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Neural + Sleep
Pathophysiology 6 - Disorders of the Neural System and Sleep
| Question | Answer |
|---|---|
| list the 2 major divisions of the nervous systems and the structures found in each | Central Nervous System (CNS) - brain and spinal cord Peripheral Nervous System (PNS) - spinal nerves, cranial nerves, ganglia |
| what are the meninges | connective tissue sheaths that surround the brain and spinal cord |
| what is the pia mater | the innermost layer of the meninges, thin and delicate and contain surface level blood vessels that perfuse the brain and spinal cord |
| what is the arachnoid layer | - 2nd layer of meninges - encases entire CNS - nonvascular - waterproof - CSF circulates in an area just below (subarachnoid space) |
| name the meninge layers | pia mater (inner most) arachnoid layer dura mater (outer most) |
| what is the dura mater | - outer layer of meninges - strong - continuous connective tissue sheath - provides brain and spinal cord with most protection |
| what is the function of csf | - cushion - maintain constant ionic environment - allows for diffusion of nutrients, electrolytes, waste |
| how is csf produced | - thin layer of neuroglial cells (ependyma) lining the ventricles and central canal of spinal cord - specialized ependymal cells (choroid plexus) project the ventricles and produce CSF |
| what is the difference between afferent and efferent neurons | afferent neurons carry sensory information from the periphery to the spinal cord and brain while efferent neurons carry motor output from the brain and spinal cord to the periphery |
| list the neuroglial cells of the CNS | - oligodendrocytes - astrocytes - microglia - ependymal cells |
| list the neuroglial cells of the pns | - satellite cells - schwann cells |
| describe phase 1 of an action potential | (Resting Potential) - resting phase - both sodium and potassium gates are closed - voltage is -70mV |
| describe phase 2 of an action potential | (Depolarization) - sodium gates open - sodium rushes into the axon - Voltage travels to 0 then up to +40 mV |
| describe phase 3 of an action potential | (Repolarization) - sodium gates close - potassium gates open -potassium rushes out of axon - returns to a negative voltage inside the axon |
| describe phase 4 of an action potential | (after-polarization/Hyperpolarization) - potassium gates are slow to close - there is an undershoot of the potential (less than -70mV) - then resting state reestablishes |
| name the three ways in which neurotransmitters are removed from the synaptic cleft | - enzymatic activity - reuptake - diffuse |
| describe how enzymatic activity helps remove neurotransmitters in the synaptic cleft | enzymes breakdown neurotransmitters into inactive substances |
| describe reuptake | the neurotransmitter is drawn back up into the presynaptic neuron |
| describe how diffusion removes neurotransmitters from the synaptic cleft | a neurotransmitter diffuses into the intercellular fluid until its concentration is too low to elicit a post synaptic response |
| what EEG wave is associated with REM sleep | beta waves |
| alpha waves are characteristic of which stage of sleep | stage 1 |
| describe NREM sleep regarding muscle tone, vital signs, and brain activity | - moderate muscle activity - decreased vital signs - decreased brain activity |
| describe REM sleep regarding muscle tone, vital signs, and brain activity | - muscle tone decreases - vital signs increase - brain activity increases |
| pt with diagnosis of Alzheimer's is able to function independently at home, but their family reports that they have trouble planning and executing everyday tasks that used to come easy to them. What stage of Alzheimers are they in? | early or mild Alzheimers |
| Pt with a diagnosis of Alzheimer's disease has not awareness of their surroundings and is completely dependent for all ADLs. What stage of alzheimer's disease are they in? | late or severe alzheimer's |
| list at least 3 non-medicinal interventions that can be used to address sleep changes in someone with Alzheimers | - regular daily routine - daily exercise (earlier in day) - avoid caffeine - discourage watching TV before bed - make sure bedroom is familiar and comfortable - provide them with security and comfort |
| what is the main difference between focal and generalized seizures (focal) | focal seizures affect one specific part of brain in 1 hemisphere |
| what is the main difference between focal and generalized seizures (generalized) | generalized seizures affect both hemispheres of the brain |
| describe the aura phenomenon | aura is a sensation or movement that feels different or "off," and is often described as a warning sign that a seizure is about to occur |
| give two reasons why it is important for someone with a seizure disorder to regularly see their care team (neurologist and pcp) | - make sure current medication is managing the disorder - make sure there are no new conditions requiring intervention - make sure no other pharm. intervention interferes with current med. regimen |
| parkinson's disease is characterized by a loss of which neurotransmitter | dopamine |
| name the 3 hallmark signs of parkinsons | - tumor - rigidity - bradykinesia |
| why is levadopa given to treat Parkinson's disease as opposed to dopamine | levadopa with cross blood brain barrier while dopamine dos not |
| what are the two types of strokes | ischemic strokes and hemorrhagic strokes |
| describe the difference between ischemic and hemorrhagic strokes (ischemic) | ischemic strokes are a disruption in blood flow to the brain as a result of a blocked blood vessel |
| describe the difference between ischemic and hemorrhagic strokes (hemorrhagic) | hemorrhagic strokes are a disruption in blood flow to the brain as a result of a ruptured blood vessel |
