ANCC Chapter 5

a nerve cell; the basic building block of the nervous system

receive and conduct electrical impulses from one part of the body to another

The largest part of a typical neuron; contains the nucleus and much of the cytoplasm. AKA soma.

The long nerve fiber that conducts away from the cell body of the neuron to connect with other neurons and cells. AKA stem

branchlike structures that receive messages from other neurons and send the signal toward the cell body

• Central and peripheral nervous systems.
• Extensive networka of specialized cells that carries information to and from all parts of the body

Brain and spinal cord

The nervous system outside the brain and spinal cord; the sensory and motor neurons that connect the central nervous system to the rest of the body

Somatic and Automatic nervous system

Voluntary division of the peripheral nervous system that controls the body's skeletal muscles

Sympathetic and Parasympathetic

Regulates "involuntary activity" in the heart, stomach, and intestines to maintain homeostasis.

Fight or flight, prepares body for stress, stimulates or increases activity of organs.

Rest and Digest, the division of the autonomic nervous system that calms the body, conserving its energy

Grey or white matter

nerve cell bodies and dendrites; the working area of the brain that contains synapses and is the area of neuronal activity.

the myelinated axons of neurons

anatomical landmarks or reference points. It also increases brain surface area to expand working area and communication area

size and depth

SHALLOW grooves or furrows in the cerebral hemispheres.

Deep grooves in the brain

The largest part of the brain which is divided into 2 halves (right and left cerebral hemispheres).

Elevated ridges of tissue in the cerebral hemispheres.

cerebrum and brainstem

Dominant in most people, controls most right-sided body functions.

Controls the left side of the body; creative, intuitive, spacial

The largest bundle of white matter (axons) connecting th two cerebral hemispheres.

four major lobes which work in an integrated and interactive mannerand with discint function

frontal, parietal, occipital, temporal

Part of the brain associated with motor control, coordination, reasoning, decision making, impulse control, language, personality, and long-term memory storage.

personality changes, emotional and intellectual changes

Frontal lobe function that coordinates muscle movement for complex, learned sequential motor activities

Frontal lobe function that allows for multimodal sensory input to trigger memory and decision making

Frontal lobe function of working memory, reasoning, planning, prioritizing, sequencing behavior, insight, flexibility, judgment, impulse control, behavioral cueing, intelligence, abstraction.

Language area in the prefrontal cortex that helps to control speech expression

A region of the cerebral cortex responsible for hearing, memory, emoion, integration of vision with sensory information, and language (Wernicke's area),

part of the temporal lobe involved in receiving and understanding speech

visual or auditory hallucinations, aphasia, amnesia

visual processing

visual field defects, blindness, visual hallucinations

A region of the cerebral cortex whose functions include processing information about touch, taste, reading and writing

visual field defects, blindness, visual hallucinations

cerebral cortex, limbic system, thalamus, hypothalamus, and basal ganglia

The convoluted outer layer of the cerebrum.

Controls contralateral (opposite) side of body, sensory information is relayed from thalamus, processed and integrated ino cortex. Responsible for much of the behavior that makes us human: speech, cognition, judgment, perception, and motor function

Essential for regulation of emotions and memory

Hypothalamus, thalamus, hippocampus, amygdala, basal ganglia

limbic system component that regulates hunger, body temperature, libido, hormonal regulation, water balance, circadian rhythms.

limbic system component that acts as relay station for all senses except smell, modulates flow of sensory information to prevent overwheming cortex, regulates emotion and memory

a neural center that is located in the limbic system; helps convert short-term memory into long-term memory

A limbic system structure involved in memory and emotion, particularly fear and aggression.

limbic system component that is responsible for coordination of motor movement and learning automatic actions such as walking or driving a car. Also known as corpus striatum.

bradykinesia, hyperkinesia, and dystonia

basal ganglia

• Connects the cerebrum to the spinal cord - made up of cells that produce neurotransmitters.
• Midbrain, pons, medulla oblongata, cerebellum.

Houses the ventral tegmental area and substantia nigra (areas of dopamine synthesis)

Houses the locus ceruleus (area of norepinephrine synthesis).

