Autonomic Nervous System and Brain Function 1

1. Review: the parasympathetic system is all about what? Conserving energy, digesting, metabolism, and rest 2. The sympathetic nervous system primarily serves to protect an individual by doing which of the following? (select all that apply) A. Decreasing mucous production B. Increasing blood sugar levels C. Increasing body temperature D. Decreasing sweat excretion E. Increasing blood pressure Increases blood sugar levels, increases body temperature, and increases blood pressure In general, sympathetic stimulation promotes responses that are concerned with the protection of the individual, which include increasing glucose, body temp, and BP. 3. Review: the sympathetic system is all about what? It’s all about mobilizing energy stores, for instance glucose to muscles, decreased release of insulin, redirects blood supply from the gut to the muscles, heart, and lungs. 4. Which characteristic is the most critical index of nervous system dysfunction? Level of consciousness LOC is the most critical clinical index of nervous system function or dysfunction. An alteration in consciousness indicates either improvement or deterioration of a person’s condition. 5. Thought and goal-oriented behaviors are functions of which area of the brain? Prefrontal lobe The prefrontal area is responsible for goal-oriented behavior such as the ability to concentrate, short-term or recall memory, and the elaboration of thought and inhibition on the limbic (emotional) areas of the CNS. 6. Where is the region responsible for the motor aspects? Broca area in the frontal lobe Broca speech area is the only region responsible for the motor aspects of speech. 7. Parkinson and Huntington diseases are associated with defects in which area of the brain? Basal ganglia 8. Maintenance of a constant internal environment and the implementation of behavioral patterns are main functions of which area of the brain? Hypothalamus Hypothalamic function falls into 2 major areas: 1) maintenance of a constant internal environment, and 2) implementation of behavioral patterns. 9. What parts of the brain mediate the expression of affect, both emotional and behavioral states? Limbic system and prefrontal cortex 10. Reflex activities concerned with heart rate, blood pressure, respirations, sneezing, swallowing, and coughing are controlled by which area of the brain? Medulla oblongata The medulla oblongata makes up the myelencephalon and is the lowest portion of the brainstem. 11. Which area of the brain assumes the responsibility for conscious and unconscious muscle synergy and for maintaining balance and posture? Cerebellum 12. The brain receives approximately what percentage of the cardiac output? 20% or 800 to 1000 ml of blood flow per minute 13. What evidence does the nurse expect to see when a patient experiences trauma to the hypothalamus? (select all that apply) A. Uneven expression of mood B. Unstable blood glucose levels C. Poor regulation of body temperature D. Visual disturbances such as blurred vision E. N/V and symptoms of gastroesophageal reflux disease Uneven expression of mood, unstable blood glucose levels, and poor temp regulation The hypothalamus forms the base of the diencephalon. Hypothalamic function controls autonomic nervous system function, regulation of body temp, endocrine function (glucose levels), and regulation of emotional expression. 14. What is the first defense of our bodies? Skin and mucous membranes 15. Which action is the purpose of the inflammatory process? To prevent infection of the injured tissue If the epithelial barrier is damaged, then a highly efÏcient local and system response (inflammation) is mobilized to limit the extent of damage, to protect against infection, and to initiate the repair of damaged tissue. 16. What are the 4 cardinal signs of infection? Edema (tumor), warmth (calor), redness (rubor), and pain (dolar). There is a 5th sign known as loss of function (functio laesa) but Dr. Wunderlich did not mention this. 17. Which type of white blood cell is first to arrive at the site of infection? Leukocytes 18. What causes the edema that occurs during the inflammatory process? Increased capillary permeability The increased flow and capillary permeability result in a leakage of plasma from the vessels, causing swelling in the surrounding tissue and is solely responsible for inflammation-induced edema. 19. What process causes heat and redness to occur during the inflammatory process? Vasodilation of blood vessels The increased blood flow, as a result of vasodilation and increasing concentration of red cells at the site of inflammation cause locally increased warmth and redness. 20. The chemotactic factor affects the inflammatory process by? Directing leukocytes to the inflamed area Two chemotactic factors, neutrophil chemotactic factor (NCF) and eosinophil chemotactic factor of anaphylaxis (ECF-A), are released during mast cell degranulation. NCF attracts neutrophils (a type of leukocytes), and ECF-A attracts eosinophils to the site of inflammation. 21. What is pain mediated by? Histamines, bradykinins, leukotrienes, and prostaglandins 22. The function of opsonization related to the complement cascade is to: Tag the pathogenic microorganisms for destruction by neutrophils and macrophages. C3b adheres to the surface of a pathogenic microorganism and serves as an efÏcient opsonin. Opsonins are molecules that tag microorganisms for destruction by cells of the inflammatory system, primarily neutrophils and macrophages. 