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101 Cards in this Set

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What are the two main subdivisions of the perpipheral nervous system (PNS)?
PNS consists of the nerves that go to and from the brain and spinal cord (cranial nerves, spinal nerves and peripheral ganglia).
1. somatic nervous system
2. autonomic nervous system
What types of sensory messages are sent and received from the somatic nervous system?
those that control voluntary muscle movement of the skeletal (striated) muscles.
What types of sensory messages are sent and received from the autonomic nervous system?
those that control more automatic or involuntary bodily functions of the smooth muscles and glands (digestion, heart rate)
What is the primary function of the ANS and what two systems does it include?
Function of ANS - maintain homeostasis. consists of sympathetic nervous systems and the parasympathetic nervous system.
What are the functions of the sympathetic nervous system?
"mobilizing" the system - fight or flight. It takes over when someone is under stress, will send hormones into blood stream
What is the parasympathetic nervous system and its functions?
"Energy conserving" system. Dominant when a person is relaxed. Main function is basic body maintenance - slowing heart rate, blood pressure, respiration.
What is the role of biofeedback in the autonomic nervous system (ANS)?
Focused on helping people decrease sympathetic arousal and increase parasympathetic system - relaxation.
CNS - Central nervous system - consists of which type of nerves?
Sensory or afferent neurons that carry information into the CNS.
Motor neuroons that carry info away from CNS to muscles and glands.
What are the 4 regions of the spine and consequences to damage in these areas?
Cervical: C1-C7; damage between C1-C5 = quadriplegia
Severing C6-7 and lower is paraplegia
Thoracic: T1-T12
Lumbar: L1-L5
Sacral (S1 for all areas)
"Paresis" muscle weakness
What are the 3 major divisions of the brain?
1. Cerebrum (cerebral cortex and subcortical areas)
2. Cerebellum
3. Brain Stem
What are the 2 layers of the cerebrum?
Outer layer is the cerebral cortex - divided into halves and lobes.
Inner layer is the subcortical areas.
What are the dominant functions of the cerebral left hemisphere?
Language functions. Also associated with being rational, analytical, logical and abstract. Left hemispher dominant in 97% of people.
What are the dominant functions of the cerebral right hemisphere?
Perceptual, visuospatial, artistic, musical, and intuitive activities. Also emotion.
What are the dominant functions of the cerebral frontal lobes?
Critical to personality, emotionality, inhibition, planning and initiative, abstract thinking, judgment and higher mental functions (e.g., cognitive flexibility)
How does the posterior aspect of the frontal lobe influence movement and speech?
The motor control area, at the back of the frontal lobes involves instigating voluntary movement. Broca's area is located here on the left and controls the muscles that produce speech.
What are the key functions of the cerebral parietal lobes?
Primary sensory areas that process somatosensory information. Sensations such as light touch, pain, heat and proprioception.
What is proprioception and how does it relate to Gertsmann's syndrome?
Proprioception is the ability to locate one's body parts. (touch your fingertip to your nose). Gertsmann's syndrome: lesions in parietal lobe that result in agraphia, acalculia, right-left disorientation and finger agnosia.
What are the dominant functions of the cerebral occipital lobes?
Located at the back of the brain and house the primary visual cortex.
What are the dominant functions of the cerebral temporal lobes?
Contains the primary auditory cortex, amygdala, and hippocampus: involved in emotional behavior and memory. Wernicke's aphasia - lesions here
Differences between Broca's and Wernicke's aphasias?
Broca's: lesions in left frontal motor cortex that controls the instigation of muscles to produce speech.
Wernicke's: lesions in left temporal lobe near the auditory cortex - ability to receive and interpret sensory inputs like speech from others.
What are the primary structures of the subcortex?
Corpus Callosum, Thalamus, Hypothalamus, Pituitary Gland,
Limbic system, substantia Nigra, Basal Ganglia
What is the function of the corpus callosum?
Primary junction for white matter that serves as a bridge between the two hemispheres making it possible for the 2 sides to communicate.
What is the function of the thalamus?
Major sensory relay center - receives inputs from all sense except olfaction. Thalamus integrates, processes, and projects these sense onto the appropriate cortical areas. Structure critical to the perception of pain and may be linked to schizophrenia (misperceptions of sensory input).
What is the function of the hypothalamus?
Homeostasis, which is accomplished through regulating the endocrine system: temperature, hunger, thirst, sex, aggression, sleep-wake cycle.
What is the function of the pituitary gland?
Labeled the master endocrine gland because it releases hormone that activate other glands. Involved in normal and abnormal growth and influences thyroid, testes, pancrease, adrenal glands.
What is the function of the Limbic system?
Group of interconnected structures (Cortical & Subcortical) involed in emotional behavior, particularly aggression.
