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NR 546 Exam 4 Flashcard
How does the orbitofrontal cortex (OFC) affect the amygdala? - inhibits and activates the amygdala Wernicke's area is associated with which of the following? - speech comprehension The limbic system is associated with which of the following - emotion and learning Which brain structure is most associated with long term memory? - hippocampus When prescribing psychotropic medications, the PMHNP knows that these medications work within which specific areas? - mood Which of the following are involved in regulating neurotransmission via excitation- secretion coupling? - voltage-sensitive sodium channels and voltage-sensitive calcium channels What system influences the length of time for a drug to achieve efficacy? - signal transduction cascades One of the signal transduction cascades, pass the message from a first receptor to a second messenger. - G protein linked systems Human central nervous system communication at synapses is which of the following? - chemical Which of the following is an excitatory neurotransmitter? - glutamate Which statement correctly pairs the pharmacodynamic effect with its definition? - antagonist effect - drug binds to receptor, but does not activate a response A major current hypothesis for the cause of schizophrenia proposes that N-methyl-d- aspartate (NMDA) receptors may be which of the following? Correct! - hypofunctional Which medication is least associated with weight gain? - aripiprazole Which dopamine pathway is associated with positive symptoms of schizophrenia? - mesolimbic pathway Which pathway is associated with negative symptoms? - The mesocortical pathway Is part of the extrapyramidal nervous system and associated with extrapyramidal symptoms (EPS) - nigrostriatal pathway This pathway is associated with hyperprolactinemia. - The tuberoinfundibular pathway
A 34-year old male recently began experiencing breast secretions while receiving risperidone. Which dopamine pathway is associated with this side effect? - tuberoinfundibular pathway A 44-year-old woman is initiated on an atypical antipsychotic for the treatment of schizophrenia. Regarding affinity, atypical antipsychotics demonstrate which of the following most often? - Atypical antipsychotics have equal positive symptom antipsychotic actions and low extrapyramidal symptoms. is a syndrome that can be associated with several different psychiatric disorders. Symptoms include hallucinations, delusions, disorganized speech, disorganized behavior, and distortions of reality. This syndrome can affect a person's cognition, affective response, communication, capacity to recognize reality, and ability to relate to others. - psychosis What Diagnosis require the presence of psychosis? - schizophrenia substance-induced psychotic disorders schizophreniform disorder schizoaffecive disorder delusional disorder brief psychotic disorder psychotic disorder due to a medical condition What diagnosis has a diagnosis of psychosis as a feature? - mania depression cognitive disorders dementia What are some positive symptoms? - Hallucinations Delusions Thought disorder Hostility Excitability What are some Negative symptoms? - Affective flattening Alogia Anhedonia Amotivation Asociality What area of the brain is associated with negative and affective symptoms? - Mesocortical and ventromedial prefrontal cortex: What area of the brain is associated with cognitive symptoms? - Dorsolateral What area of the brain is associated with aggressive, impulsive symptoms? - Orbitofrontal and connections to the amygdala Non-selectively blocks dopamine D2 receptors, specifically in mesolimbic pathway. Improves Positive Symptoms
This is involved in complex motor actions and linkage of cognition to motor actions. It is the main input area for the basal ganglia and is activated when anticipating or engaging in pleasure - Dorsal striatum This is involved in the reward circuit and reinforces addictive behaviors. - Nucleus accumbens This is associated with pleasure, reward, and reinforcing behavior. Drug abuse affects the limbic system, disrupting emotions and feelings associated with normal behavior. - Limbic system Associated with movement, intelligence, abstract thinking. etc. - Frontal lobe Associated with speech - Brocas area Involves object identification and auditory signals - Temporal lobe Involved in Coordination - cerebellum Involved in Speech comprehension - Wernicke's area Primary visual area - Occipital Lobe Keeps us alert to what is going on around us - Parietal lobe Involved in the reward process. - Nucleus accumbens Involved in sensory organ and motor command processing - thalamus Involved in complex motor actions, also links cognition to motor actions - Striatum This includes circuits that are associated with pleasure and reward, emotion and learning - LIMBIC SYSTEM A group of structures involved in voluntary motor movements - basal ganglia Controls the communication between the two brain hemispheres - Corpus callosum Contains nerve fibers that connect neurons from different regions into functional circuits - white matter enzyme system mediates how the body metabolizes many drugs, including antipsychotics. The enzyme in the gut wall or liver converts the drug into a biotransformed product in the bloodstream. After passing through the gut wall and liver (left), the drug will exist partly as unchanged drug and partly as biotransformed drug - CYP450 system Which medication classes increases serotonin? - SSRIs, Tricyclic, SNRIs