The part of the brainstem that links the medulla oblongata and the thalamus.

midbrain structure where dopamine is produced; involved in control of movement

area of norepinephrine synthesis

Base of brainstem; controls heartbeat and breathing. Part of the brain nearest the spinal cord

A large structure of the hindbrain that maintains equilibrium and gross motor skills. Each hemisphere has ipsolateral control (same side of body)

ataxia

Used to evaluate cerebellar function and balance. Tell the client to close eyes and stand upright with feet together --see if they sway

Structure in the brain stem that maintains alertness and consciousness. The primitive brain. Receives input from cortex and innervates thalamus, hypothalamus and cortex.

involuntary movement, reflex, muscle tone, VS control, b/p, RR. Critical to ability to mentally focus.

glia and neurons

Form the myelin sheath - cells located in the nervous system to nourish and protect neurons

a specialized cell transmitting nerve impulses; a nerve cell.

cell body, dendrites, axon

AKA the "cell body" of the neuron, responsible for maintaining the life of the cell, contains nucleus and cytoplasm within cell membrane

Branchlike parts of a neuron that are specialized to receive information.

A threadlike extension of a neuron that carries nerve impulses AWAY from the cell body.

The narrow gap that separates the presynaptic neuron from the postsynaptic cell. It converts an electrical signal (action potential) from presynaptic neuron into a chemical signal (neuron transmitter) that is transferred to the postsynaptic neuron.

an electrical activity (action potential)

depolarization and repolarization

State in which the polarity of the neuron is reversed as sodium and calcium ions rush into the cell. Excitatory response.

Period during which potassium ions diffuse out of the cell or chloride eners the cell. Inhibitory response.

• Depolarization
• Involves OPENING of sodium and calcium channels with these ions going INTO the cell

Repolarization. Occurs when a neuron's firing rate decreases due to inhibition from another neuron.

Chemicals synthesized from dietary substrates that carry signals from one cell/neuron to another

a surface on which an organism grows or is attached, the material or substance on which an enzyme acts

specialized proteins that speed up chemical reactions

symptoms commonly seen in mental health disorders

monoamines, amino acids, cholinergic, neuropeptides

"Biogenic -amines": dopamine, epinephrine, norepinephrine and serotonin. (biogenic=produced by living things)

produced by living things

• 1. present in nerve terminal
• 2. stimulation of neuron must cause sufficient release of neurotransmitter to cause action to occur at post synaptic membrane
• 3. Effects of exogenous transmitter on post-synaptic membrane must be similar to those caused by stimulation of presynaptic neuron
• 4. A mechanism for inactivation or metabolism of the neurotransmitter must exist in the area of the synapse.
• 5. Exogenous drugs should alter the dose-response curve of the neurotransmitter in a manner similar to naturally occuring synaptic potential.

end of the axon from which neurotransmitter molecules are released, also called the synaptic bouton

externally caused rather than produced within an organism or system

a neurotransmitter that regulates motor behavior, motivation, pleasure, and emotional arousal

Neurotransmitter secreted by the adrenal medulla glands in response to stress - also known as adrenergic system. A catecholaminer

aka catecholamines - produced in the locus cereus of the pons. Precurser is tyrosine, it is removed from synaptic cleft and returned to storage by reuptake. Implicated in mood, anxiety and concentration disorders.

a neurotransmitter, known as an indole, that serves as the precursor to tryptophan and is removed from the synaptic cleft and returned to storage via an active reuptake process. Impicated in mood and anxiety disorders. Produced in the raphe nuclei of brainstem.

Produces Hormones: Epinephrine, Corticosteroids, and Norepinephrine

a class of amines that includes the neurotransmitters dopamine, norepinephrine, and epinephrine, all which have similar chemical structures

the inner part of the adrenal gland that secretes adrenalin

outer section of each adrenal gland; secretes cortisol, aldosterone, and sex hormones

a particular chemical structure found in serotonin (and LSD).

nuclei located in the pons that participate in the regulation of sleep and arousal - serotonin is produced here

an amino acid supplement commonly used for depression, obesity, insomnia, headaches and fibromyalgia. Increases risk of serotonin syndrome if taken with SSRI, MAOI, or St. Johns wort. Serotonin is precurser to tryptophan.