23. During phagocytosis what is occurring during the step referred to as opsonization? Phagocytes recognize and adhere to the bacteria During phagocytosis, opsonization involes only the recognition and adherence of phagocytes to bacteria. 24. What is the correct sequence of phagocytosis? Recognition (opsonization), engulfment, fusion, and destruction Once the phagocytic cell enters the inflammatory site, the only correct sequence of phagocytosis involves opsonization or recognition of the target and adherence of the phagocyte to it, engulfment, or ingestion or endocytosis, and the formation of phagosome, fusion with lysosomal granules within the phagocyte and destruction of the target. 25. Which manifestations of inflammation is systemic? Fever and leukocytosis The only primary systemic changes associated with the acute inflammatory response are fever, leukocytosis (a transient increase in circulating leukocytes), and increased levels in circulating plasma proteins. 26. The acute inflammatory response is characterized by fever that is produced by the hypothalamus being affected by? Endogenous pyrogens Fever-causing cytokines are known as endogenous pyrogens. 27. When considering white blood cell differentials, acute inflammatory reactions are related to elevations of which leukocyte? A. Monocytes B. Eosinophils C. Neutrophils D. Basophils Neutrophils Only neutrophils are the predominant phagocytes in the early inflammatory site, arriving within 6-12 hours after the initial injury, they ingest (phagocytose) bacteria, dead cells, and cellular debris at the inflammatory site. 28. What occurs during the process of repair after tissue damage? Nonfunctioning scar tissue replaces the destroyed tissue Repair is the replacement of destroyed tissue with scar tissue. Scar tissue is primarily made up of collagen, which fills in the lesion and restores tensile strength but cannot carry out the physiologic functions of the destroyed tissue. 29. When cellular damage occurs and regeneration is minor with no significant complications, the process of returning the cells to pre-injury function is referred to as: Resolution If damage is minor with no complications and destroyed tissues are capable of regeneration, then returning the injured tissues to an approximation of their original structure and physiologic function is possible. This restoration is called resolution. 30. The role of fibroblasts during the reconstructive phase of wound healing is to? Synthesize and secrete collagen and the connective tissue proteins. Fibroblasts are the most important cells during the reconstructive phase of wound healing because they synthesize and secrete collagen and other connective tissue proteins. Macrophage-derived transforming growth factor-beta (TGF-Beta) stimulates fibroblasts. 31. Some older adults have impaired inflammation and wound healing because of which problems? Underlying chronic illness(es) exists In some cases, impaired healing is not directly associated with aging, in general, but can instead be linked to a chronic illness such as cardiovascular disease or diabetes mellitus. 32. Which cell is the body’s primary defense against parasite invasion? Eosinophils Eosinophils serve as the body’s primary defense against parasites. 33. Normal bacterial flora found in the intestines produce vitamin K to assist in the absorption of which of the following? (select all that apply)  Calcium  Fatty acids  Large polysaccharides  Iron  Magnesium Calcium, iron, and magnesium The flora’s production of vitamin K is needed to absorb various ions, such as calcium, iron, and magnesium. 34. An individual’s acquired-immunity is dependent on the function of which cells? (select all that apply)  T lymphocytes  B lymphocytes  Macrophages  Opsonins  Neutrophils T lymphocytes, B lymphocytes, and macrophages These cells along with dendritic cells are involved in acquired-immunity. 35. Which type of immunity is produced by an individual after either natural exposure to the antigen or after immunization against the antigen? Active-acquired immunity An individual produces active-acquired immunity (active immunity) after natural exposure to an antigen or after immunization, whereas passive-acquired immunity (passive immunity) does not involve the host’s immune response at all. The innate immune system, also known as nonspecific immune system and the first line of defense, is composed of the cells and mechanisms that defend the host from infection by other organisms in a nonspecific manner, which means that the cells of the innate system recognize and respond to pathogens in a generic way 36. What is the role of a natural killer (NK) cells? Elimination of malignant cells The main function of NK cells is to recognize and eliminate cells infected with viruses, although they are also somewhat effective at eliminating other abnormal host cells, specifically cancer cells. 37. What type of immunity is produced when an immunoglobulin crosses the placenta? Passive-acquired immunity Passive-acquired immunity (passive immunity) does not involve the host’s immune response at all. Rather, passive immunity occurs when preformed antibodies or T lymphocytes are transferred from a donor to the recipient. This transfer can occur naturally, as in the passage of maternal antibodies across the placenta to the fetus, or artificially, as in a clinic using immunotherapy for a specific disease. 