Brain and Behaviour Flashcards
1
Q
What is the corpus striatum made up of?
A
Caudate nucleus and putamen
2
Q
What do the putamen and globus palidus make up?
A
Lentiform nucleus
3
Q
What type of neurons are medium spiny neurons?
A
Inhibitory GABAergic neurons
4
Q
What do D1 receptors do?
A
They increase CAMP, leading to increased phosphorylation and increased sensitivity of striatum to glutamate
5
Q
In PD what part of the brain loses dopaminergic neurons?
A
Substantia Nigra pars compacta
6
Q
What medication primarily treats dyskinesia symptoms?
A
Amantadine
7
Q
What is abnormally repeated in Huntington’s?
A
CAG codon - glutamate
8
Q
What chromosome do you find mutated Huntington gene?
A
Chromosome 4
9
Q
What is lost in Huntington’s?
A
Loss of GABAergic neurons in striatum = less inhibition = shift towards direct pathway
10
Q
Where can you find the aggregated Huntintin?
A
They are intranuclear inclusions
11
Q
What mutations are associated with PD?
A
SNCA mutation, codes for alpha synuclien
LRRK2
GBA, codes for B glucocerebrosidase
12
Q
What enzyme converts L-tyrosine to L-dopa?
A
Tyrosine hydroxylase
13
Q
What enzyme converts L-dopa into dopamine
A
L-aromatic amino acid decarboxylase
14
Q
What are ropinirole, rotigotine, apomorphine, bromocriptine examples of?
A
Dopamine agonists
15
Q
What are rasagiline, selegilline and safinamide examples of?
A
MAO-b inhibitors
16
Q
How do anticholinergic compounds work for PD?
A
Counteract imbalance - dopamine loss leads to hyperactivity of cholinergic cells
17
Q
What is tetrabenazine?
A
A vesicular amine transporter inhibitor - causes depletion of neuroactive peptides such as dopamine in nerve terminal (for HD)
18
Q
Name some antidopaminergic drugs
A
haloperidol, olanzapine
19
Q
What do lesions of premotor cortex lead to?
A
Motor apraxia - difficulty performing complex tasks (but normal reflexes)
20
Q
What might abnormal saccades be a sign of?
A
Damage to frontal eye fields
21
Q
Where does decussation happen in corticospinal tract? And if there is injury below decussation what will you get?
A
C1-C5
Motor deficit on the same side
22
Q
Where does rubrospinal tract arise? and what does it do?
A
Red nucleus in brain stem - it excites flexor muscles and inhibits extensor muscles
23
Q
What does tectospinal tract do and where does it arise?
A
It originates in the superior colliculus and it coordinates voluntary head and eye movements
24
Q
Which posturing indicates lesion above red nuclues?
A
Decorticate
25
If the cerebellum is injured on one side where will symptoms be and why?
On the same side as lesion as anterior spinocereballar tract decussates twice and posterior is direct = net effect zero
26
What is anterior lobe syndrome?
Damage to spinocerebellum - leads to ataxic gait, hypotonia, depressed or pendular reflexes. Can also be seen in alcoholics due to malnutrition
27
What are symptoms of flocculonodular syndrome? (vestibulocerebellar injury)
Little control of axial muscles, ataxic gait, tendency to fall to side of lesion, nystagmus
Often occurs due to medulloblastoma tumour in 4th ventricle that compresses nodulus
28
Name the capsaicin/vanilloid receptor
TRPV1 channel
29
What does ASIC channel stand for?
Acid sensing ion channel
30
What nociceptor detects menthol?
TRPM8
31
What can cause congenital insensitivity to pain?
Loss of Nav1.7
32
What causes inherited erythomelalgia?
Mutation of SCN9A gene that encodes Na1.7
33
How do C fibres activate lamina 1?
Via excitatory interneurons in lamina II
34
What causes congenital insensitivity to pain anhidrosis?
mutation to TRKA gene
35
What region modulates descending pain?
