Physio final 4-5 Flashcards by Molly Zall

mesolimbic dopamine pathway

route between VTA, nucleus and limbic system (hippocampus and amygdala)
key pathway to pleasure and reward
substance use

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mesocortical dopamine pathway

route between VTA/nucleus accumbens and PFC

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stress

high corticotropin-releasing hormone (CRH)
strengthens the amygdala
weakens the hippocampus and PFC

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role of stress and SUD

results in:
negative emotional state
lack of executive control = increase risk of relapse
brings back memory of relief/craving

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stress studies

1/3 of adol. with reported abuse/neglect will develop a SUD before 18
2-4x of those with PTSD develop chemical dependencies
SGM across lifespan = increase risk of TUD and AUD + homelessness = 5x
covid-19 = increased 23% increase in AUD

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potential health benefits of moderate drinking

small amount still increased risk of CVD-related illness = risks attenuated by healthy lifestyle

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Moderate drinking (CDC)

females = up to 1 drink/day
males = up to 2 drinks/day

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heavy drinking (CDC)

females = 8 or more/week
males = 15 or more/ week

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binge drinking (CDC)

in 2-3 hours
females = 4 or more
males = 5 or more

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stimulants impact the brains levels of …
(stimulant pharmacokinetics)

epinephrine/norepinephrine
dopamine
serotonin

impact each to varying degree
cause attention, alertness and energy

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uses for stimulants (Freud’s Uber Coca)

pain management
ADHD
Asthma
Obesity
Narcolepsy

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Primary risk factors of stimulants
(stimulant pharmacokinetics)

reduced seizure threshold (more likely to have a seizure)
increased BP, HR, HTN = increased risk of stroke and MI
poor appetite, mood swings, anxiety, insomnia
toxic levels = paranoia and psychosis

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endocannabinoid system

comprises a vast network of chemical signals and cellular receptors that are densely packed throughout our brains and bodies
“Neuromodulation system”
has CB1 and CB2 receptors

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CB1 receptor

increased in brain and lower concentration in body
wide spread
mediates most of the psychoactive effects of cannabinoids
targets Motor activity, thinking, appetite, STM, pain perception and immune cells

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CB2 receptors

principally involved in anti-inflammatory and immunosuppressive actions
target: gut, kidney, pancreas, adipose tissue, skeletal muscles, respiratory tract, CNS, cardiovascular

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phytocannabinoid

biologically active compound found in cannabis
most notable: THC and CBD

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THC content

< .3% in hemp
> .3% in marijuana

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anandamide

endocannabinoid (neuromodulator) found in the endocannabinoid system

THC mimics anandamide = effecting the endocannabinoid system
THC much more potent than anandamide
effects energy, mood, appetite, and perception of time

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Absorption of cannabis
(Pharmacokinetics of Cannabis)

inhalation - peak plasma concentration 3-10 mins; bioavailability = 10-35%
oral - peak plasma concentration ~120 mins; bioavailability = 6-20%

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distribution of cannabis
(pharmacokinetics of Cannabis)

rapidly to well-vascularized organs
accumulates in adipose tissue

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metabolism of cannabis
(pharmacokinetics of cannabis)

predominately hepatic (liver)
able to cross the placenta; released through breast
excreted through urine, feces and sweat

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Primary source of fuel for the brain (and info)

glucose

~20% of glucose-derived energy
provides precursors for NT synthesis and apoptosis
glucose levels correlated with thinking, memory and learning

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high sugar diet =

decreased brain-derived neurotrophic factor (BDNF)
BDNF modulates growth, development and communication between synapses
decreased BDNF = increased risk of neurodegenerative D/O d/t atrophy and small vessel disease

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Americans consume ________ lbs of sugar per year

156

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AMA recommends _______ of sugar per day

6-9 tsps

technology addiction/ "internet gaming disorder"

teens (13-18) spend about 8.4 hour/day on screens "like" "re-tweets" "novelty" = increased mesolimbic activation (need to check alerts)

increased use of technology =

increased SUD ADHD depression anxiety

role of covid-19 and technology addiction

triggers: boredom, isolation, low self-esteem

center of internet and technology addiction

digital distraction test smartphone compulsion test virtual addiction test

ventromedial Prefrontal cortex (VMPFC) controls...

