349 chapter 6 prep u notes

pons

The pons helps regulate respiration

A nurse is teaching family members about the brain's connection to behaviors commonly seen in mental illnesses. How can the nurse best explain the term "neurotransmitter" to the family?

A molecular substance released in the brain. Neurotransmitters are small molecules that play a key role in synaptic transmission. They are chemicals stored in the neuron and released as neural messengers when stimulated by an electrical impulse. They are involved with functions that affect human emotions and behavior. Neurotransmitters are the target for drugs used to treat mental illnesses. They are stored in the axon terminal of the presynaptic neuron. A neurotransmitter is not a hormone that is stored in a gland or a location in the brain, nor is it a nerve. 67

A nurse is reviewing the function of the sympathetic nervous system and how the body responds to sympathetic stimulation. The nurse demonstrates understanding of the information by identifying which event as a sympathetic response of the lungs?

A sympathetic response of the lungs includes relaxation of bronchial muscles. The parasympathetic response of the lungs includes bronchoconstriction and secretion from the bronchial glands. Dilation of blood vessels is a parasympathetic response. 63

The nurse is educating the client and family members regarding schizophrenia. The nurse explains to them that schizophrenia is associated with an abnormality of which structure of the cerebrum?

Abnormalities in the frontal lobes are associated with schizophrenia, attention deficit hyperactivity disorder (ADHD), and dementia. The parietal lobes interpret sensations of taste and touch and assist in spatial orientation. The temporal lobes are centers for the senses of smell and hearing and for memory and emotional expression. The occipital lobe assists in coordinating language generation and visual interpretation, such as depth perception.

A client suffers from low mood and disturbed sleep. This client is most likely experiencing a change in which neurotransmitter?

Abnormalities of serotonin are involved in mental depression and sleep disorders. Calcitonin is a hormone produced by the thyroid gland. Melatonin is a peptide hormone not a neurotransmitter. Parathyroid is a gland that secretes parathyroid hormone. 70

Which is the primary cholinergic neurotransmitter found in greatest concentration in the peripheral nervous system?

Acetylcholine is the primary cholinergic neurotransmitter. Dopamine is an excitatory neurotransmitter found in distinct regions of the central nervous system and is involved in cognition, motor, and neuroendocrine functions. Norepinephrine is an excitatory neurochemical that plays a major role in generating and maintaining mood states. Serotonin plays a role in emotions, cognition, sensory perceptions, and essential biologic functions. 67

A client taking an antipsychotic is exhibiting manifestations of neuroleptic malignant syndrome (NMS). Which area of the brain is involved with the increased temperature noted with NMS?

Body temperature is regulated by the hypothalamus. The thalamus functions as a regulatory structure to relay all sensory information, except smell, sent to the central and peripheral nervous systems. The amygdala is directly connected to more primitive centers of the brain involving the sense of smell. The hippocampus is involved in storing information, especially the emotions attached to memories. 61-62

A client is brought to the emergency department with reports of slurred speech, spasms, and jerky movements. The significant other shows the nurse a pill bottle and states that the client has been taking antipsychotic medications for "awhile". The nurse notices that an "improper dose" is ordered on the prescription bottle. How would the nurse explain what system is causing the movements?

Dysfunction of the extrapyramidal motor track can manifest serious neurologic symptoms including dystonia, pseudoparkinsonism, and akathisia" The extrapyramidal system is a bundle of nerve fibers connecting the thalamus to the basal ganglia and cerebral cortex. Muscle tone, common reflexes, and automatic voluntary motor functioning are controlled by this nerve track. Dysfunction of this motor track can manifest serious neurologic symptoms including dystonia, pseudoparkinsonism, and akathisia. The term pyramidal tracts refers to upper motor neurons that originate in the cerebral cortex and terminate in the spinal cord (corticospinal) or brainstem (corticobulbar). Pyramidal signs basically mean plantar extension and hyperreflexia. The role of the primary motor cortex is to generate neural impulses that control the execution of movement. You can end up paralyzed on the opposite side of the lesion (so damage the left side means paralysis on the right side), fully paralyzed, or difficulty to learn and select the right movement for the action you want. The corticospinal tract is a descending tract of the spinal cord which contains bundles of axons which originate in the cerebral cortex and descend to synapse within the brainstem or spinal cord. If fibers of the corticospinal tracts are damaged anywhere along their course from the cerebral cortex to the lower end of the spinal cord, this will give rise to an upper motor neuron syndrome. A few days after the injury to the upper motor neurons, a pattern of motor signs and symptoms appears, including spasticity, hyperactive reflexes, a loss of the ability to perform fine movements, and an extensor plantar response known as the Babinski sign. Symptoms generally occur alongside other sensory problems. Causes of damage may include masses such as strokes, subdural hemorrhage, abscesses and tumors, inflammation such as meningitis and multiple sclerosis, and trauma to the spinal cord, including from slipped discs. 62

Which neuropeptide suppresses pain and modulates mood and stress?

