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- Equal amounts of energy are consumed during wakeful states and during sleep.
True or False
- TRUE
- What are the 2 phases of sleep?
- -REM
-Non-REM
- Explain the 1st stage of Non-REM...
- -Stage 1= light sleep, slow eye movements, EEG alpha waves interspread with low frequency theta waves
- Explain the 2nd stage of Non-REM...
- -Stage 2= further slowing of the EEG with the presence of sleep spindles and slow eye movements.
- Explain the 3rd stage of Non-REM
- -Stage 3= low-frequency delta waves with occasional sleep spindles, no rapid eye movements
- Describe the 4th stage of Non-REM...
- Stage 4= Delta waves
- Where is the major sleep center?
- Hypothalamus
- How are PGD2 and adenosine significant with regards to sleep?
- PGD2 and adenosine are important endogenous sleep-promoting factors of the basal forebrain.
- How is Non-REM sleep initiated?
- By withdrawal of neurotransmitters from the reticular formation and by the inhibition of arousal mechanisms in the cerebral cortex.
- How does Non-REM sleep affect basal metabolism and vital signs, muscle tone and pupils?
- -basal metabolism is decreased by 10-15%
-Temperature is decreased by 0.5-1.0 C
-HR decreases by 10-30 beats
-RR, BP and muscle tone decrease
-pupils constrict
- What happens to cerebral blood flow during Non-REM stages 1-2?
- Blood flow to the brain stem and cerebellum is decreased
- What happens to cerebral blood flow during Non-REM stages 3-4?
- Blood flow to the cortex is decreased.
- At what stage of sleep is growth hormone released and levels of corticosteriods and catecholamines depressed?
- Stage 4
- What controls respiration during non-REM sleep?
- metabolic processes
- This state is characterized by desynchronized, low-voltage, fast activity that occurs every 90 minutes during Non-REM sleep.
- REM Sleep
- Why is REM sleep referred to as paradoxic sleep?
- Because EEG pattern is similar to an awake state.
- What are some characteristics of REM sleep?
- -bursts of conjugate rapid eye movement
-atonia of antigravity muscles (ex; tongue)
-loss of temperature regulation
-alteration in HR,BR,RR
-penile erection
-clitoral engorgement
-high rate of memorable dreams
- What happens to cerebral blood flow during REM?
- Increases in both hemisperes
- Where is REM sleep controlled and where is it generated?
- -Controlled by the pontine reticular formation
- Name some neurotransmitters associated with excitatory and inhibitory sleep mechanism....
- -Catecholamines
-acetylcholine
-serotonin
-histomine
-L-tryptophan
-prostagladins
-adenosine
*mechanisms are complex and poorly understood.
- While one is asleep they progress through REM and Non-REM sleep in predictable cycles.
True or False
- TRUE
- About how many cycles per night will an individual pass through?
- 4 to 5
- How does on progress throught the sleep cycles?
- -Stages 1 to 2 to 3 to 4 to 3 to 2 to REM sleep.
-New cycle begins at stage 2 unless awakened then they will start at stage 1.
- What is the purpose of Acetlecholine and somatostatin?
- They play a role in the transition of sleep stages.
- What is the purpose of sleep?
- UNKNOWN, Thought to be a restorative process because growth hormones peaks are associated with slow-wave sleep (Non-REM)
- How important is REM sleep?
- -Very important, people spend 1/3 of their lives sleeping.
-Loss of REM sleep impairs learning and memory
*we better get some sleep*
- Who requires more sleep newborns, young individuals or older individuals?
- -NEWBORNS
-Younger adults tolerate sleep deprivation better than older adults
-Older adults total sleep times are decreased and it takes longer for them to fall asleep.
- Inabiity to fall asleep and stay asleep.
- Insomnia
- What are some causes of short-term and long-term insomnia?
- -Short-term = related to crossing time zones or acute stress
-Long-term = drug or alcohol abuse, chronic pain disorders, chronic depression and certain medications
- This sleep disorder is characterized by loud snoring, decreased O2 sats, fragmented sleep, chronic daytime sleepiness and fatigue.
- Obstructive sleep apnea
- What are parasomnias?
- Unusual behaviors occurring during sleep including sleep walking, night terrors, rearranging furniture, eating food, violent behavior and enuresis.
- What are some common causes of secondary sleep disorders?
- -depression
-alteration in thyroid hormones
-pain
-sleep apnea
- What diseases are affected by disease?
- -CAD
-broncial asthma
-COPD
-diabetes
-duodenal ulcers
- When during the sleep cycle is CAD aggravated?