PAG. (Which can then activate locus coreulus which contains noradrenergic neurons - further modulation)
36
How can serotonin modulate pain?
serotonin and noradrenlin active interneurons which can stimulate release endogenous opioids which open Cl- channels and block Ca2+ channels on sensory neurons inhibiting firing
AND
serotonin can activate 5HT1a receptors on first order neurones to inhibit neurotransmission
37
How do you treat morphine overdose?
NA-loxone (opiate antagonist)
38
How does paracetamol work?
It stops prostaglandin synthesis by reducing active form of COX1 and COX2. It also inhibits reuptake of endogenous cannabinoids
39
What is celecoxib an example of and why is it not normally used?
A selective COX2 inhibitor and bc of the cardiovascular effects
40
How does diclofenac work?
It inhibits prostaglandin formation but it preferentially inhibits COX2
41
What do carbamazepine and sodium valproate act on?
Sodium channels - prevent sustained firing of action potentials
42
What does pregablin work on?
Inhibits Alpha2 delta1 subunit of calcium channels. Causes decreased release of neurotransmitters
43
What type of drug is baclofen?
muscle relaxant - GABAb receptor agonist
44
How does tramadol work?
Acts on mu receptors and interacts with monoaminergic systems - inhibits 5ht and NA uptake
45
What drug is duloexetine?
SNRI
46
Clonazepam is used for trigeminal neuralgia, what kind of drug is it?
a benzodiazepine - amplifies GABAa receptor
47
What is the MAO of local anaesthetics?
Blockade of sodium channels
48
What is the name of fluid found in ear which is rich in potassium?
Endolymph
49
What is Meniere's disease?
disorder of inner ear - vertigo, tinnitus etc. results from excessive endolymph accumulation
50
What is Hallpike maneouvre?
Lower head to the floor, if patient gets dizzy the ear pointing the floor is affected
51
What is the pathopysiology of cell death in ischaemic stroke?
Less ATP- failure of Na/K pumps, resulting in depolarisation. Leads to influx of calcium ions and glutamate release. Elevated calcium = cell death
52
What kind of stroke is likely to be pure motor OR pure sensory Or cause ataxic hemiparesis
lacunar stroke
53
What is alteplase
Dissolves clot in a stroke by cleaving plasminogen
54
What is secondary prevention of stroke?
clopidogrel 75mg daily or aspirin and a statin such as atorvastatin
55
Which region of brain do you find prominent loss of cells in epilepsy?
CA2 and CA3 hippocampal area
56
What cells are lost in epilepsy?
Inhibitory chandelier cells
57
What cells can cause abnormal neuronal excitability in epilepsy?
Glial cell deficiency
58
What epilepsy drugs induce drug metabolism in the liver and are also not used in absence seizures?
phenytoin and carbamazepine
59
What epilepsy drug is zero order?
Phenytoin
60
What is an anti-epileptic drug that can be used in all types of seizures?
Sodium valproate
61
What GABA receptor does Topiramate act on?
Gaba A topirAmate
62
What epilepsy drugs target calcium channels?
Ethosuximide and Gabapentin
63
What are the difference between benzodiazepines (clonazepam) and barbiturates (phenobarbitone, striripentol)?
Both work on GABAa but Ben increases channel opening frequency and Barb makes them open for longer.
Ben wants it more frequently, Barb wants it for longer
64
What do you give in status elipticus?
Lorazepam or diazepam
65
Difference between primary headaches and secondary headaches?
Primary - absence of physical signs eg migraine,
Secondary - presence of signs eg meningitis, sinusitis
66
What centre is activated in migraine?
Trigeminal vascular system
67
What neurotransmitter acts on blood vessels in dura causing them to dilate in migraine?
Serotonin
68
What area leads to central sensitisation which mediates allodynia in mirgaine?
Spinal trigeminal nucelus caudilis
69
What part of the brain is responsible for the premonitory changes in migraine?