Structures include: hypothalamus, hippocampus, amygdala, septum, parts of thalamus, frontol lobe and temporal lobes.
Which areas of the limbic system are most involved with agression?
Amygdala and septum; septal rage.
Describe the Kluver-Bucy syndrome and its relationship to the limbic system.
first described in monkeys that had undergone bilateral temporal lobectomies and removal of amygdala.
Symptoms: placidity, apathy, hyperphagia, hypersexuality, and agnosias.
Which structure in the limbic system is responsible for storing new events as lasting memories?
Hippocampus
What is the main function of the cerebellum?
responsible for maintaining smooth movement and coordinating motor activity. Also controls for automatic adjustments of posture that result in our ability to stay balanced.
What are the three main areas of the brain stem?
pons, medulla, reticular activating system
What are the functions of the pons and the medulla?
Pons: upper portion of the brain stem.
Medulla - bottom of brain stem
Fucntions: facial expressions, sleep (including initiating REM), respiration, movement, cardiovascular. Damage to either can result in death
What is the RAS in the brain stem and its function?
Reticular activating system, consists of medulla, pons, hypothalamus, and thalamus. Serves as filter for incoming sensory information. Activates the cortex into alertness.
What are the three parts of a neuron?
dendrites (receive info)
cell body (soma - integrates info)
axon - transmits info
What is the "all or none prniciple" regarding neurons
Threshold reached or it will not fire. Axons do not fire more strongly or less strongly given the strength of the stimulation - fires all the way or not at all.
How are neurotransmitters released?
After an axon has fired, neurotransmitters are released from axon terminal buttons in the synapse and bind to dendrite receptors. Reuptake may occur.
What are the two types of neurotransmitters?
Excitatory - acetylcholine, norepinephrine - increase likelihood of an action potential.
Inhibitory - GABA, endorphin -decrease the likelihood of an action potential
What is the difference between an agonist and antagonist?
Agonist - any substance that enhances the effect of the neurotransmitter. Antagonist refers to any substance that inhibts the neurotransmitter effect.
As a classical neurotransmitter, acetylcholine (Ach) has what two significant functions?
Most common neurotransmitter.
1. Voluntary movement
2. Memory and cognition
Particulary prevalent in hippocampus
most notable deficienciy in levels of acetylcholine is Alzheimer's Disease.
What are the two types of catecholamines and their effects?
1. Dopamine. Excesses implicated in schizophrenia. Decrease in Dopamine thought to impact Parkisons.
2. Norepinephrine: significantly involved in mood and hypothes. to play a role in pain perception and sleep.
"Cateholamine hypoth of affective disorders" - depression = deficiency while mania = excess.
What is the classical neurotransmitter Serotonin most implicated in affecting?
Serotonin (5-HT)signicantly involved in mood disorders. Believed to play a role in aggression, sexual activity, sleep onset, pain perception, and eating disorders. connected with suicidality and associated impulsivity.
What is the hypothesized role of serotonin in schizophrenia?
Early theories suggested serotonin in schizophrenia. Ne research has been rekindled because the novel antipsychotics (Clozapine) work but do not block domaine, instead the are serotonin receptor antagonists.
What is the role of GABA, a classical neurotransmitter in the CNS?
GABA has a major inhibitory effect - a calming effect. Beleived that in anxiety and epileptic sezures that there is a deficiency in levels of GABA. Benzodiazepines are GABA agonists, increase levels of GABA and decrease overarousal.
What are the endogenous neurotransmitters?
over 25 peptide neurotransmitters, Two are the enkephalins and endorphins, also referred to as endogenous opioids, the body's natural painkillers. These peptide neurotransmitters are thought to regulate stress and pain.
Why is the pituitary referred to as the master endocrine gland?
Because it releases hormones that activate other endocrine glands. Disruption results in a variety of medical conditions, which many have comorbid psychological symptoms.
What is hypopituitarism?
Results from under secretion of pituitary hormones.
Children = dwarfism, pubertal delay
Adults = gonadal failure (impotence) or contributions to diabetes, hypothyroidism
What is hyperpituitarism?
Involves startling skeletal overgrowth:
Prepuberty = gigantism
Postpuberty = acromegaly
What is hyperthyroidism?
Excessive secretion of Thyroxin (hormone that controls metabolism):
Results in weight loss despite increased appetite, heat sensitivity, sweating, diaarrhea, palpitations, agitated depression, insomnia, impaired memory.
Most common form is Grave's Disease.
What is hypothyroidism?
Undersecretion of thyroxin. Results in unexplained weight gain, sluggishness, fatigue, impaired memory, and sensitivity to cold. If it progresses, myxedematous symptoms appear (dry skin, sparse hair, decrease in cardiac output). Most severe -results in madness - delusions, mania, hallucinations.