- REM, dreams provoke nocturnal angina
- When during the sleep cycle do asthmatics experience bronchole spasms?
- During REM
- Which population suffers from decreased O2 tension and increased CO2 tension during REM sleep?
- COPD patients
- What are possible problems for diabetes patients and patients with duodenal ulcers have during their sleeping cycles?
- -DM patients need to be careful due to glucose fluctations at night.
-People with duodenal ulcers have 2 to 20 times more gastric acid secretion during REM sleep.
- What is Blepharitis?
- Inflammation of eyelids
- What is a hordeolum (stye)?
- An infection of the sebaceous glands of the eyelids.
- What is a chalazion?
- A infection of the meibomian (oil-secreting)gland.
- What is Trachoma?
- Chlamydia trachomatis. Associated with poor hygiene and is the leading cause of preventable blindness
- What is strabismus?
- a deviation of one eye form the other caused by weakness or hypotonic muscle.
- What is amblyopia?
- reduction or dimness of vision for unknown reasons.
-associated with diseases such as DM, renal failure, malaria and substance abuse such as tobacco and alcohol
*most common cause of loss of vision in children
- What is diplopia?
- double vision
- What is nystagmus?
- an involuntary unilateral or bilateral rhythmic movement of the eyes.
- Describe pendular nystagmus.
- regular to and from movement of the eyes in which both phases of the movement are equal in length.
- Describe jerk nystagmus.
- one phase of eye movement is faster than the other.
- What are some causes of nystagmus?
- -imbalance in the normally coordinated feflex activity if the inner ear, vestibular nuclei, cerebellum, medial longitudinal fascicle or nuclei of the oculomotor trochlear and abducens cranial nerves.
-Drugs, retinal disease and diseases involving the cervical cord
- The ability to see objects in sharp detail is known as..
- Visual acuity
- Identify 8 causes for decreased visual acuity..
- -amblyopia
-scotoma
-cataracts
-papilledema
-dark adaptation
-glaucoma
-retinal detachment
-maculat degeneration
- What is scotoma?
- A defect in the field of vision.
- What is retrobulbar neuritis?
- -inflammatory lesion of the optic nerve frequently associated with multiple sclerosis
- A cloudy or opaque area in the ocular lens is known as...
- Cataract
- Why do cataract develop?
- due to alterations of metabolism and transport of nutrients within the lens.
- What are the manifestations of cataracts?
- -decreased acuity
-blurred vision
-glare
-decreased color perception
- What is the treatment of cataracts?
- removal of the entire lens and replacement with an artificial lens.
- Edema and inflammation of the optic nerve at the point of entrance into the eyeball is known as...
- papilledema
- What are 3 principle causes for papilledema?
- -increased intracranial pressure
-retrobulbar neuritis
-changes in the retinal blood flow
- Characterized by intraocular pressures above the normal pressures
- Glaucoma
- What are normal aqueous fluid pressures?
- 12 to 20
- Obstruction to outflow of aqueous humor at trabecular meshwork or schlemm canal, is a type of glaucoma known as....
- open-angle glaucoma
- Forward displacement of iris toward cornea with narrowing of iridocorneal angle and obstruction to outflow of aqueous humor from anterior chamber, is a type of glaucoma known as....
- narrow-angle glaucoma
- Acute closure of iridocorneal angle with a sudden rise in intraocular pressure producing nerve pain and visual disturbances, is a glaucoma known as....
- Acute angle closure glaucoma
- What is the treatment for glaucoma?
- -Eye drops to either reduce secretion or increase absorption of aqueous humor.
-surgery may be needed to open the spaces of trabeculae and reduce intraocular pressure
- A process whereby the thickness of the lens changes is known as...
- accommodation
- What alterations would decrease accommodation?
- -Pressure
-inflammation
-disease of oculomotor nerve
- What is presbyopia?
- -Loss of accommodation in older adults.
-Ocular lens become larger, firmer and less elastic.
- What is the major symptom of presbyopia?
- reduced near vision causing the individual to hold reading material at arm's length.
- What is myopia?
- Nearsightedness
- What is hyperopia?
- farsightedness
- What is hemianopia?
- describes defective vision in half of a visual field
- What is homonymous hemianopsia?
- -complete loss of vision in the inner half of one eye and the outer half of the other.
-caused by destruction of one optic tract
-for example: an injury of the left optic tract, blindness will occur in the right eye's inner firld and the left eye's outer field.
- Air filled sinuses that promote conductivity between the external and the middle ear
- mastoid air cells that are contained in the mastoid process.
- These transmit vibration of the tympanic membrane to the inner ear.