Hypothalamus
70
What is an important inflammatory neuropeptide that gets released in migraine?
CGRP
71
What metabolite increases in urine immediately after a migraine?
5HIAA metabolites
72
What is the mechanim of action of triptans?
5HT 1D/1B agonists - vasoconstrictive
73
What type of drugs are rimegepant, ubrogepant, atogenpant and how do they work?
Gepants - small molecule CGRP antagonists. They prevent vasodilation
74
What functional deficits are normally present in a middle cerebral artery stroke on the non dominant hemisphere?
Neglect syndrome - left becomes more active so results in attention and and eye movements towards the right. Might bump into things on left
75
Functional deficits of anterior cerebral strokes?
contralateral sensorimotor loss below waist. Personality defects if frontal lobe
76
Functional deficits of posterior cerebral strokes?
Contralateral homonymous hemianopia, reading writing deficits
77
What cranial nerve is normally affected by epidural hematoma?
CN III. Because of increase in pressure - herniation of temporal lobe (uncal herniation), gets compressed at tentorial edge (eyelid drooping, pupil dilation)
78
What type of extra-axial bleed is a venous bleed?
Subdural haematoma
79
What type of bleed often presents with a severe thunderclap headache?
Subarachnoid
80
What might an Alzeimher's post mortem look like?
1) Extreme shrinkage of hippocampus,
2) extreme shrinkage of cerebral cortex
3) severely enlarged ventricle
81
What are the senile plaques in AZD made up of?
deposits of amyloid-beta protein
82
What are neurofibrillary tangles in AZD made up of?
tau protein
83
What might you see in a FGD-PET scan for AZD?
Hypometabolism in temporal, parietal, frontal regions and posterior cingulate cortex
84
What cleaves amyloid precursor protein in AZD?
beta secretase and gamma secretase to produce A-beta peptides
in healthy brain it is alpha secretase and gamma secretase to P3 peptide
85
What does hyperphosporylation of Tau cause?
Causes it to detach from microtubules which makes them become unstable and depolymerise
86
Which APOE mutations cause what?
APOE epsilon 2 is rare and can protect, epsilon 3 is neutral and epsilon 4 increases risk of AD
87
What mutations can lead to early onset AZD?
Presenlin-1 (chromosome 14)
Presenlin-2 (chromosome 1)
Amyloid precursor protein (chromosome 21)
88
Name some acetylocholinesterase inhibitors
Donepezil, Galantamine and Rivastigmine
Don Galanting to the River.
89
Name a NDMA receptor antagonist for AZD
Memantine (think people doing MDMA making memes)
90
What is the Default Mode network and how does it function in patients with depression?
It is a network of brain regions active when brain is at wakeful rest. Depressed patients have increased functional connectivity between DMN and fronto-parietal networks
91
What areas of brain are hyperactive in ruminating thoughts?
Hippocampus, amygdala, subgenual cinugulate medial prefrontal cortex
92
What areas of the brain are hypoactive in ruminating thoughts?
ventrolateral prefrontal cortex, dorsolateral prefrontal cortex
93
How does ketamine work as an antidepressant?
An NMDA glutamate receptor antagonist, enhances transmission at glutamergic synapse
94
What is brexanalone?
Used in post partum depression. Progesterone related compound - post modulator of GABAa
95
What can monoamine oxidase inhibitors interact with?
tyramine containing food
96
Name some selective serotonin reuptake inhibitors
Citalopram, fluoxetine, paroxetine
97
What type of drug is moclobemide?
Monoamine oxidase inhibitor (selective for MAOa)
Social anxiety and depressive illness
98
What class of drug is Duloxetine?
SNRi
99
What kind of drug is Agomelatine?
It is a a new drug for depression. It is an agonist at MT1 and MT2 receptors
100
How is bipolar managed?
With lithium
101
What part of the brain evaluates the degree of pleasure or pain in an outcome and then suggests appropriate action?
Anterior cingulate cortex
102
What is the role of the insula in memory?
