Neuroscience - Final - Part 1

davidwurbel7's version from 2016-04-08 16:59


Question Answer
This is the place in the brain that regulates to subjective aspect of painCingulate Gyrus
Immediate sensation of painAcute Pain
Usually caused by the tumor taking up space and crowding other organs or by destroying boneCancer-Related Pain
Persist pain beyond the point of tissue damageChronic Non-Malignant Pain
Substance P, CGRP, Bradykinins, Histamine, Prostaglandins, Serotonin, Potassium (K+), Neurokinins are used of transmission of this signalPain Transmission
Enkephalins/Endorphins are used for thisPain Suppression
Pain information is transmitted through this tractSpinothalamic Tract
Fast pain is transmitted by these fibersA Fibers
Slow pain is transmitted by these fibersC Fibers
Perception is very rapid <0.1 sec after stimulus. Acute, sharp, prickling. Not felt by deeper tissues. Easily localizedFast Pain
Perception begins approximately 1 second after initial pain stimulus. Occurs in both skin and deeper tissues. Typically localized to general areasSlow Pain
Neospinothalamic tract for pain is conducted by these fibersA Fibers
Paleospinothalamic tract for pain is conducted by these fibersC Fibers
Type IV axons (unmyelinated)C Fibers
Type III axons (myelinated)A Fibers
These are the A fibers for painA-Delta Fibers
This phenomenon results in the release substance P and CGRP (calcitonin-gene releasing peptide) from the sensory axon endingsAxon Reflex
Substance P and CGRP act on these cells to release histamine, which further stimulates pain endingsMast Cells
Substance P and CGRP act on mast cells to release this, which further stimulates pain endings Histamine
This substance cause the degranulation of mast cells, which then release more histamine and serotoninSubstance P
Low levels of histamine produce thisItching
Higher levels of histamine produce thisPain
These axons descend into the spinal cord to presynaptically inhibit pain transmission in the dorsal hornRaphe Axons
Raphe nucleus receive axons from the brain structurePeriaquaductal Gray
These fibers keep the ‘gate’ openC Fibers
These fibers close the gateA Fibers
Concerned with localization of painPrimary Somatosensory
Concerned with ‘affective’ perception of painCingulate gyrus, insula
Pain results from problems with spinal joints, discs, vertebrae, or soft tissues. The cause of the back pain is still present (i.e. disc compressing the nerve)Mechanical
The original stimulus is no longer present, but the pain is. This type of pain is also less responsive to medsNeuropathic
Herniated disc (i.e. Sciatica), Spinal stenosis (narrowing of spinal canal), Osteoarthritis (joint degeneration, if Specific to cord can be called Spondylosis), Spondylolysis (vertebral defects), Scoliosis (curvature of the spine) can lead to thisNerve Compression
Visceral pain is often severe, but more importantly is poorly localized. In addition, this type of pain is often perceived as coming from the surface (ie. skin)Referred Pain
Long lasting, past the original stimulus. Elicited by non-noxious stimuli. Occurring spontaneously. Can spread to areas previously unaffected. Pain that extends beyond the expected period of healingChronic Pain
Increased pain sensitivityHyperalgesia
Pain from stimuli that would not ordinarily be painfulAllodynia
Activation of pain receptorsNociceptive
Damage or abnormal activity in CNSNeuropathic
An interneuron is inhibited with pain and stimulated during touch. Rubbing an area will stimulate the interneuron and will suppress the pain signalsGate Control Mechanism
This likely operates at both the spinal cord level (between 1st and 2nd order neurons), and also within the thalamus (between 2nd and 3rd order neurons)Gate Control Mechanism
Primary somatosensory: concerned with localization of painSI
Cingulate gyrus, insula: concerned with ‘affective’ perception of painSII

Analgesic Medications and Administration

Question Answer
Anti-inflammatory, antipyretic, anti-clotting. Blocks production of prostaglandins, leukotrienes, and thromboxanes. NSAIDAspirin
An NSAID. Potential GI issues.Ibuprofen (Advil, Motrin)
An NSAID. Potential GI issues, don’t take with MAO-I’s.Naproxen (Aleve)
Not an NSAID. Side effects could include hepatic toxicityAcetaminophen (Tylenol)
Inhibit cyclo-oxygenase enzymes (COX-1 and COX-2, which convert arachidonic acid into prostaglandins)NSAID
Block production of arachidonic acid. Strong anti-inflammatory. Side effects - Numerous, including osteoporosis, immunosuppression, growth retardation, etc.Corticosteroids
May be effective if analgesics are not, for neuropathic pain. Side effects - Fatigue, constipation, blurred visionAntidepressants
Cause sedation along with pain relief. Side effects - Tolerance and withdrawal symptoms may occur. (Not to be confused with addiction)Opiates
Tramadol, codeine phosphate‘Mild’ Opioids
Oxycodone, morphineStrong Opioids
Administration of small quantities of meds to spinal fluid (similar to the epidural given during labor). Typically done in patients who have lots of side effects to high dose oral medicationsIntrathecal Pump
Uses high frequency AC current to thermally lesion C fiber axonsRadiofrequency Lesion/Ablation
Using small electric currents specifically targeted to problem areasNeuromodulation