- -The ossicles bones, malleus, incus and stapes
- What two structures are connected by the eustachian tube?
- The middle ear and thorax
- What is the function of the eustachian tube?
- It opens briefly when a person swallows or yawns, it equalizes the pressure in the middle ear with atmospheric pressure
- What is perilymph?
- The fluid that fills the osseous labyrinth spaces in the inner ear
- What are the 3 divisons of the bony labyrinth?
- cochlea
vestibule
semicircular canals
- Where is the organ of Corti found?
- Within the cochlea
- What is the function of hair cells?
- hearing receptors
- Where do the hair cells transmit information to?
- They transmit impulses along the cochlear nerve ( a divison of the vestibulocochlear nerve)
- Where does sound interpretation take place?
- temporal lobe of the brain
- What kind of receptors are found in the semicircular canals and vestibule?
- equilibrium receptors
- What are otoliths and what are their function?
- Otoliths are small pieces of calcium salts that move in a gel-like material in response to changes in pulls on the hair cells in the maculae. This helps the body sense static equilibrium.
- hearing loss affects about one-third of older people.
True or False
- TRUE
- This defict interfers with understanding speech, particularly high frequency, it is known as...
- Presbycusis
- How is conductive hearing loss manifested?
- -Occurs when a change in outer or middle ear impairs sound from being conducted to the inner ear.
-Occurs when there is interference in air conduction
- What is paracusia willisiana?
- A condition where hearing is better in noisy places as compared to quiet places for those who suffer conductive hearing loss.
- A form or sensorineural hearing loss
- Presbycusis
- What causes sensorineural hearing loss?
- -Impairment of the organ of Corti or its central connections.
- What are some conditions that commonly cause sensorineural hearing loss?
- -congential
-hereditary
-noise exposure
-aging
-ototoxic drugs
-systemic disease
many more...
- What causes functional hearing loss?
- No organic reason, thought to be caused be emotional or psychological factors. Rare occurances.
- What are seven primary classes of olfactory stimulants?
- -camphoraceous
-musky
-floral
-peppermint
-ethereal
-pungent
-putrid
- What are the four primary sensations of taste?
- -sweet
-sour
-salty
-bitter
- What relationship creats a sensation of flavor?
- smell and taste
- What are some changes that occur in taste and smell with aging?
- -sensitivity to odors decline
due to loss of olfactory sensory neurons and loss of olfactory bulbs.
-decline in taste and difficulty differentiating between combinations of flavors.
-marked decrease in appetite has been noted with these changes
- What does hyposmia mean?
- impaired sense of smell
- What does anosmia mean?
- loss of smell
- What does Parosmia refer to?
- an abnormal sense of smell, may occur with severe depression
- What does hypogeusia mean?
- decreased taste sensation
- What does ageusa mean?
- absence of taste
- What does parageuaia mean?
- a perversion of taste in which has an unpleasant taste
- Where are sweet, sour and salt taste receptors located and which cranial nerve is involved?
- Receptors are located on the anterior portion of the tongue and the facial nerve is involved.
- Where are the bitterness taste receptors located and which cranial nerve is involved.
- Receptors are located at the base of the tongue and the glossopharyngeal nerve is responsible.
- What are meissner and pacinian corpuscles?
- rapidly adapting touch receptors
- What are merkel disks and ruffini endings?
- slow adapting touch receptors.
- Where are touch receptors most numerous?
- skin of fingers and lips
- Where are touch receptors most scarce?
- skin of the trunk
- Specific senory input is carried to the higher levels of the CNS by the.....
- dorsal column of the spinal cord and anterior spinothamic tract
- There is a increase in the size of pacinian corpuscles and a decreased in the number of corpuscles with advancing age.
True or false
- True, this causes a decrease in tactile stimulation with age.
- What are some causes for tactile dysfunction?
- -Trauma
-tumor
-infection
-metabolic changes
-vascular changes
-degenerative diseases
- What is tactile dysfunction?
- Either heightened or diminished tactile perceptions.
- What is vestibular nystagmus?
- A constant, involuntary movement of the eyeball caused by ear disturbances
- A sensation of spinning that occurs with inflammation of the semicircular canals in the ear is known as....
- vertigo
- Perception and awareness of the position of the body and its parts depend on....
- impulses from the inner ear and from the receptors in joints and ligaments
- What are two common causes of proprioceptive dysfunction.
- Vestibular dysfunction,neuropathy
- What is Meniere disease?
- A vestibular disorder that can cause proprioceptive dysfunction.
- Gait changes often occur with proprioceptive dysfunction.
True or False
- True
- Gait changes often occur with proprioceptive dysfunction.
True or False
- True