| what is a TIA | transient ischemic attack (TIA) are often referred to as a "mini stroke." - temporary disruption of blood flow as with an ischemic stroke usually do to atherosclerotic blockage in the main arteries feeding the brain - symptoms resolve in 24 hours |
| why are TIA's important | - should not be ignored as they serves as a warning sign - most people who experience a TIA will eventually experience a stroke |
| what type of strokes are tPA drugs used to treat | tPA druges are used to to treat ischemic strokes |
| how soon after the onset of a stroke must a tPA be administered | tPA must be administered within 3-4.5 hours after the onset of ischemic stroke symptoms |
| what are the goals of a cute treatment of a hemorrhagic stroke | control bleeding and decrease pressure on the brain tissue |
| list at least two factors that could contribute to depression | - inherited/familiar link - chemical imbalance - hormonal imbalance/change - stress/trauma leading to an altered HPA axis |
| a "nervous tick" is associated with what specific type of depression | depression with catatonic features |
| hypersomnia is associated with what specific type of depression | atypical depression |
| list the 4 diagnostic characteristics of insomnia | - difficulty initiating sleep - difficulty maintaining sleep - waking up too early - chronic nonrestorative/poor sleep (for a dx. a pt must have at least 3 of the above symptoms) |
| what is sleep hygiene | -the establishment of consistent sleep patterns -creating a "sleep friendly" environment - avoidance of excessive light before bed -avoidance of stimulants |
| what stage of sleep is impaired with a diagnosis of narcolepsy | REM sleep |
| what is central sleep apena | the brain does not properly signal the respiratory muscles (the muscles cease to function) |
| what is obstructive sleep apena | airway collapses but the respiratory muscles maintain their fuction |
| name at least 3 risk factors for obstructive sleep apnea | - male gender - advanced age - family history - drug/ETOH abuse - obesity - neck girth > 40 cm |
| two treatment options for moderate obstructive sleep apnea | - custom dental appliance - nasal/naso-oral continuous positive airway pressure (NCPAP) |
| how do custom dental appliances help with obstructive sleep apnea | - positions tongue forward and protrudes the mandible - can help maintain an open airway |
| how does a nasal/naso-oral continuous positive airway pressure (NCPAP) help with obstructive sleep apnea | - mask is placed over the nose/nose and mouth - the mask is connected to a machine that produces positive pressure - prevents airway from collapse |
| CNI (name and function) | - olfactory nerve - sense of smell |
| CNII (name and function) | - optic nerve - sight |
| CNIII (name and function) | - oculomotor nerve - pupillary constriction - accommodation - eye movement and lid movement |
| CNIV (name and function) | - trochlear nerve - movement of eye down and inward |
| trochlear nerve (function) | eye movement down and inward |
| trochlear nerve (number) | IV |
| oculomotor nerve (function) | -pupillary constriction -accommodation -eye movement -eye lid movement |
| oculomotor nerve (number) | III |
| optic nerve (function) | sight |
| optic nerve (number) | II |
| olfactory nerve (function) | smell |
| olfactory nerve (number) | I |
| CNV (name and function) | - trigeminal nerve - mastication (chewing) - sensation to the face, nose, and mouth |
| CNVI (name and function) | - abducens nerve - movement of the eye laterally |
| CNVII (name and function) | - facial nerve - expression - sense of taste (anterior tongue) |
| CNVIII (name and function) | - vestibulocochlear nerve - hearing - balance - equilibrium |
| vestibulocochlear nerve (function) | - hearing - balance - equilibrium |
| vestibulocochlear nerve (number) | VIII |
| facial nerve (function) | - expression - sensation of taste (anterior tongue) |
| facial nerve (number) | VII |
| abducens nerve (function) | movement of eye laterally |
| abducens nerve (number) | VI |
| trigeminal nerve (function) | - chewing - sensation to face, nose, and mouth |
| CNIX (name and function) | - glossopharyngeal nerve - innervates swallowing muscles - sensation of taste (posterior tongue) |
| CNX (name and function) | - vagus nerve - digestion - regulation of heart rate - sensation of digestive tract |
| CNXI (name and function) | - accessory nerve - motor nerve (cervical muscles and trapezius) |
| CNXII (name and function) | - hypoglossal nerve - voluntary tongue movements |
| glossopharyngeal nerve (function) | - motor (swallowing muscles) - sensation of taste (posterior tongue) |
| glossopharyngeal nerve (number) | IX |
| vagus nerve (function) | - digestion - regulation of heart rate - sensation to digestive tract |
| vagus nerve (number) | X |
| accessory nerve (function) | - motor (cervical rotator muscles and trapezius) |
| accessory nerve (number) | XI |
| hypoglossal nerve (function) | voluntary tongue movements |
| hypoglossal nerve (number) | XII |
| different divisions of PNS | - somatic nervous system (skeletal nerve muscles) - autonomic nervous system |
| different divisions of the autonomic nervous system | - sympathetic nervous system - parasympathetic nervous system |
| nonmodifiable risk factors for stroke | - age - gender - race - prior history of stroke - family history of stroke |
| how is age a risk factor for stroke | - incidence increase with age |
| how is sex a risk factor for stroke | - men have higher rate of incidence at younger ages - women are more likely to die of a stroke because they live longer than men on average |
| how is race a risk factor for a stroke | - AA and Hispanic/Latino have a higher mortality than Caucasian |
| modifiable disease factors for stroke | -hypertension -hypercholesteremia -diabetes -hypercoagulopathy - cardiac disease |
| modifiable risk factors for stroke | - smoking - alcohol consumption - birth control pills (especially in combination with smoking) - immobility - obesity - illicit drug use |
Created by:
kandriot
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