bind more potently to the 5HT 2A receptor than the D2. Sedation is common and relates to a high affinity for histamine. These medications have the least risk of EPS but a high risk for weight gain and metabolic abnormalities. - The "Pines" more potently to the 5HT 2A receptor than to D2 or bine equally between the 2 receptors. These medications are less sedating and cause less weight gain, but have a higher risk for hyperprolactinemia and EPS. - Two dones and a rone bind more potently to D2 receptors than to 5HT-2A. They have low risk of metabolic side effects and weight gain, but they have a potential for EPS. The rip binds equally to both D2 and 5HT-2A receptors. The medications has low risk for metabolic disorders. - 2 Pips and a Rip What medication has the highest risk for galactorrhea, due to hyperprolactinemia. - risperidone Include other symptoms such as disorganized speech, disorganized behavior, gross distortions of reality testing, and as diminished emotional expression and decreased motivation. - Negative symptoms If the functioning of this pathway is disrupted by lesions or drugs, prolactin levels can also rise. Elevated prolactin levels are associated with galactorrhea (breast secretions), gynecomastia (enlarged breasts especially in men), amenorrhea (loss of ovulation and menstrual periods), and possibly other problems such as sexual dysfunction. - tuberoinfundibular DA neurons Projects from the midbrain VTA but sends its axons to areas of the prefrontal cortex, where they may have a role in mediating cognitive symptoms (dorsolateral prefrontal cortex or DLPFC) and affective symptoms (ventromedial prefrontal cortex or VMPFC) of schizophrenia. - The mesocortical dopamine pathway which projects from the substantia nigra to the basal ganglia or striatum, is part of the extrapyramidal nervous system and controls motor function and movement. - Nigrostriatal dopamine pathway projects from the midbrain ventral tegmental area (VTA) to the nucleus accumbens, a part of the limbic system of the brain thought to be involved in many behaviors such as pleasurable sensations,the powerful euphoria of drugs of abuse, and delusions and hallucinations of psychosis. - mesolimbic dopamine pathway What are the three major hypotheses of pychosis? - The Dopamine theory, the Glutamate theory, and the serotonin theory. Treat both positive and negative signs of psychosis. They are considered serotonin- dopamine antagonists, as they maintain D2 antagonism but also have simultaneous serotonin 5HT2A antagonism. Serotonin (5HT) can regulate DA release directly or indirectly, producing various effects on dopamine (DA) neurons. 5HT1A and 5HT2A receptors have opposite actions on dopamine release.
too much can cause antsy, nervous, and affect your ability to focus - Norepinephrine one of the key neurotransmitters that psychotropic drugs target. Within the central nervous system, I affect arousal, motivation, attention, learning, and REM sleep. I work within the parasympathetic nervous system too. I can make you sweat and salivate. - acetylcholine Substances that block me can paralyze you because I am the link between the brain and muscles. When there's not enough of me, I can be involved in Alzheimer's and Parkinson's disease. Increase me, and I can help with symptoms, but be cautious, because I also have a role in addiction. Dr. Stahl refers to me as "the brain's own nicotine" when he talks about my role in addiction. - acetylcholine I help to regulate mood. I've been called the "happy hormone," but actually I am not a hormone at all; I am a monoamine neurotransmitter. Your body synthesizes me naturally from tryptophan. I help to regulate sleep, arousal, libido, aggression, and pain perception. - serotonin ( 5HT ) I am one of the key monamine neurotransmitters that regulate mood. I am associated with executive function, your ability to perform well, be organized, and all those good things including emotional intelligence. That's when I'm working hard in the prefrontal cortex. I'm also essential to your movement and coordination. Being balanced is very important to me; too much or too little can cause problems. - Dopamine When my levels are low you'll lose pleasure, interest, alertness, and even self- confidence. Low levels are also found in clients who have Parkinson's disease. - Dopamine Too much of me is not always a good thing. I can lead to the hallucinations you see in schizophrenia and psychosis. Another thing, do you know that great feeling you get when you win something? That's me, at work in your reward center. - Dopamine Some people have trouble with me because my reward properties can lead to all types of addictions. - Dopamine amino acid and THE excitatory neurotransmitter. I've been referred to as the workhorse of the brain because I can affect almost every neuron in the brain. I'm quite the firecracker. You'll find me working hard all over the brain affecting energy, memory, learning, and neural plasticity. I also work to relay sensory information and regulate spinal and motor reflexes. - glutamate When my levels are too high, I've been associated with schizophrenia, epilepsy, and mania. - glutamate In depression is acetylcholine increased or decrease? - Increased In depression is norepinephrine increased or decreased? - Decreased