Endogenous opioids, such as endorphins and enkephalins, suppress pain and modulate mood and stress. Melatonin helps regulate the sleep-wake cycle. Substance P is involved in pain transmission, movement, and mood regulation, especially sensory neurons associated with pain perception. Cholecystokinin is the primary intestinal hormone involved in satiety. 71

Which of the following is an inhibitory neurotransmitter?

GABA is an inhibitory neurotransmitter that controls sleep and wakefulness, temperature regulation, and regulation of emotions. Dopamine, norepinephrine, and epinephrine are excitatory neurotransmitters.

The nurse is teaching the client with anxiety about the mechanisms of benzodiazepines. Which is increased with this medication?

GABA is the major inhibitory neurotransmitter in the brain and has been found to modulate other neurotransmitter systems rather than to provide a direct stimulus. Dopamine, norepinephrine, and epinephrine are excitatory neurotransmitters. 71

A client brings a spouse to the mental health clinic with reports that the spouse has been exhibiting a tendency to self-mutilate, experiences fits of intense rage, and is increasingly aggressive toward others. How should the nurse elaborate on the type of symptoms this client is demonstrating?

Lack of serotonin in the body produces symptoms such as aggression, hostility, and compulsiveness." Explanation: Serotonin plays a role in emotions, cognition, sensory perceptions, and essential biologic functions such as sleep and appetite. Serotonin also controls food intake, irritability, sleep and wakefulness, compulsiveness, temperature regulation, pain control, sexual behaviors, and regulation of emotions. Norepinephrine, histamine, and dopamine are not correct. Lack of norepinephrine may lead to conditions such as attention deficit hyperactivity disorder, depression, and hypotension. Lack of histamine means dopamine levels will be elevated and this may result in anxiety, paranoia, being suspicious, and hallucinations. Lack of dopamine may lead to imbalance difficulties, speech problems, and postural changes. 70

Which functions are controlled by the extrapyramidal motor system? Select all that apply.

Muscle tone, common reflexes, and automatic voluntary motor functioning, such as walking, are controlled by this nerve track. Memory and vision are not affected by the extrapyramidal motor system. 62

The physician orders a neurotransmitter for a client who has difficulty in regulating some chemicals in the brain. The nurse knows which is a neuromodulator?

Neuropeptides are neuromodulators. Glutamate and dopamine are excitatory neurotransmitters. GABA is an inhibitory neurotransmitter 66

Sensory deprivation in infancy and childhood can adversely affect brain development. Which characteristic of the brain is involved in this process

Neuroplasticity is the brain's ability to develop and alter in response to experiences with various stimuli. Reactive plasticity and adaptive plasticity are two basic phenomena involved in neuroplasticity, both of which depend on a structural change in neurons. 65

Neurotransmitters are small molecules that exert their actions through specific proteins, called receptors, embedded in the postsynaptic membrane. Where are neurotransmitters synthesized?

Norepinephrine is made by the nerve cells using tyrosine, obtained in the diet. Dihydroxyphenylalanine (dopa) is produced by a nerve, using tyrosine from the diet and other chemicals. With the help of the enzyme dopa decarboxylase, the dopa is converted to dopamine, which in turn is converted to norepinephrine in the axon terminals of adrenergic cells. The norepinephrine then is stored in granules or storage vesicles within the cell. 13-14

A client with Parkinson's disease is hospitalized on a medical unit. The nurse would be correct in identifying which neurotransmitter decreased in this disease?

Parkinson's disease develops from decreased availability of dopamine, while acetylcholine binding to muscle cells is impaired in myasthenia gravis. Therefore acetylcholine, neurontin, and serotonin are incorrect. 69

After attending an anatomy and physiology review class on the nervous system, a group of nurses demonstrate understanding of the information when the group identifies which function as associated with the thalamus?

Sometimes called the "relay-switching center of the brain," the thalamus functions as a regulatory structure to relay all sensory information, except smell, sent to the CNS from the PNS. From the thalamus, the sensory information is relayed mostly to the cerebral cortex. The thalamus relays and regulates by filtering incoming information and determining what to pass on or not pass on to the cortex. In this fashion, the thalamus prevents the cortex from becoming overloaded with sensory stimulus. It is not responsible for voluntary movement, adjusting body temperature and heart rate, or maintaining red blood cell production. 61

The brain stem consists of which structure?

The brain stem consists of the midbrain, pons, and medulla 62

The client has difficulty with motor coordination and walks with an unsteady gait. Of the following brain structures, which is most likely affected in the client's brain?

The cerebellum controls and guides movements, as well as maintains muscle tone. The cerebrum is composed of the frontal, parietal, occipital, and temporal regions and contributes to intellectual function, including learning, judgment, reasoning, and memory. The medulla oblongata controls respiration, gastrointestinal motility, and circulation. The hippocampus is part of the limbic system. 62-63

A client is having difficulty standing without assistance and is exhibiting swaying. The client has a history of falls. Which area of the brain is most likely affected?