Makes the decision whether an event is worth remembering or not. Insula = internalise feelings or not?
103
What are the low and high road through which fear reaches the amygdala?
Low - fast - fight or flight. Thalamus >>> amydala
High - slow. Thalamus >> sensory cortex >> amygdala.
104
What is Urbach Weithe disease?
Rare disease that causes collagen to build up in amydala - no fear
105
What parasite can exploit the amygdala and leads to increased risky behaviour?
Toxoplasma gondii
106
What are panda eyes / orbital ecchymoisis signs of?
Basal skull fracture
107
In severe TBI what seizure prophylaxis would you use?
Phenytoin / levetiracetam
108
What parts of the hypothalamus promotes arousal and sleep?
Arousal - tuberomammillary nucleus TMN and suprachiasmatic nucleus
Sleep - ventrolateral preoptic nucleus
109
How can consciousness be assessed through auditory stimulation?
positive P300 around 300ms after auditory change
MMN (mismatch negativity) around 100-250ms after an auditory change
110
What is often damaged in locked in syndrome?
Ventral pons - interruption of corticospinal and corticobulbar tracts
111
Zolpidem can be used for brain injury. How does it work?
It is indirect GABAa receptor agonist. Restores normal inhibition in the GPi, allows an increase of thalamic excitatory influence on prefrontal cortex to initiate movement
112
What an be up-regulated in drug abuse?
dynorphin receptors
113
In cocaine abuse what receptors are there less of?
D2 receptors
114
What is upregulated in all kinds of addiction?
Delta- Fos-B
115
What inhibits aldehyde hydrogenase in addiction?
Disulfiram
116
What antidepressant drug can be given for nicotine addiction?
Bupropion (a monoamine reuptake inhibitor)
117
What opioid agonists can be used for opiate addiction?
Methadone - opioid agonist. Buprenorphine - partial agonist
118
What does naltrexone do?
It is an opioid antagonist. Blocks high that addicts might have, used after detoxification
119
What do clonidine and lofexidine do for addiction?
They are alpha-2-adrenoreceptor agonists - they alleviate the autonomic hyperactivity during withdrawal
120
What will a schizophrenia MRI show?
Larger ventricles, and a reduction in brain volume
121
What part of the brain is hyperactive in SCH?
Mesolimbic dopaminergic pathway (think hyper-limbs. someone thrashes their limbs around)
122
What area is hypoactive in SCH?
mesocortical dopaminergic pathway and nigrostriatal pathway
123
What pathway can be blocked in SCH and can lead to a rise in prolactin and sexual dysfunction?
Blockade of tuberoinfundibular pathway
124
How can you test for frontal cortical dysfunction testing?
Wisconsin card sorting
125
What do all SCH drugs do?
Antagonists at D2 receptors
126
What are first line for SCH treatment
atypical antipsychotics - risperidone, olanzapine, clozapine, aripiprole etc
(dopamine D2 receptor antagonists, and also signific antagonistic activity at 5HT2a receptors
127
What antipsychotic can cause neutropenia or agranulocytosis?
Clozapine
128
How does pregablin treat insomnia?
It binds to alpha 2 delta 2 subunit of voltage gated calcium channels
129
What are orexins?
They are peptides produced in the hypothalamus as either orexin A or orexin B. They regulate arousal, appetite and wakefulness
130
How does suvorexant work?
It is a orexin antagonist to treat insomnia
131
What do the Z drugs bind to?
alpha 1 subunit of GABAa
132
Name some benzodiazepines?
Clonazepam, alprozolam, lorazepam
133
What kind of drugs are used for stage fright like symptoms?
B adrenoreceptor antagonists (propanolol)
134
How do benzodiazepines work?
They are positive allosteric modulators - they enhance GABAa receptor activity. Means increased chloride influx which means firing less likely
135
How is benzo overdose managed?
