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72 Cards in this Set
- Front
- Back
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What are the three types of disease prevention?
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PDR
PREVENT (prevent occurrence, i.e. through vaccination) DETECT (early detection - PAP smear) REDUCE DISABILITY (insulin for diabetes) |
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What are actions of the Reticular Activating System?
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Activation and Inhibition/Filtration
Arousal (disorder-stupor) Orienting Response to Novel Stimuli (Disorder-Attn Deficit) |
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What are the components of the limbic system?
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Cingulate & Parahippocampal gyri of limbic cortex
Hippocampus, dentate gyri, subicular complex Amygdala (basolat, centromed complexes) Hypothalamus (Nucl. Accumbens, mamillary bodies) Thalamus (ant. nuc, DM nucl) Cortical regions (OF,Temp,Insula) |
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What types of behaviors arise from the limbic system?
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Instincts:
Aggression Sexuality Memory: amnesia, Korsakoff's |
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What are the five zones of the cortex?
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Limbic, Paralimbic, Primary Sensory, Primary Motor, Unimodal association, heteromodal association
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Functions of five?
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Limbic: homeostasis, emotionality, drives/instinct, memory/learning
Paralimbic: assoc limbic&heteromodal - OF,insula,temporal,parahipp, cingulate gyri Primary sensory, Primary motor(duh) Unimodal Assoc: Organizes sensory info into recognizable patterns Motor programs for complex mvmnts Sensory info about space used to guide above Heteromodal: Inf Parietal, Prefrontal cortex Synthesize unimodal sensory, integrated language-relevant perception (ID names attached to objects) |
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What are the dominant and non-dominant hemisphere responsible for?
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Dominant: (maj pop=Left)
Process info sequentially in detail Process language input&output Nondominant (maj=right) process info for general patterns parallel fashion Multiple inputs simultan. Visual-Spatial input/output |
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What would right hemisphere dysfunction in a right handed individual cause?
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Dysregulated mood (explosiveness, shifting overly intense moods)
Problems with recognition (faces, places) Poor visual-spatial function |
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What are some of the functions of the frontal lobe?
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Executive Functions:
Planning Initiating planned action Monitoring/self corr. action Terminating completed action |
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How would someone with a frontal lobe lesion present?
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make mistakes
less efficient (poor plan) Become inactive (no plans for ADL's come to mind) Perseverate (repeat same actions) b/c can't terminate. Judgment, problem solving disrupted FIRST AID: Personality Changes, Deficits in Concentration/Orientation/Judgment |
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What are some other frontal lobe functions?
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Abstract Thinking
Short Term Memory Expressive Lang/Speech Voluntary mvmnt |
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What would lesion of the non-dominant frontal lobe produce?
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Motor Aprosidia = monotonous speech, expressionless face
Nondom. fr. lobe involved in expression of emotion/musicality/intonationin speech |
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What are some functions of the temporal lobe?
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Memory
New Learning Emotional tone to perceptions Facial Recognition Language |
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Define:
Prosopagnosia Receptive Aprosodia |
Prosopagnosia = inability to recognize faces, despite adeq. vision
Receptive Aprosidia: inabiliity to respond/recognize emotions of others Both due to temporal lobe lesions |
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Parietal Lobe Functions?
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Recognizing concurrent sensory signals as single perception
3-D space & self relation to space Integration Visual/tactile with language Linking perception to motor performance/mvmnt guidance |
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What do lesions in the parietal lobe cause?
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Huge effect on IQ scores
intellectual life understanding abstract concepts |
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Define:
astereognosis Agraphesthesia |
Astereognosis: cannot ID objects by touch in extremity contralat to lesion
Agraphesthesia= can't ID #s/letters traced on contralat palm to lesion both are parietal lobe lesions dependent |
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Dyspraxia or Apraxia
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inability to perform simple motor tasks (using scissor/hammers)
w/ intact primary motor skills parietal lobe lesion |
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What two behavioral states correlate with Dopamine?
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1) Substance Abuse - reward pathway for some drugs utilizes dopa release
Repeated use=dopa stores depleted=no pleasure 2) Schizophrenia (too much Dopa, meds block Dreceptors) |
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What effects does NE have?
What is it synthesized by? |
1) stimulants - energizing effect can produce aggression/violence
2) Reduces pain perception 3) Increased amnts in cleft tx depression Made from Dopamine by B-Hydroxylase Enzyme Found in Locus Coeruleus |
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Behavioral effects of Serotonin?
