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Neuro Chapt 14, Sleep


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Equal amounts of energy are consumed during wakeful states and during sleep.
True or False
What are the 2 phases of sleep?
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?
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....
*mechanisms are complex and poorly understood.
While one is asleep they progress through REM and Non-REM sleep in predictable cycles.
True or False
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?
-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.
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?
-alteration in thyroid hormones
-sleep apnea
What diseases are affected by disease?
-broncial asthma
-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..
-dark adaptation
-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...
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
-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...
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
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...
What alterations would decrease accommodation?
-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?
What is hyperopia?
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?
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
This defict interfers with understanding speech, particularly high frequency, it is known as...
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
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?
-noise exposure
-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?
What are the four primary sensations of taste?
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?
-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....
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

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