function of limbic system
Linked to emotion
120
Components of limbic system
```
Amygdala
Hippocampus
Fornix
Mamillary body
Cingulate cortex
Septal nuclei
```
Other (parahippocampal gyrus, hypothalamus, basal forebrain, nucleus accumbens, orbitofrontal cortex)
121
Function of amygdala
Assigns emotional importance to experiences and regulates hippocampal activity accordingly (emotional events easier to remember)
Linked to fear/anxiety
122
Papez circuit
Part of limbic system
Hippocampus + fornix + mamillary body + anterior nucleus of thalmus + cingulate gyrus
123
Reward center of brain
Nucleus accumbens
124
Clinical significance of nucleus accumbens
Reward center of brain
| Part of mesolimbic pathway
125
Main pathways of reward system
Mainly mesolimbic pathway
| Also mesocortical pathway
126
Clinical significance of basal forebrain
Basal forebrain complex stores most cholinergic neurons
Main structure with memory
Part of limbic system
127
Brain structures important for memory formation
Amygdala
Hippocampus
Basal forebrain
Certain diencephalic nuclei
128
Function of hippocampus
Converts short term to long term memory
129
What is astereognosis
Inability to recognize objects based on touch
130
Location of lesion with astereognosis
Somatosensory cortex
| Inability to recognize objects based on touch
131
Inability to recognize objects based on touch
Astereognosis
132
What is prosopagnosia
Inability to recognize faces
133
Inability to recognize faces
Prosopagnosia
134
Location of lesion with prosopagnosia
Disconnect from L inferior temporal cortices to visual association area in L parietal lobe
135
Balint's syndrome
Triad of optic ataxia, oculomotor apraxia (inability to direct gaze rapidly), and simultanagnosia (inability to integrate a visual scene to become part of a whole)
136
Triad of optic ataxia, oculomotor apraxia (inability to direct gaze rapidly), and simultanagnosia (inability to integrate a visual scene to become part of a whole)
Balint's syndrome
137
What is simultanagnosia
Inability to integrate a visual scene to become part of a whole
138
Inability to integrate a visual scene to become part of a whole
Simultanagnosia
139
Gerstmann's syndrome
Agraphia + acalculia (calculation difficulties), right-left disorientation, finger agnosia (can't recognize own finger)
140
Agraphia + acalculia (calculation difficulties), right-left disorientation, finger agnosia (can't recognize own finger)
Gerstmann's syndrome
141
Location of lesion of Balint's syndrome
Parietoccipital lobe
(Triad of optic ataxia, oculomotor apraxia (inability to direct gaze rapidly), and simultanagnosia (inability to integrate a visual scene to become part of a whole) = movement + vision problems)
142
Location of lesion of Gerstmann's syndrome
Temporooccipital lobe
(Agraphia + acalculia (calculation difficulties), right-left disorientation, finger agnosia (can't recognize own finger))
143
Steps for brain development
1. Ectoderm --> neural plate --> folds into neural tube --> becomes CNS
2. Neuroblasts (neural stem cells) multiple in ventricular zones and migrate up radial cells (specialized glial cells) to outer edge of cortex to differentiate and mature
3. Neuron growth and branching
4. Pruning of axons and synapses based on usage
5. Myelination continues into adulthood
144
Normal EEG findings
Awake EEG = predominately alpha waves + occasional beta waves
Sleep EEG = theta waves (drowsy) --> sporadic sharp waves --> sigma waves (aka sleep spindles; progress into sleep) --> delta waves (deep sleep)
145
Generalized diffuse slowing on EEG
Nonspecific encephalopathy
146
Focal slowing on EEG
Focal lesion / focal seizure
147
Triphasic waves on EEG
50% hepatic encephalopathy
| 50% other toxic-metabolic encephalopathy
148
Epileptiform discharges on EEG
Classic interictal finding for epilepsy
149
Classic EEG finding for hepatic encephalopathy
Triphasic waves
150
Hormones released by pituitary gland
```
Anterior lobe
- Thyroid stimulating hormone (TSH)
- Growth hormone
- Luteinizing hormone (LH)
- Follicle stimulating hormone (FSH)
- Prolactin
- Adrenocorticotrophic hormone (ACTH)
Posterior lobe
- Oxytocin
- Antidiuretic hormone (ADH)
```
151
Anterior pituitary gland releases what hormones
- Thyroid stimulating hormone (TSH)
- Growth hormone
- Luteinizing hormone (LH)
- Follicle stimulating hormone (FSH)
- Prolactin
- Adrenocorticotrophic hormone (ACTH)
152
Posterior pituitary gland releases what hormones
- Oxytocin
| - Antidiuretic hormone (ADH)
153
Adrenal gland releases what hormones
```
Cortex (outer section)
- Aldosterone
- Cortisol
- Testosterone
Medulla (inner section)
- Epinephrine
```
154
Adrenal cortex releases what hormones
- Aldosterone
- Cortisol
- Testosterone
155
Adrenal medulla releases what
Epinephrine
156
Function of sleep
Energy conservation
Tissue repair
Consolidate growth/learning
Remove neurotoxic metabolite waste products
157
How light affects sleep-wake cycle
Blue light stimulates ganglion cells in retina -->
signal travels to anterior hypothalamus to suprachiasmatic nucleus ("master biological clock")
--> stimulates pineal gland to release melatonin --> melatonin regulates circadian rhythm
158
Clinical significance of suprachiasmatic nucleus
Master clock of circadian rhythm
159
Master clock of circadian rhythm
Suprachiasmatic nucleus
160
Location of suprachiasmatic nucleus
Anterior hypothalamus
161
What sleep cycle is regulated by
```
Process C (normal circadian rhythm)
Process S (sleep homeostat; sleep debt; modulated by adenosine)
```
162
Clinical significance of adenosine
Main neuromodulator for sleep debt (process S)
163
Main neuromodulator for sleep debt
Adenosine
164
MOA caffeine
Inhibits adenosine production (main neuromodulator for sleep debt)
165
Stages of sleep cycle
```
Stage 1 (drowsy)
Stage 2 (progression into sleep, less aware)
Stage 3 (previously stage 3+4) = deep sleep, slow-wave sleep
REM (rapid eye movement) sleep
```
166
Alpha waves on EEG
Predominant EEG finding when awake
167
Beta waves on EEG
Associated with awake EEG
168
Theta waves on EEG
Drowsiness
169
Sigma waves
Stage 2 sleep (progression into sleep)
| Aka sleep spindles
170
Delta waves on EEG
Main finding with deep sleep
171
Stage 2 sleep findings on EEG
```
Sigma waves (aka sleep spindles)
K complexes
```
172
Stage 3 sleep findings on EEG
Delta waves
173
Part of sleep associated with restorative sleep
Stage 3
| old Stage 3+4; slow wave sleep
174
Normal changes with sleep with aging
Advanced sleep phase (wake time + bedtime earlier)
Decreased need for sleep
Lighter sleep (i.e. less slow-wave (stage 3) sleep + REM sleep)
Decreased tolerance for dramatic phase shifts (e.g. jet lag)
175
Acetylcholine is broken down by
Acetylcholinesterase in synaptic cleft