impulse control courage moral decision making

VMPFC

interface between emotional response and control of complex bxs uses emotional reactions to guide behaviors

patient E.R and VMPFC

bilateral damage of the VMPFC excellent social judgement in VERBAL responses to hypothetical situations, expansive reasoning shared real-life situation = unable to prioritize between trivial and important decisions

courage = _________ VMPFC activation

increased

impulsive/emotional murderers = _____________ VMPFC activation vs calculating/careful people = ________ brain patterns

decreased typical

antisocial PD = _______________________ in VMPFC

decreased 11% of gray matter

photos of romantic partners =

increased caudate nucleus (processing visual information and controls movement) increased ventral Tegmental area (mediates reward system) = increased hyper-focus

increased cortisol and adrenalin (Love on the brain)

increased HR, sweating, anxiety, nervousness decreased appetite, concentration dilated eyes

"love is blind"

decreased PFC activation d/t fight or flight = reduced judgement and increased risk taking

post-orgasm brain chemicals

in women = increased oxytocin = feelings of attachment and bonding in men = increased vasopressin = vigilance and need to guard/protect partner

sleep cycles last ...

approximately 90 minutes alternating between REM and NREM

________ predominates first half of night

slow wave sleep (SWS)

_______ predominates second half of sleep

REM

hypnogram

tool that measures sleep cycle and sleep waves

______% increase in myocardial infarction (after daylight savings)

________% increase in traffic accidents (after daylight savings)

____________ mood disturbance and suicide (after daylight savings)

increased

_________________ is attributed to impact of sleep deprivation on frontal lobe fxing

volatility in the stock markets

effects of sleep deprivation

extensive sleep deprivation is fatal

fatal familial insomnia

inherited neurological progressive insomnia results in damage to portions of the thalamus death after 12 months

potential etiology; effects on sleep deprivation

sleep destroys free radicals and prevents their damaging effects

adenosine (inhibitory)

by product of ATP steadily increases throughout the day producing the "sleepy feeling" at night caffeine blocks adenosine receptors = decreased sleepy feely BUT increased fatigue sleep deprivation = decreased glycogen stores and increased adenosine = sleepiness accumulation of adenosine = increased delta sleep

melatonin is produced by ________ and is a response to ______________

pineal gland evening/darkness about 2 hours before normal sleep time

_________ is converted into melatonin

serotonin

exogenous melatonin

take ~1-2 mg 30 - 1 hour before bedtime light (especially blue light) negates the effects

melatonin and dementia

contraindicated

sleep apnea

18 million Americans difficulties sleeping and breathing at the same time increased CO2 = stimulates chemoreceptors = wake up gasping for air and decreased slow wave activity

2 types of sleep apnea

obstructive sleep apnea = narrowing of airways (d/t obesity, enlarged tonsils, hormonal changes) central sleep apnea = brain does not signal the need to breath

sleep apnea untreated

significant deficits in attention, memory and executive fxing increased risk of stroke (in kids) 2.5x risk of behavioral problems

tx for sleep apnea

CPAP, BiPAP can reverse cognitive deficits with tx

REM sleep behavior D/0

lack of muscle paralysis during REM = act out dreams (move around a bunch during sleep) can be comorbid with narcolepsy typical onset = 60+ years believed to be neurodegenerative tx = clonazepam

drugs that are used to treat symptoms of cataplexy will _________ the symptoms of REM sleep behavior DO

worsen!

Narcolepsy

orexin-related neurological disorder missing >85% orexin producing neurons hereditary component sleep attacks = overwhelming urge to sleep cataplexy sleep paralysis tx = modafinil, SSRIs

cataplexy

sudden muscle weakness/paralysis seen in narcolepsy

_________ % less sleep than earlier generations

___________% Americans employed in shift work

________% of adults report falling asleep during the day without meaning to at least once a month

Insomnia

effects 30% of adults 80 million Americans (40% women, 30% men) 2 types (primary, secondary) high comorbidity rates with chronic medical conditions chronic use of sleep-promoting drugs can cause rebound insomnia (20-80%)

primary insomnia

difficulty falling asleep after going to bed or after awakening during the night

secondary insomnia

inability to sleep due to another mental or physical condition (i.e. pain, medication

acetylcholine has to be

high when awake drops for slow wave sleep increases in REM

Physio final 4-5 Flashcards

(70 cards)