• SSRI or MAOI induced
• autonomic instability
• hyperthermia
• seizures
• coma or death

Abbreviation for serotonin. Serotonin is formed by hydroxylation and decarboxylation of tryptophan.

compounds containing amino groups

organic compounds containing amine and carboxyl functional groups, along with a side chain specific to each amino acid. long chains of amino acid are also called proteins. GLUTAMINE ASPARTATE GABA GLYCINE

nitrogen atom bonded to 2 hydrogen atoms- NH2

excitatory neurotransmitter - works with glutamine

A universal inhibitory neurotransmitter in the brain. Site of action of BZDs, alcohol, barbituates, and other CNS depressants.

an inhibitory neurotransmitter, works with GABA

The most common neurotransmitter in the brain. Excitatory. Involved in memory, excitatory neurotransmitter, oversupply causes migraines or seizures

below the voice box; regulates body metabolism and causes storage of calcium in bones

Cells in the nervous system that support, nourish, and protect neurons

stimulates parasympathetic nervous system:

A neurotransmitter that enables learning and memory and also triggers muscle contraction

Brain chemicals, such as enkephalins, dynorphins and endorphins, that regulate the activity of neurons. Decreased amount of neuropeptides is thought to cause substance abuse

occurs inside terminal cytosol or synapse - the neurotransmitter can be destroyed by the enzymes monoamine oxidase (MAO) in the cortisol or catechol-O-methyl transferase (COMT) intracellularly or in the synapse

diffuse off its receptor to be destroyed by enzymes OR transported back to presynaptic neuron for reuse.

intracellular fluid portion of the cytoplasm

• Decrease = Alzheimers, impaired memory
• Increase = Parkinsonian symptoms

• Decrease = substance abuse, anhedonia, Parkinson's
• Increase = Schizophrenia, psychosis

• Decrease = depression
• Increase = Anxiety

Decrease = depression, OCD, anxiety, schizophrenia

• Decrease: memory and learning difficulty, negative symptoms of schizophrenia
• Increase = Bipolar affective disorder, psychosis from ischemic neurotoxicity, or excessive pruning

Decrease = anxiety disorders

Decrease = substance abuse

can remove neurotransmitter from acting in synapse (reloads into synaptic neuron to be recycled)

• D1, D2
• thinking, decision making, reward seeking behavior, fine muscle action, integrated cognition.

• a1, a2:
• alertness, focused attention, orientation, primes "Fight or flight", learning, memory

• 5HT1a, 5HTId, 5Ht2, 5HT2a, 5HT3:
• regulation of sleep
• pain perception
• mood states
• temperature
• regulation of aggression,
• precursor for melatonin
• libido

• Nicotinic and Muscarinic:
• attention, memory, thirst, mood regulation, REM sleep, sexual behavior, muscle tone

• GABAa and GABAb:
• reduces arousal reduces agression, reduces anxiety, reduces excitation

• AMPA and MNDA:
• memory, sustained autonomic functions

• mu - kappa - epsilon - delta - sigma
• modulates emotions, reward function center, consolodation of memory, modulates reactions to stress

Mild: improved creativity, abstract thinking, executive function, and spatiality

Severe: Disorganized thinking, loose associations, tics, stereotypic behaviors

Mild: poor impulse control, poor spatiality, lack of abstract thought.