What is hyperparathyroidism?
Parathryroid plays a role in calcium retention. hyperparathyroidism produces hypercalcemia with resultant delirium, depression, personality changes, psychosis, stupor, coma.
What is hypoparathyroidism?
Parathryroid plays a role in calcium retention.
hypoparathyroidism produces neuromusclualr symptoms, parasthesia (tingling) or tetany (cramps, convulsions). Psychiatric: delirium or personality change
Which organ is involved in Diabetes?
Pancrease undersecretes or becomes nonsecreting.
Type I -juvenile onset or Insulin Dependent.
Type II - adult onset or non-insuline dependent.
What is diabestes insipidus?
Relatively rare form -typically induced by medication (e.g., from lithium toxicity).
What is Addison's Disease?
Undersecretion of corticosteroids (adrenal insufficiency). Symptoms of apathy, weakness, irritability, depression, gastrointestinal disturbance.
What is Cushing's Disease?
Oversecretion of corticosteroids (Adrenal gland). Physically experiences "adiposity" or swelling and fattening of the face, neck, and trunk. Results in agitated depression, irritability, and emotional lability, difficulty with memory and concentration, even suicide.
What is hypoglycemia?
Abnormally low blood sugar. Symtpoms include nervousness, irritability, trembling, cold sweats, fatigue, rapid heart rate, hunger, headache, confusion.
What is hyperglycemia?
Abnormally highblood sugar. Evidence in persons with diabetes. Sumptoms include increased thirst and urination, dehydration, fatigue, weakness, abdominal pain, nausea, loss of appetite.
What is an aphasia?
A language disorder resulting from damage to the left hemisphere.
What is Broca's aphasia?
"broken speech" - Lesions are in the left frontal lobe, near the motor cortex, which controls the muscles that produce speech. Fair comprehension but speak in short phrases. Effortful speech with poor articulation (dysarthria). Expressive or motor aphasia.
What is Wernicke's aphasia?
Results from lesions in the left temporal lobe. Problems with language comprehsnion. Speak easily and fluently but speech is empty, marked by use of filler words. Frequent misuse of rwords and misproduced speech sounds (paraphasisas). They don't make much sense. Wernicke's is a receptive or sensory aphasia.
Broca's is to Wernicke's as
frontal lobe is to temporal lobe. or
Expressive is to receptive.
What is a conduction aphasia?
Due to lesions in the connections between expressive and receptive speech areas. most resemble individuals with Wernickes (intact fluency, paraphasias) but have well-preserved languagecomprehension that is not found in Wernicke's.
What is global aphasia?
REsults from so much damage to the cortex that most language functions are impaired, including fluency, comprehension, repitition, naming, reading, and writing.
What are some examples of one-sided neglect?
Forgetting to dress one side of the body, eating food from only one side of the plate. full or partial loss of motor functioning on one side.
What is apraxia?
Refers to inability to carry out purposeful motor movements (waving). persona can move limbs normally but wrong muscles are innervated. (left brain lesions).
What is agraphia?
Impairment in the ability to write (specifically acquired after the person has learned to write). Deficits in spelling, word selction, grammar, spatial arrangement. Left hemisphere.
What is alexia?
inability to read after reading has been learned.
Left hemipshere - most common cause is a stroke to the dominant/left hemisphere.
What is the difference between retograde and anterograde prosopagnosia?
Retrograde - inability to recognize faces of previous known individuals.
Anterograde - inability to learn new faces.
Thought to be due to an injury in the visual association cortex.
What is hydrocephalus?
pathological accumulation of cerebrospinal fluid (CSF) in the brain's ventricles.
According to DSM-IV, what are the characteristics of dementia?
"memory plus"
dementia is characterized by short or long-term memory impairment PLUS at least one of the following:
1. aphasia (language)
2. apraxia (motor activities)
3. agnosia (object recognition)
4. executive functioning (planning, organizing, abstracting)
What is the prevalence of Alzheimer's dementia?
* most common form of dementia, accounting for over 1/2 of all cases.
* Also, more prevalent in women.
* 1st degree relative of patients iwth AD have a 6 times greater risk.
* most rapid and relentless course occurs with early onset or before 65.
*diagnoses confirmed in autopsy.
What are the phases of Alzheimer's?
Early phase - recent memory impairments, forgetting, difficulty problem-solving. some irritability, frustration.
Middle - memory as well as cognitive deficits such as aphasia. also exhibits confusion, wandering, sociall undesirable behaviors.
later stage characterized by gait and motor problems; may become mute and bedridden.
What is the neurotransmitter most implicated in Alzheimer's disease?
acetylcholine (ACh).
What are the markers or brain changes associatd with Alzheimer's disease?