38. When antigens are administered to produce immunity, why are different routes of administration considered? Each route stimulates a different lymphocyte-containing tissue, resulting in different types of cellular and humoral immunity. Each route preferentially stimulates a different set of lymphocyte-containing (lymphoid) tissues and therefore results in the induction of different types of cell-mediated or humoral immune responses. 39. Which immunoglobulin is present in blood, saliva, breast milk, and respiratory secretions? IgA IgA can be divided into two subclasses, IgA1 and IgA2. IgA1 molecules are predominately found in the blood, whereas IgA2 is the predominant class of antibody found in normal body secretions. 40. Which antibody initially indicates a typical primary immune response? IgM Typically, IgM is produced first (primary immune response), followed by IgG against the same antigen. 41. An individual is more susceptible to infections of mucous membranes when he or she has a seriously low level of which immunoglobulin antibody? IgA The IgA molecules found in bodily secretions are dimers anchored together through a Jchain and secretory piece. This secretory piece is attached to the IgA antibodies inside the mucosal epithelial cells and may function to protect these immunoglobulin antibodies against degradation by enzymes also found in the secretions, thus decreasing the risk of infections in the mucous membrane. 42. Which is an example of an endogenous antigen? Cancer cells 43. When a person is exposed to most antigens, antibodies can be usually detected in his or her circulation within? 6 days After only approximately 5-7 days is an IgM antibody specific for that antigen detected in the circulation. 44. Vaccinations are able to provide protection against certain microorganisms because of the? Level of protection provided by IgG IgG production is considerably increased, making it the predominant antibody class of the secondary response. IgG is often present in concentrations several times larger than those of IgM, and levels of circulating IgG specific for that antigen may remain elevated for an extended period of time. 45. How does the aging process of the T-cell activity affect older adults? Tendency to develop various infections T-cell activity is deficient in older adults, and a shift in the balance of T-cell subsets is observed. These changes may result in increased susceptibility to infection. 46. A hypersensitivity reaction that produces an allergic response is called? Anaphylaxis Examples of systemic anaphylaxis are allergic reactions to bee stings, peanuts, and fish. 47. The common hay fever allergy is expressed through a reaction that is mediate by which class of immunoglobins? IgE Type I reactions are mediated by antigen-specific IgE and the products of tissue mast cells. The most common allergies (pollen allergies) are type I reactions. In addition, most type I reactions occur against environmental antigens and are therefore allergic. 48. Which type of antibody is involved in type I hypersensitivity reaction? IgE 49. Blood transfusion reactions are an example of? Alloimmunity Only alloimmunity (also termed isoimmunity) occurs when the immune system of one individual produces an immunologic reaction against tissues of another individual. 50. What is the mechanism that results in type II hypersensitivity reactions? Antibodies bind to the antigens on the cell surface The mechanism that results in a type II hypersensitivity reaction begins with antibody binding to tissue-specific antigens or antigens that have attached to particular tissues. The cell can be destroyed by antibody IgG or IgM and activation of the complement cascade through the classical pathway. 51. When mismatched blood is administered causing an ABO incompatibility the erythrocytes are destroyed by? Complement-mediated cell lysis Erythrocytes are destroyed by complement-mediated lysis in individuals with automimmune hemolytic anemia or as a result of an alloimmune reaction to ABO mismatched transfused blood cells. 52. When antibodies are formed against red blood cell antigens of the Rh system, the blood cells are destroyed by? Phagocytosis in the spleen Antibodies against platelet-specific antigens or against red blood cell antigens of the Rh system coat those cells at low density, resulting in their preferential removal by phagocytosis in the spleen, rather than by complement-mediated lysis. 53. How are target cells destroyed in a type II hypersensitivity reaction? Natural killer cells The mechanism that results in a type II hypersensitivity reaction involves a subpopulation of cytotoxic cells that are not antigen specific (natural killer [NK] cells). Antibody on the target cell is recognized by Fc receptors on the NK cells, which releases toxic substances that destroy the target cell. 54. Graves disease (hyperthyroidism) is an example of which type II hypersensitivity reaction? Modulation 55. Graves disease is a result of? Autoantibodies binding to thyroid-stimulating hormone (TSH)-receptor sites 56. Type III hypersensitivity reactions are a result of which action? Antibodies binding to soluble antigens that were released into body fluids and the immune complexes being deposited in the tissues. Antigen-antibody (immune) complexes that are formed in the circulation and then deposited later in vessel walls or extravascular tissues cause most type III hypersensitivity diseases. 57. Reyaud phenomenon is an example of which type of hypersensitivity? Type III Raynaud phenomenon is a condition caused by the temperature-dependent deposition of immune complexes in the capillary beds of the peripheral circulation.