Severe: Parkinson's, endocrine alterations, movement disorders

Dullness, low energy, depressive affect

Anxiety, hyper-alertness, increased startle, paranoia, decreased appetite

Irritability, hostility, depression, sleep dysregulation, loss of appetite, loss of libido

Sedation, increased aggression, and rare hallucinations

Lack of inhibition, decreased memory, euphoria, antisocial action, speech decrease, dry mouth, blurred vision, constipation

Over-inhibition, anxiety, depression, somatic complaints, self-consciousness, drooling, extrapyramidal movements

Irritability, hostility, tension, worry, anxiety, seizure activity

Reduces cellular exciteability, sedation, impaired memory

Poor memory, low energy, distractible

Kindling (stir up emotions), seizures, anxiety/panic

Hypersensitivity to pain and stress, decreased pleasure sensation, dysphoria

Insensitivity to pain, catatonic-like movement disturbance, auditory hallucinations, decreased memory

1. Structural imaging (CT)

2. Magnetic Resonance Imaging (MRI)

• 3. Functional Imaging:
• EEG and evoked potentials test
• MEG: magnetoencephalography - similar to EEG but detects different electrical activities
• SPECT: single photon emission computed tomography
• PET: positron emission tomography

4. Combined structural and functional imaging: functional MRI, 3D event related functional MRI, flourine magnetic spectroscopy, dopamine D2 receptor binding

Technique that provides a series of 2D images.

Advantages: can view brain structur close to the skull and can separate white matter from grey matter, readily avaiable, resolution of brain tissue is superior to CT scanning.

Disadvantages: expensive, multiple contradictions (pacemaker, metal implants, ventilator, claustraphobia)

Measures function of areas of the brain through assessment of blood flow. EEG, MEG, SPECT, PET. Mainly used for research.

Positron emission tomography that provides a visual display of brain activity. Expensive, requires extensive resources and support team

Single photon emission tomography - provides info on cerebral flow, limited availability, expensive

the branch of genetics that studies organisms in terms of their genomes (their full DNA sequences) to determine genetic disorders in families

gender, marital status, adoption, twins, pregnancy, conditions, consanguinity (relatives having children, common ancestry)

50% (ex. Marfan syndrome)

Hyperflexible joints, arachnodactyly, aortic dissection, lens dislocation

A genetic trait that lacks the ability to manifest itself when a dominant gene is present, appears onl in one generation

are caused by faulty genes on an X chromosome (fragile X syndrome, color blindness)

A process of communication that deals with the occurrence or risk of a genetic disorder in a family

structures of DNA (deoxyribonucleic acid) in the nucleus of cells that carry genetic information. There are normally 23 pairs (46 total) in humans.

A complex molecule containing the genetic information that makes up the chromosomes. It is made up of 2 twisted, paired strands, composed of sugars linked by 4 nucleotide bases - adenine (A), thymine (T), cystocine (C) and guanine (G) specifying the amino acids that make proteins. A is always paired with T and G is always paired with C.

sequence of DNA that codes for a protein and thus determines a trait

mRNA that transports information from DNA in the nucleus to the cell's cytoplasm, codes for an amino acid

In 2003 an international collaborative effort mapped and sequenced the DNA of the entire human genome. The genome is a complete set of DNA.

An organism's appearance or other detectable characteristic (i.e. fast metabolizer of CYP4502D6 medications)

genetic variability

The process of inserting normal genes into human cells to correct genetic disorders

Family studies that investigate the occurrence of disorders in 1st degree relatives (parents, siblings, offspring and 2nd degree relatives (grandparent, aunts, uncles, cousins)

compare concordance rates (presence) of a disorder in a monozygotic (identical) and dizygotic (fraternal) twins

analysis of how traits vary in individuals raised apart from their biological relatives

40-90%

prenatal insults, stress, infections, poor nutrition, town exposure, catasrophic loss, physical and sexual abuse

environmental and genetic factors; single gene disorders are rare

variations of DNA sequence by a single nucleotide

disease in person at genetic risk

the cellular level

the study of genetically determined variations in the response to drugs

gene variants that may help determine dosing of medications

anticonvulsant carbamazepine due to risk of Stevens-Johnson Syndrome and toxic epidermal necrolysis (TEN)

one of the alternative forms of a gene that governs a characteristic, such as hair color

Severe form of Steven-Johnson Syndrome with over 30% body surface involved

• -Life threatening
• -Skin: blistering, rash, detachment of epidermis
• -Meds that can cause: carbamazepine, lamotragine

Specific receptors found on the dendrites of post-synaptic neurons that bind glutamate