The cerebellum regulates postural balance and positioning. The hypothalamus regulates temperature. The thalamus functions as a regulatory structure to relay all sensory information, except smell, sent to the central nervous system from the peripheral nervous system. The hippocampus is involved in storing information, especially the emotions attached to memories. 62-63

A client is experiencing acute stress leading to the stimulation of increased gastric acid. In this situation, which body system uses acetylcholine as a neurotransmitter?

The cholinergic system uses acetylcholine as a neurotransmitter. The dopaminergic system uses dopamine as its neurotransmitter. The GABA-ergic system uses GABA as its neurotransmitter. The noradrenergic system uses norepinephrine as its neurotransmitter. 67

The hypothalamus affects the body primarily through which action?

The diencephalon consists of the thalamus, hypothalamus, and pineal gland. The hypothalamus maintains homeostasis and controls the autonomic nervous system and the pituitary gland

A client diagnosed with a stroke is exhibiting expressive aphasia. Which area in the frontal lobe is responsible for the motor function of speech?

The frontal lobe contains Broca's area, which controls the motor function of speech. Damage to Broca's area produces expressive aphasia, or difficulty with the motor movements of speech. Wernicke's area is primarily responsible for receptive speech. The basal ganglia are involved with motor functions and association in both the learning and the programming of behavior or activities that are repetitive and, when done over time, become automatic. Basic emotions, needs, drives, and instinct begin and are modulated in the limbic system. 59

A client is returning from military service and has been diagnosed with post-traumatic stress disorder (PTSD). Dysfunction in which brain structure contributes to the rage and fear experienced in PTSD?

The hypothalamus is a part of the limbic system, which is sometimes called the emotional brain. The hypothalamus is involved in impulsive behavior associated with feelings of anger, rage, or excitement. The pons connects the cerebellum and the brainstem. The basal ganglia initiates motor function. The corpus callosum is the pathway that connects the two hemispheres of the brain.

The nurse is working with a client that has not been diagnosed yet. The client is aggressive, unable to control anger, and violent at times. The client was brought to the emergency deparment by local police. The nurse selects what system as the etiology for the clients' behavior? Classify the symptoms according to origin in the body

The limbic system that includes the thalamus, hypothalamus, hippocampus, and amygdala. The thalamus regulates activity, sensation, and emotion. The hypothalamus is involved in temperature regulation, appetite control, endocrine function, sexual drive, and impulsive behavior associated with feelings of anger, rage, or excitement. Not only does the limbic system function as the seat of emotions, but the limbic system also is involved with aspects of memory. The endocrine system is the collection of glands that produce hormones that regulate metabolism, growth and development, tissue function, sexual function, reproduction, sleep, and mood. The endocrine system influences how the heart beats, how bones and tissues grow, even the ability to make a baby. It plays a vital role in the development of diabetes, thyroid disease, growth disorders, sexual dysfunction, and a host of other hormone-related disorders. The human circulatory system functions to transport blood and oxygen from the lungs to the various tissues of the body. The heart pumps the blood throughout the body. The lymphatic system is an extension of the human circulatory system that includes cell-mediated and antibody-mediated immune systems. Common diseases of the cardiovascular system include: coronary artery disease, stroke, hypertension, and heart failure. The peripheral nervous system includes all of the nerves that branch out from the brain and spinal cord and extend to other parts of the body including muscles and organs. The three major forms of nerve damage are: peripheral neuropathy, autonomic neuropathy, and mono-neuropathy. The most common form is peripheral neuropathy, which mainly affects the feet and legs. Sciatica is pain, tingling, or numbness produced by an irritation of the sciatic nerve.

A client is brought to the emergency room following a motor vehicle accident in which he sustained head trauma. The client is complaining of blindness in the left eye. The nurse would be correct in documenting this abnormal finding as corresponding to which of the following cerebral lobes?

The posterior (occipital) lobe of the cerebral hemisphere is responsible for visual interpretation. The temporal lobe contains the auditory receptive areas. The parietal lobe contains the primary sensory cortex, and is essential to an individual's awareness of the body in space, as well as orientation in space and spatial relations. The frontal lobe functions in concentration, abstract thought, information storage or memory, and motor function. 60

The function of the thalamus and the hypothalamus is to coordinate:

The thalamus and hypothalamus coordinate internal and external responses and direct information into the cerebral cortex. 61-62

Concordance rates for schizophrenia in monozygotic twins are only 50%. Which statement best explains this phenomenon?

While human genes play an enormous role in certain pathologies, the pathophysiology of psychiatric disorders, like all disorders, depends on a complex interaction of genetic factors and environmental factors. These genetic and environmental factors also affect the brain's development and subsequent function. 73

brain stem

connects the cerebrum and diencephalon with the spinal cord

In which way do neurons communicate through the use of synapses?

electrochemically

diencephalon

homeostasis and controls the autonomic nervous system and the pituitary gland

The cerebellum coordinates

voluntary muscles and maintains balance and muscle tone