Flumazenil - antagonist at BZD sites
136
What receptors are redistributed to potentiate or weaken memories
AMPA receptors
137
What can be examined in lumbar puncture of patient with MS?
oligoclonal bands of IgG. OCB bands determine presence of neurofilaments
138
What do MS drugs do?
They all suppress the immune system. Alemtuzumab and cladribine are first line for induction and they work on CD52. For acute relapse = high dose corticosteroid
139
Romberg's test what does it mean if problem when eyes are open and closed vs just closed?
open and closed = cerebellar deficit
closed = propioceptive deficit
140
What is the Uthoff phenomenon?
It is temp vision loss linked to physical activity (due to temp) that is associated with optic neuritis
141
What type of EEG will you get when awake?
Low amplitude waves as the asynchronous firing cancels out
142
What free radical scavenger is released during sleep?
Melatonin from pineal gland - removes free radicals - antioxidant
143
What part of brain decides when we need sleep?
Hypothaolamus decides and then it commands to pons to turn off reticular formation and trigger sleep
144
What hormones inhibits and increases sleep?
Grehlin inhibits
Leptin and adenosine induce sleep
145
Where are cholinergic cells located?
Pedunculopontine nucleus
146
What are the online nuclei active in REM sleep?
Cholinergic nuclei. (think ACEtylcholine responsible for ACE dreams)
147
why are people with sleep apnoea at a higher risk of stroke?
surge in sympathetic activity that happens after anoxia, increases BP and can rupture a cebreal blood vessel
148
How do TCAs promote sleep?
They exert blockade of histamine H1 receptors
149
What nerves leave through superior orbital fissure?
Occulomotor CN3
Trochlear CN4
Abducens CN6
and opthalmic branch of trigeminal CNV1
150
What nerve goes through the foramen rotendum?
CNV2 = maxillary nerve
151
What nerve goes through foramen ovale?
CNV3 = mandibular
152
What foramen does the facial nerve leave through?
Stylomastoid foramen
153
What nerve travels within the carotid sheath?
Vagus
154
What does a lesion to occulomotor nerve cause?
Down and out position, pupil dilates due to loss of parasympathetic innervation and also drooping of the eyelid
155
what does injury to trochlear nerve cause?
Rarely injured alone but double vision when looking down
156
What would injury to abducens present with?
Medial deviation and dilopia (double vision)
157
What is the path taken by CSF?
Lateral ventricles > Interventricular foramina > third ventricle > cerebral aqueduct > fourth ventricle
158
Of delusions, hallucinations, disorganised speech, disorganised behaviour and negative symptoms how many must you have to have shizophrenia?
At least two of them and one of them much be hallucinations, delusions or disorganised speech
159
What are the advantages of atypical anti-psychotics?
They better address cognitive symptoms and they have less extrapyramidal side effects
160
What are the main disadvantages of atypical side effects?
metabolic side effects - weight gain, dyslipideamia, T2D
also anticholinergic side effects eg dry mouth, constipation
161
What must be checked before starting someone on lithium?
Renal and thyroid function
162
Where do noradrenergic originate?
Locus coeruleus
163
What do the TCA drugs end with? (two things)
-pramines and -triptylines
eg clomipramine and amitriptyline
164
In DBS for depression what part of the brain would you target?
Subcallosal cingulate white matter - area 25
165
What is MAO of moclobemide?
selective and reversible MAOA inhibitor
166
167
Why can diclofenac lead to increased bleeding risk?
Bc it inhibits thromboxane
168
What tract is involved in occulomotor reflex, saccacidic eye movements and vestibular occular reflexes?
Medial vestibulospinal tract (head and eye coorindation, upright posture of head and neck)
169
What part of the brain directs the correct emotional or motor response in light of knowledge from past experience?
Medial prefrontal cortex (might be absent in people with autism)
170
What part of the brain works with the medial prefrontal cortex to play a role in reward mediated behaviours?