Senile plaques (protein globes)

Neurofibrillary tangles (neuronal filaments)
What is the etiology and prevalence of vascular dementia?
10-15% of all dementia cases.
Twice as prevalent in men as women. Results from numerous small Cerebrovacular accidents or strokes.
Age of onset much younger than Alzheimer's.
Describe Parkinson's Disease
Affects men slightly more than women. Considered a subcortical movement disorder.
Marked by tremor, rigidity, bradykinesia (slowed initiation of movement), shuffling gait, and sometimes neuropsychiatric symtoms. 30-50% have dementia. 50-90% have depression.
Which brain structures are associated with Parkinson's disease?
The degeneration of neurons in the substantia nigra, a section of the basal ganglia. decrease in dopamine. Affects speed of processing and executive functions (planning, organizing, sequencing).
Describe Huntington's Disease.
Results from autosomal-dominant gene involving the basal ganglia.
First sign is personality change.
Does not become apparent until age 35-45.
offspring have a 50% chance of being affected
What neurotransmitters are associated with Huntington's Disease?
Acetylcholine and GABA
* All patients with Huntington's have progressively deteriorating dementia as well.
What are the choriform and athetosis movements in Huntington's Disease?
Frequent, discrete, brisk jerking movements of the pelvis, trunk and limbs.
Athetosis - slow writhing movements.
Both occur within months to years after the onset of the disease.
What is Pick's Disease?
Frontotemporal dementia. affects women twice as much as men.
*onset peaks between 50's and 60's.
*characterized by disihibition, decreases initiative, tactless and inappropriate behavior, explosive temper, poor impulse control, impaired insight as well as memory and language problems.
What is the prevalence of Aids Dementia Complex?
ADC affects approximately 10-15% of people with AIDS.
*includes cognitive, motor, and behavioral changes.
What are the 2 most common types of closed-head injuries?
1. Concussion: most common in which the skull is not pierced or cracked - results fom a blow to the head, hard enough to cause temporary neural dysfunction - but not cerebral bruising or contusion.
2. Contusion - far more serious. Pt. pay lose consciousness, may experience aphasia, hemparesis, etc. upon returning to alert state.
How do anterograde and retrograde amnesia differ?
Anterograde - inability to remember new information about things that occur after the head trauma.
Retrograde - loss of membory for info acquired before the injury. (usually things that occured right before the incident).
What is a postconcussive syndrome and its associated symptoms?
Constellation of somatic and psychological symptoms including headache, dizziness, fatigue, loss of concentration and memory, anxiety, insomnia, hypersensitivity to light and noise. Most common: headaches, dizziness, fatigue, irritability
What is an open-head injury
penetration of the skull - such as a gunshot wound.
What is the average period for recovery from head trauma?
Most cognitive recovery occurs within the first six to nine months. May take 2-3 years. Order of recovery: general intelligence then memory functions.
What is pseudodementia?
Cognitive impairment due to depression that mimics dementia.
What is delirium?
Acute confusional state. Acute onset, fluctuating course, clouded sensorium and most likely to be reversible.
What are common causes of delirium?
Infections, substance withdrawal, intoxication, postoperative states, metabolic and endocrine disorders.
What is the drug of choice for delirium?
Haldol
What is Korsakoff's syndrome?
Amnestic syndrome thought to be caused by chronic thiamin (B1) deficiency associated with alcoholism.
What is one of the most significant problems associated with Korsakoff's?
Anterograde amnesia. My also suffer retrograde amnesia - especially for their adult lives. These patient's frequently confabulate - make up plausible stories about past events that did not occur. They lack insightand limited spontaneous conversation although they are alert, attentive, motivated and have generally normal IQs.
What is the gate control theory (Melzak and Wall, 1965)?
Sensations of pain are not directly related to activation of pain receptors, but rather they are mediated by a neural gate in the spinal cord that allows these signals to continue to the brain. Pressure stimulation tends to close the gate - which is why rubbing a hurt relieves the pain. Attitudes and moods may open the gate and increase pain.
What type of schedule should narcotic and non-narcotic medicines be administered for chronic pain?
Time-contingent, fixed interval schedule. Never prn for pain.
Beta Waves?
Person is alert and attentive
Alpha Waves?
Person is relaxed with a brain wave pattern of 8-12 Hz per second.
Theta Waves?
Stage 1 sleep - a transitionalb stage between wakefulnees and sleep when brain waves of 4-8 Hz occur.
Stage 2 sleep?
characterized by spindles, or rhythmical responses of 12-16 Hz.
Delta Waves?
Stages 3-4. slow waves of 1-2 Hz.
REM sleep?
Follows stage 4. Newborns spend 50% of their time in REM. By age five it is about 20-25%. By old age only 18%.