In depression is histamine increased or decreased? - Decreased In depression is glutamate increased or decreased? - Decreased This is located deep in the temporal lobes and is involved in anxiety and memory, and shifting short-term to long-term memory - Hippocampus This structured is impaired in schizophrenia and dementia - Hipocampus This is associated with pleasure, reward, and reinforcing behavior. Drug abuse affects this system, disrupting emotions and feelings associated with normal behavior. - Limbic system This is located deep in the temporal lobes and involved in emotional regulation and perception of odors. All smells travel directly to this. Cooking smells can elicit memories of childhood events and holidays. A traumatic event can result in the formation of the fear response, causing the fight or flight reflex within the autonomic nervous system and affects the hypothalamic-pituitary-adrenal (HPA) axis causing the release of stress hormones (e.g. cortisol). Also is involved in the interpretation of facial expressions and sexual stimuli. - Amygdala This is involved in the reward circuit and reinforces addictive behaviors. - Nucleus Accumbens A group of structures involved in voluntary motor movements, cognition, and emotion. movement disorders include Parkinson's disease, obsessive-compulsive disorder (OCD), and Tourette syndrome. The striatum is a group of structures that includes the caudate, putamen, and nucleus accumbens. The dorsal striatum contains the caudate nucleus and the putamen. The ventral striatum contains the nucleus accumbens. Both are involved in facilitating voluntary movement. - Basal Ganglia This is an egg-shaped structure involved in sensory organ and motor command processing. All sensory systems except for the olfaction process through this, which is responsible for processing all external information. Has been associated with symptoms related to schizophrenia and post-traumatic stress disorder (PTSD). - thalamus This is involved in complex motor actions and linkage of cognition to motor actions. It is the main input area for the basal ganglia and is activated when anticipating or engaging in pleasure. - Dorsal Striatum This controls the communication between the two brain hemispheres. Is involved in attention, impulse control, and emotion regulation. It integrates impulses from both sides of the brain. Persons with an underdeveloped or missing _____ may have intellectual impairment. - The corpus callosum Is located on the sides of the brain and involved in short-term memory, speech, auditory signals, and smell recognition. It identifies "what" things are - object identification. It contains the limbic system, amygdala, and hippocampus. There are
when there's not enough of me, I can be involved in Alzheimer's and Parkinson's disease. Increase me, and I can help with symptoms, but be cautious, because I also have a role in addiction. Dr. Stahl refers to me as "the brain's own nicotine" when he talks about my role in addiction. I've got lots of receptor friends; my best friends are nicotinic and muscarinic receptors. - Acetylcholine I help to regulate mood. I've been called the "happy hormone," but actually I am not a hormone at all; I am a monoamine neurotransmitter. Your body synthesizes me naturally from tryptophan. You know that amino acid in turkey that makes you content and happy after a big turkey meal? That's me, helping you to feel relaxed, comfortable, and less stressed. I help to regulate sleep, arousal, libido, aggression, and pain perception too! That's how I work in medications too. - Serotonin one of the key monamine neurotransmitters that regulate mood. First of all, I am associated with executive function, your ability to perform well, be organized, and all those good things including emotional intelligence. That's when I'm working hard in the prefrontal cortex. I'm also essential to your movement and coordination. Being balanced is very important to me; too much or too little can cause problems. When my levels are low you'll lose pleasure, interest, alertness, and even self-confidence. Low levels are also found in clients who have Parkinson's disease. Too much of me is not always a good thing. I can lead to the hallucinations you see in schizophrenia and psychosis. - Dopamine I've been referred to as the workhorse of the brain because I can affect almost every neuron in the brain. I'm quite the firecracker. You'll find me working hard all over the brain affecting energy, memory, learning, and neural plasticity. I also work to relay sensory information and regulate spinal and motor reflexes. When my levels are too high, I've been associated with schizophrenia, epilepsy, and mania. My receptors, NMDA and AMPA, work with me across many regions of the brain. I can really make things happen. - Glutamate
