Phys and Pharm
The Limbic system mediates ___________
long term memory and emotions
what occurs in Cushing Triad
Bradycardia, HTN, and irregular respiratory pattern
secondary and primary seizures differences
secondary- known cause, any disorder that alters the neuronal environment may cause seizure activity
primary- unknown cause, frequent seizures of this type may lead to seizure disorder
How does Parkinson's affect the brain
Degenerative disorder of the basal ganglia involving the dopaminergic nigrostriatal pathway
What is the somatic NS and what does it consist of
- voluntary branch
- 12 cranial nerves and 31 spinal nerves
- most are myelinated
- nerve bundles grouped together to form fascicles
The ______ controls vital functions and visceral activities.
Diencephalon
In Global Ischemia what occurs and why
blood flow is inadequate- does not meet metabolic needs
- Na/K ATPase pump fails
- Ca++ influx
Pharm mechanisms to suppress seizures
- suppress sodium influx
- suppress calcium influx
- promote potassium eeflux
- antagonize glutamate
- potentiate GABA
What is part of the Glasgow Coma scale
- eye opening response
- cerebral response
- motor response
Minor brain injury= 13-15 points
Moderate brain injury= 9-12 points
Severe brain injury= 3-8 points
3 sensory pathways and sensations for each
1) Spinothalamic tract
- lateral: pain, temperature
- anterior: touch
2) Posterior column
- vibration
3) Corticospinal tract
- anterior: 10% of neurons, remain uncrossed
- lateral: 90% of neurons, motor cortex
Primary excitatory NT in CNS is ______
Primary inhibitory NT in CNS is _____
1.) Glutamate
2.) GABA
Reasons for excess glutamate
1) Astrocyte dysfunction (decreased ATP and toxicity of lactate)
2) Cell damage (intracellular glutamate concentration is really high)
Class, Action, use, and side effects of Diazepam
AKA: Valium (low toxicity)
class- Benzodiazepine
Action- status epilepticus
Side effect- drowsiness, ataxia, personality changes
Name 3 Immunomodulators for MS
- interferon beta (Avonex)
- Dimethyl fumarate (Tecfidera)
- Galatimir acetate (copaxone)
Spinal cord injury and spinal shock phases
1) spinal shock
- phase 1: areflecia/hyporeflexia
- phase 2: initial reflex return
- phase 3: hyperreflexia
- phase 4: hyperreflexia with spasticity
2) neurogenic shock
3) autonomic dysreflexia
Midbrain- vision and auditory coordination
Pons- relay from cerebellum to brainstem
Medulla oblongata- reflex activities
the Modified Monro-Kellie Hypothesis consists of _______
1.) brain tissue is least able to compensate
2.) Initial ICP changes are buffered by CSF shunting to the spinal cord
3) only small amount of blood can compress sinuses, vasoconstrictor arteries
types of partial seizures
simple partial- 1 hemi, no impairment of consciousness
complex partial- impairment of consciousness, often from temporal lobe, automatisms are common
secondarily generalized partial seizure- starts as partial but spreads to both hemis, thalamus, and reticular formation
Bacterial Meningitis causes, where in the body and how replicate, risks
- streptococcus pneumoniae, H. influenza, Neisseria Meningitidis, E. coli
- reside in throat and nasopharynx, pathogens live/replicate through CSF, endotoxins are released --> inflammation--> disrupts BBB
- risks: close living quarters, head trauma with basilar fracture, otitis media, sinusitis
signs of autonomic dysreflexia
- full bladder or stimulus from bowel
- afferent stimulus
- massive sympathetic response
- widespread vasoconstriction
- HTN
- Baroreceptors detect HTN
- HR slowed
- descending inhibitory signals blocked at level of injury
supporting cells of the CNS and their functions are _____
Astrocytes- maintain integrity of BBB (regulate)
Oligodendrocytes- form myelin sheath
Microglia- phagocytic function
Ependymal cells- line ventricles & produce CSF
What are the two types of hydrocephalus and what makes them different
Noncommunicating (obstructive)- obstruction in the ventricular system prevent CSF from reaching absorption, dilates ventricles proximal to blockage
Communicating- impaired reabsorption of CSF from arachnoid villi into the venous system. two few villi to obstruction of villi
Phenytoin (Dilantin)- limits spread of seizure activity and elevates seizure threshold, stabilizes neurons in motor cortex to prevent hyper-excitability
Carbamazepine (Tegretol)- Delayed recovery of Na+ from inactive state
Valproic acid (Depakote)- blocks Na+ channels, supresses Ca+ influx, might augment GABA
What occurs in Chronic traumatic encephalopathy (CTE) and symptoms
Neurodegenerative disease caused by repeated head trauma, diagnosed at autopsy
- atrophy and loss of neurons
tau proteins
- 3 stages
1st: ADHD, confusion, disorientation, headaches
2nd: memory loss, impulsive behavior, poor judgment
3rd and 4th: progressive dementia, movement disorders, speech impediments, vertigo
Explain Myasthenia Gravis, symptoms, and drugs used
- autoimmune disease, antibodies develop against Ach receptors at the neuromuscular junction r/t abnormal T-cell function
- eye weakness (ptosis, diplopia) (initial), generalized weakness (respiratory muscles), chewing and swallowing become difficult--> risk for pneumonia
- Drugs: Immunosuppressive therapy, acetylcholinesterase Inhibitors, + with plasmapheresis