Reticular Formation and Limbic System

Question Answer
A ‘net-like’ structure with extensive afferent and efferent connections. It extends throughout the brainstemReticular Formation
This can be divided into median, medial, and lateral cell columns within the brainstemReticular Formation
Contains the raphe nuclei which release serotoninMedian Reticular Formation
Motor coordinationMedial Reticular Formation
BreathingLateral Reticular Formation
ACh/NE axons project from the rostral RF to intralaminar nucleus of thalamus which in turn project to the cortexAscending Reticular Activating System (ARAS)
The ARAS projection also inhibits this of the thalamus, which normally functions to inhibit the relay of sensory information to cortexReticular Nucleus
When the ‘brain’ learns to ignore repetitive, meaningless stimuliHabituation
Disorientation, ‘not thinking clearly’Confusion
Semi-consciousness or drowsiness. Stimuli will arouse patient but only for the duration of the stimuli.Somnolence
Patient responds in a limited way to painful, or extremely intense, stimuliStupor
No response to external stimuliComa
Respiratory center in this location controls rhythmic activation of these neuronsVentrolateral Medulla
Motor neurons located at C3/C4 of the spinal cord innervate the diaphragm as thisPhrenic nerve
Repiratory center responsible for only inspirationDorsal respiratory center
Repiratory center responsible for both Inspiration/ExpirationVentral respiratory center
Bilateral damage to forebrain (or diencephalon) structures results in hyperapnea alternating with apnea. Often seen in terminal careCheyne-Stokes Respiration
Cheyne-Stokes respiration is caused by lesion hereForebrain Lesions
Damage to periaqueductal gray and RF in midbrain or upper pons. Sustained, rapid, deep hyperapneaCentral Neurogenic Hyperventilation
Damage to dorsolateral tegmentum of the pons. Prolonged inspiration followed by prolonged expirationApneustic Breathing
Midpontine damage resulting in 3-5 rapid, deep breaths followed by periods of apneaCluster Breathing
Damage to dorsomedial RF in caudal pons or rostral medullaAtaxic Breathing
Damage to ventrolateral medulla respiratory centers, or the descending axons in the caudal medullaRespiratory Arrest
Involved in the expression and control of emotional behaviorLimbic System
Connects mammillary bodies with anterior nucleus of thalamus. This tract continues on to the cingulate gyrusMammillothalamic Tract
Originates in the medial part of the hippocampus, and becomes the Fornix at the posterior end of hippocampusFimbria
From hippocampus to mammillary bodies. Also anterior nucleus of thalamus, tegmentum, septum, and hypothalamusFornix
Hippocampus along with the parahippocampal gyri, dentate gyri, and entorhinal cortex , are called theHippocampal Formation
Involved in recent memory functions, particularly consolidation of memory. Also known as Ammon’s Horn, for it’s shape. Also has a role in the recognition of noveltyHippocampus
Connected to hypothalamus by stria terminalis. By this connection, this can influence autonomic responses to certain stimuliAmygdala
Connected (via thalamus) to frontal and cingulate cortices; regions associated with attaching meaning to a stimuliAmygdala
Connections to hippocampus, a region critical for memory functionAmygdala
The combination of ‘psychic’ and physiological responses to a stimuli is calledEmotion
Located in the rostral temporal lobe, near the hippocampus. Brodmann’s areas 28 and 34. Helps connect hippocampus and neocortex, thus involved in memory consolidation. Atrophies before other structures in Alzheimer’sEntorhinal Cortex
Thin sheet of gray matter that separates the lateral ventriclesSeptum (Septum Pellucidum)
The SII (affective perception) of pain sensation (SII is the "emotional" component of pain.) Connected to entorhinal cortex via cingulum. Important area for ‘learning how to recognize and avoid negative consequences’. Often divided into anterior and posterior portionsCingulate Cortex/Gyrus
Sudden fit or outburstParoxysm
Blood tests - Check for low blood sugar or dehydration. EEG and Echocardiogram - For heart abnormalities. Tilt Table - Patient strapped to table and…well, tilted. Good for diagnosing dysautonomia or syncope). Therapy/Behavioral - Some patients with vasovagal syncope respond well to cognitive behavioral therapiesSyncope Diagnostic Testing
Damage to nerves outside the brain or spinal cordPeripheral neuropathy
Damage/loss of a single nerve or nerve group. (Ex. Carpal tunnel, sciatica).Mononeuropathy
Many peripheral nerves lose function simultaneously (Ex. Guillan Barre, diabetes, kidney failure, Lyme disease, alcoholism, and many others)Polyneuropathy
When the nerve root(s) are the affected areaRadiculopathy
When multiple nerve roots are the damaged areaPolyradiculopathy
Symptoms include, Ocular palsy, Gait ataxia, Mental confusion, Most often results from chronic alcohol consumption. Treatment involves thiamine (B1) administrationWernicke’s Encephalopathy
Results in destruction of mammillary bodiesKorsakoff’s Syndrome
Symptoms include anterograde memory deficits, mental confusion, and confabulation damage cerebellum, patient may also show cerebellar symptomsKorsakoff’s Syndrome