Orbitofrontal cortex
(remember it as it is near the eyes and the eyes see the reward)
171
Where does the globus pallidus external project to?
subthalamic nucleus
172
What pathway becomes dominant in PD?
Indirect pathway
(decreased inhibition of GPi which increases inhibition on the thalamus)
173
What does athetosis suggest a lesion to?
Striatum
(athetosis is slow writing movements)
174
What does ballismus suggest a lesion to?
Subthalamic nucleus
(violent involuntary flinging movements_
175
What are the main cells lost in Huntington's?
Loss of medium size spiny neurons
176
What is the most common site of infarct in posterior circulation?
PICA - posterior inferior cerebellar artery
177
Damage to what part of the cerebellum can lead to vertigo, nystagmus and ataxic gait?
Vestibulocerebellum
178
Damage to what part of the cerebellum can lead to intention tremors, dysmetria and dysdiadochokinesis?
Neocerebellum
(as it is involved in motor planning)
179
Damage to what part of the cerebellum can lead to ataxic gait, hypotonia and pendular reflexes?
spinocerebellum
(called anterior lobe syndrome common in alcoholics)
180
What does medial vestibulospinal tract and lateral vestibulospinal tract do?
medial - balance of head on body
lateral - balance of body on ground
181
What tumour commonly causes flocculonodular syndrome?
Medulloblastoma in 4th ventricle
182
What are the semi circular canals full of?
endolymph
183
What movements does utricle detect?
horizontal
184
What movements does the saccule detect?
vertical movement
185
What is the central main connection for the occulomotor, trochlear and abducens nerves?
Medial longitudinal fasiculus
186
When is the COWS mneumonic correct?
for the nystagmus (referring to the fast component) but not for initial eye movement which is CSWO
187
What nerve does the caloric test test?
cranial nerve 8 - vestibulocochlear
188
If you still have the slow component of caloric reflex in both eyes intact what does this mean vs just in one eye?
Both eyes means the brainstem is intact
One eye only means there is an MLF lesion
189
What fibres carry the first sharp, stinging pain
A delta (myelinated)
190
191
Which spinothalamic tract is more associated with pain and temp?
Lateral
whereas anterior is mainly crude touch
192
Where does lateral STT project to to cause emotional aspect of pain?
anterior cingulate cortex and rostral insular cortex
193
Whereabouts is peri-aqueductal grey?
Midbrain (around cerebral acqueduct)
194
what is activated by PAG for descending pain modulation?
Locus coeruleus (contains noradrenergic neurons)
195
What are activated by serotonin and noradrenaline in descending pain modulation and what do they release?
Lamina II inhibitory interneurons
They release GABA and enkephalins to block noiceptor input
196
What channels do opioid receptors have an effect on to inhibit firing of sensory neuron?
Thye open Cl- ion channel and block Ca2+ channek
197
Why does meptazinol result in less resp depression?
It is a partial mu receptor agonist
198
Why is pethidine and morphone avoided in patients with kidney failure?
Bc its metabolites norpethidine M6G and can accumulate
199
Why can glial cell abnormalities play a role in epilepsy?
Bc glial cells clear glutamate through transporters like EAAT1 and EAAT2
200
How does levetiracetam work for seizures?
Binds to SV2A which inhibits presynaptic calcium channels modulating neurotransmittter release
201
What blood vessels come off at a right angle to middle cerebral artery?
Striate arteries
202
What is blood supply to corpus collosum?
Anterior cerebral artery (lesions = split brain)
203
Where is the blood in a subdural hematoma?
Between dura mater and arachnoid mater
204
What brain bleed can lead to xanthochromia and often resembles a STEMI on ECG?
subarachnoid hematoma
205
Which type of headache is only headache more common in men?
cluster headache
206
How do ditans work for migraine?
They are 5HT1F agonists (they dont cause vasoconstriction so can be used in people with cardiac issues)
207
What drugs are non specific to migraines but can be used as prophylactic treatment?
anti epileptics and beta blockers
208
What is the minimum and maximum GCS score?