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Regulates:
Mood Agression/Violence Sleep Pain IMPULSE CONTROL Low levels= depression, other NT's become pathogenic high levels= incr sleep, decr sexual activity Hallucinogens impact 5HT rec. Found Dorsal Raphe Nuclei |
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Histamine
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Hypothalamus
Vegetative functions: sedation, wt control, CV effects H2 blockade (antipsychotics, tricyclics) may -> wt gain, incr appetite |
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Ach
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MEMORY (dementia-Alzheimers)
Degenerate also in Downs, mvmnt disorders |
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GABA
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Inhibitory
Decreases anxiety (Benzodiazepines are anti-anxiety and potent. GABA) Anticonvulsant properties Losso of GABA neurons seen in Parkinsons, Huntingtons |
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Glutamate
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Excitatory
Schizophrenia PCP acts on a glutamate receptor to produce schiz-like psychosis |
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How is obesity defined?
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Body weight 20% or grtr over idea body wt for persons gender, age, build.
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What does excessive abdominal weight correlate with, and in whom is it more prevalent?
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Correlates with:
High blood pressure diabetes early Heart disease Some cancers More common in Men |
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What is the difference btwn childhood onset obesity and adult onset?
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Childhood onset: fat cell hyperplasia
Adult: fat cell hypertrophy |
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What is the BMI a measure of?
How is it calculated? |
Measure of weight adj for height.
BMI=wt in KG/(ht in m)squared |
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What are important BMI numbers to know?
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less than 18.5=underweight
18.5-24.9 Normal 25-29.9 Overweight greater than 30 Obese |
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Four Correlates of Chronic Pain
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1. True physiological substrate
2. Psychological (I'm weak) 3. Social control (self/others) 4. Holding onto loved one by developing similar symptoms |
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What happens with sensory deprivation?
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1. Hypnotic condition
2. Profound anxiety, depression, hostility 3. Auditory/visual hallucinations Depressed level consciousness 4. Extreme stimulus hunger& suggestibility |
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What are the wave forms noted in awake periods?
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Awake, alert, mental conc:
High Frequency BETA waves (15-18 Hz) Awake, eyes closed, relaxed: ALPHA Waves (8-12 Hz) |
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Describe the first stage of sleep.
What percent of YOUNG ADULT'S sleep cycle spent here? |
Stage 1:
Theta Waves (4-7 Hz) Ligh sleep, slow rolling eyes 5% |
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Second Stage of Sleep
Percent of sleep cycle? |
Stage 2
Deeper Sleep Sleep Spindles (12-14 Hz increasing and decr. waves) K complexes 45% |
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Third Stage of Sleep-Fourth Stage
What actions occur? Percent of Sleep Cycle? |
Slow Wave/Delta Sleep
Delta Waves (lowest freq, highest amplidtude freq 4Hz) Occur only first two cycles of night. Breathing/HR slow, muscle tone normal. Sleepwalking, night terrors, bed-wetting 25% (does not develop fully til mos after birth, dim. with age) |
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REM sleep?
What causes rapid eye movements? |
Rapid-eye-Mvmnt - PPRF (paramedian pontine reticular formation/conjugate gaze center)
Beta Waves, bursts saw tooth waves and alpha occiptal waves (8-12 hz) Loss Motor Tone Erections/ clitoral tumes. Increased 02 use by brain least responsive to external stimuli increased/variable BP,Pulse Loss of DTR's DREAMING 25% (decreases with age) |
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Structure of Typical Sleep cycle?
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all four stages NREM sleep
REM sleep every 90 minutes, lasts about 20 min, progr longer thru night |
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What is the role of NT's in REM sleep?
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NE induces it but decreases total sleep time and total REM time
Ach is principal transmitter that mediates REM sleep (increases sleep time) Serotonin increases sleep time Dopamine increase --> decreases sleep |
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What can be used to treat night terrors and sleepwalking?
Bedwetting? |
Benzodiazepines, which shorten Stage 4 Sleep
Imipramine for enuresis - also shortens Stage 4 Sleep |
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What is the definition of Sleep Apnea?
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Person stops breathing for at least 10 seconds.
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What are the two types of sleep apnea?
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Obstructive: muscle atonia/tongue/tonsillar obstruction/nasalobstruction
CONTRIBUTING FACTORS: Obesity, Hypothyroid, alcohol/sedative use Central: failure of MEDULLA to respond to CO2 (occurs esp in kids, cause ofSIDS) - morning cyanosis |
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What are symptoms/effects of sleep apnea (esp obstructive)?
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Loud snoring
Daytime Sleepiness, Aystole/heart failure Arhythmias Icreased risk for ischemia/stroke/HTN Reduced libido (adults) |
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How to treat sleep apnea?
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Weight Loss, CPAP (positive pressure mask), surgery, avoid alcohol/sedatives
Kids with central: sleep posture, buzzer warning system, theophylline to keep sleep light, usually grow out of by age 2-3 |
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How to treat insomnia?
Define? |
Relaxation techniques/systematic desensitization
no daytime naps,light snack bedtime, bedfor sleep only, exercise, routine Barbiturates/non-benzos: ADDICTIVE, suppress REM sleep Benzos: reduce slow-wave sleep, higher doses red REM Last resort: short acting benzos LESS THAN 1-2 MOS (otherwise addiction) Problem falling asleep 3x/wk for min 1 mo |
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Define Narcolepsy.