Minimum = 3
Max = 15
209
what is considered moderate TBI score?
9-12
210
When would you perfom CT head?
If GCS is less than 13 at initial assessment or less than 15 at two hours post
211
What is normal intracranial pressure?
5-15mmHg
212
213
How are TBI patients sedated?
Propofol and benzos
214
What does systematic desensitization refer to?
The idea of replacing one response (anxiety) with another (relaxation)
215
What does operant conditioning use?
Rewards and punishments
216
Difference between pos and neg punishment?
pos - application of unpleasant stimulus
neg - removal of a pleasant stimulus
217
What is Bandura's theory and how can we apply it?
theory people can change by watching other people cope - befriending interventions
218
What does Schacter-Singer Two Factor theory suggest?
That physiological arousal is interpreted in context of the experience to produce the emotion
219
When does Moro reflex disappear?
Between 3-6 months of age
220
Where does amygdala mainly project to in fear?
prefrontal cortex for behavioural response
hypothalamus and autonomic nuclei for autonomic fear responses
221
How is rhabdomyolysis blocked?
By dantrolene - muscle relaxant that lessens excitation-contraction coupling in muscle cells.
222
Where are CB1 and CB2 receptors located?
CB1 in CNS, CB2 - peripheral organs
223
What is acamprosate?
Helps reduce alcohol cravings, modulator of glutamatergic transmission
224
Difference between methadone and naltrexone?
Methadone is a mu opioid agonist - suppress withdrawal and naltrexone is an antagonist- used after detoxification
225
what cerebellar nuclei involved in motor execution and which in motor planning?
fastigial and interposed = motor execution
dentate = motor planning
226
What can mutations in MAPT cause?
frontotemporal dementia
227
What results in aggregation of Tau?
Its hyperphosphorylation
228
What synapses are particularly affected by neurotoxic alpha beta oligomers?
cholinergic synapses
229
What can interact with alpha beta peptide and promotoe amyloid fibril formation?
acetylcholinesterase
230
How can memantine work for AZD?
It is an NMDA receptor antagonist, blocks the ion channel and decreases glutamate mediated neurotoxicity
231
Which neurons increase their activity during REM sleep to same level as alert waking?
Cholinergic neurons
232
What do anterior and posterior hypothalamic lesions cause?
anterior = insomnia
posteior = hypersomnia
think towards front of lecture theatre everyone is awake but towards the back they are sleepy
233
What is nucleus reticularis paragigantocellularis?
Involved in descending pathyway of pain, projects to nucleus raphe magnus
234
What do the neurons of the tuberomamillary system release?
Histamine. They are tonically active during wakefulness
235
What is the brain's sleep promoting region?
Ventrolateral preoptic nucleus
236
What stage of sleep is vital for maintenance and repair?
slow wave sleep
237
What stage of sleep does somnambulism occur during?
slow wave sleep
238
What neurons are involved in sleep?
GABA and galanin
239
Which waves are present during normal wakefulness and then which when youre awake but relaxed?
normal wakefulness= beta waves
awake and relaxed = alpha waves (slower)
240
Which receptors do buspirone, ipsapirone act on? (anxiety treatment)
5HT 1A (partial agonists)
241
What subunits of GABA receptors are to do with what effect?
alpha1 = hypnotic
alpha2= anxiolytic
242
Damage to which part of the brain causes locked in syndrome?
Ventral pons - causes interruption to corticospinal and corticobulbar tract
243
When is vegetative state deemed permanent?
12 months after traumatic injurt
3 months after non traumatic injurt
244
What drugs are used in treatment resistance schizoprhenia?
Clozapine - only drug that seems to work when resistant
245
How does baclofen work for pain?
GabaB receptors agonist
246
How does ketamine work for pain?
It is an NMDA glutamate receptor antagonist
247
What toxic metabolite can build up if using opioids and have renal failure
M6G metabolite
248
first line for trigeminal neuralgia?
carbamazepine