Tx? |
Sudden onset REM sleep during day.
Strong Genetic Component. Stimulant drugs |
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What are the two types of hallucinations that can occur (w or w/o n)?
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Hpnagogic hallucinations: just BEFORE falling asleep
Hypnopompic: just before awakening may occur w/ or w/o sleep paralysis (similar to cataplexy) |
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Define cataplexy
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Sudden loss of voluntary muscle tone (usually follows strong emotions or abrupt mvnmnts).
Attacks last less than 2 min, recover, often accompanies narcolepsy. |
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Disorders of sleep-wake :
Delayed Sleep phase Advanced Sleep phase |
delayed sleep phase: difficulty arising in morning (jet lag, obscure work shifts)
advanced: can't stay awake in evening, early morning awakenings (mor common in elderly) |
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Parasomnias:
Somnabulism Pavor Nocturnus |
Somnambulism: Sleepwalking kids: deep sleep, adults; NREM sleep. FAMILIAL. clumsy.
abates by puberty. Pavor Nocturnus: night terrors. NREM sleep. familial, episodes minutes, amnesia of event on waking. Tx of both: Protect from falls alert family, ID anxieties, long acting benzos to suppress stage 4 |
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Sleep-Related Enuresis
Bruxism Head Banging |
Enuresis: slow wave in kids, first third of night
Bruxism: jaw grinding NREM stage 2 Head banging: early childhood, during sleep onset |
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Sub-cortical aphasia
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lesion in left thalamus or caudate
Initial loss fluency/spont speech regains fluency paraphrasic errors, ok repet. resembles schizophrenic speech. |
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Difference between global and conduction aphasia?
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Global = lesion to both Broca's and Wernickes (slow, labored, dysarthric, telegraphic speech)
Conduction: arcuate fasciculus lesion, repitition impaired but output/comprehension of language mildly affected only |
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What are key changes in the sleep patterns of depressed individuals?
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Decreased slow wave sleep
Decreased REM latency Early morning awakenings |
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Name some genetic study techniques to assess environment vs. genetic contributions.
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FAMILY studies - prevalence compared to control
Twin- coincidence rates & environment/vs genetics in twins reared apart Adoption studies: environment cross-fostering: study adopted kids and biological kids in a family (env. vs genes) Linkage: find markers linked to characteristic |
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Orientation - x3 and x4
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Patient oriented to person, place, time.
x4 includes to present situation (what are we doing) |
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What is lost first in orientation?
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lost first: time
second: place last: person |
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Define
anosognosia autotopagnosia depersonalization |
anosognosia: unaware that one is ill
autotopagnosia: unable to locate own body parts depersonalization: body seems unreal/dissociated |
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Define the following:
immediate memory recent memory |
immediate memory: within last 10-15 minutes (repetition of 3 things)
recent memory: last two weeks (news events) |
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Remote Memory
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More than two years old
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What type of memory is lost first with aging?
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immediate memory first, remote memories last
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Differentiate between the following:
hallucinations illusions delusions |
Hallucinations: Perceptions in absence of stimuli
Illusions: misinterpretations of real stimuli Delusion: false beliefs maintained in spite of obvious proof to contrary |
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Define:
circumstantiality tangential |
Thought defect: give excessive detail about situation
off target/ straying to related issues |
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Diff. btwn:
delusion loose association |
Delusion: disorder in the content of the thought, the actual idea.
Loose association: problem in stringing together/ form of thoughts (when only strung together based on word sounds=clang associations) |
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What is another aspect of thought (other than delusions, tangentiality, circumstantiality, loose assocations)
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RATE of thought:
accelerated retarded totally blocked out (can't recall thoughts) |
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What are intelligence tests good at predicting?
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Academic achievement, NOT occupational success
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What are the different test results and how can they be used?
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Full Scale IQ (FSIQ)
Verbal IQ Performance IQ If verbal IQ sig. less than performance, could guess dom. hemisphere defect. |
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What is the mean on IQ tests?
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Mean: 100, SD of 15 (85-115)
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What IQ scores define levels of mental retardation?
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IQ<70 = MR (or 2 SD below mean)
IQ<40 = Severe MR IQ<20 = Profound MR |
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What are some issues in using these tests cross-culturally?
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Language: require English, oral lang skills
Time: cultures vary in prep for rapidity Item content: req. ID of items some may not be exposed to |
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What are the two most famous tests and how do the calculate IQ?
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Stanford Binet (good for young kids since less lang)
IQ as (MENTAL AGE/CHRON AGE) x100 Wechsler: 11 subtests (6 verbal, 5 performance) |
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What is the difference between and objective and a projective test?
What are intelligence tests? |
Objective: questions that are scored and easily analyzed.
Projective: subject interprets questions, response based on subject motivational/defense system Intelligence test=objective |
