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NEUROBIOLOGICAL BASES OF BEHAVIOR MODULE 1 RNSG 2213 PART I Anatomy and Physiology Review A & P Review Three Main Parts of the Brain 1. Forebrain: a. Cerebrum b. Diencephalon 2. Midbrain 3. Hindbrain or Brain Stem Cerebral cortex = Gray matter The Forebrain Cerebrum Consists of right and left hemispheres connected by the corpus callosum = deep band of nerve cell fibers 1. Each cerebral hemisphere is divided into four lobes: • Frontal lobes • Parietal lobes • Temporal lobes • Occipital lobes Lobes of the Cerebrum The Lobes of the Cerebrum: a Closer Look • Frontal Lobes – “The Executive” or decision maker; regulation of behavior, e.g. planning, adaptation to change, etc. • Reliant on other parts of the brain for data. • Prefrontal area relates to features of the personality, motivation & goal setting • Motor and Premotor areas: voluntary movement • Parietal Lobes – Perception, interpretation, touch, body perception Lobes of the Cerebrum, cont’d • Temporal Lobes – Hearing • Occipital Lobes – Vision The Forebrain: Cerebrum, cont’d Limbic System • “The Emotional Brain:” – Consists of many structures – Controls the “4 F’s”: Feeding, Fighting, Fleeing and Fornicating – Functions include Memory, Pleasure, Emotions, Motivation Functions of The Limbic System Other Functions of Limbic System • Olfactory Functions • Feeding Functions (We won’t study these, but consider the relationships between emotions, pleasure, smell, and food intake!) Some Important Structures Connecting to the Limbic System • Hypothalamus-activates & controls many body functions: endocrine, sleep, appetite, body temp. • Pineal Gland- role in sleep (secretes melatonin) and consciousness; exact function not known Important Structures Connecting to Limbic System, cont’d • Hippocampus-memory processing, and making of new memories • Amygdala-stores feelings relating to memories, i.e.: fear, anger, rage, love, happiness, etc. Structures Connecting to Limbic System cont’d • VTA (Ventral Tegmental Area) – “Pleasure pathway” or “Reward Center” – Contains many dopaminergic neurons that connect to sites in limbic system – seat of craving in addiction Important Structures Connecting to the Limbic System, cont’d • Basal Ganglia or Extrapyramidal System Regulate motor behavior, appropriate muscle tone and posture – Balances excitatory and inhibitory neurotransmitters. The Forebrain, cont’d Diencephalon – The diencephalon connects the cerebrum with the lower brain structures The Midbrain • Midbrain, or Mesencephalon --Responsible for visual, auditory, and balance reflexes. Substantia Nigra produces Dopamine in this area The Hindbrain • Brain Stem Pons: regulates respiration and muscle tone Medulla: reg. heart rate, blood pressure Cerebellum: muscle tone and coordination More (Hindbrain) Brainstem Structures • Reticular Formation- Integrates sensory input – Reticular Activating System-regulates alertness and ability to pay attention; allows us to fall asleep as well as wake up A & P: Systems • Autonomic Nervous System – Sympathetic: Dominates in stressful situations, prepares body for fight or flight – Parasympathic: Dominates when person is relaxed Neurons: A Review Nerve Tissue • CNS: neurons, composed of: – Cell body contains nucleus – Axon transmits message to next cell – Dendrites receive messages from cell Neurons: Review, cont’d Three classes of neurons in CNS • Afferent (sensory) • Efferent (motor) • Interneurons Neurons: Review, cont’d • Synapse: the contact point between two neurons. • Synaptic Cleft: space between neurons • Pre-synaptic neuron: area of axon where neurotransmitters are stored. • Postsynaptic neuron: area of dendrite where receptor sites are located. Neurotransmission (Physiology) • Neurotransmitters are released into the synaptic cleft (space) from the axon to the dendrite. (--Calcium ions facilitate NT release) • NTs bind with receptors on post-synaptic neuron (dendrite) and activate it • Then NT substance is either deactivated or returned to the axon (“reuptake”). • Nerve cells can release more than one type of neurotransmitter Pre-synaptic and postsynaptic neuron interchange Neurotransmission Across the Synapse Role of Neurotransmitters in Mental Health • Neurotransmitters – Play an important role in human emotions and behavior – Influence motor activity and hormone levels – Are the target for the mechanism of action for psychotropic medications Categories of Neurotransmitters Cholinergics • Acetylcholine (ACh): involved in sleep, arousal, movement, memory Categories of Neurotransmitters, cont’d MONOAMINES • Norepinephrine: affects mood, cognition, perception, locomotion, CV functioning, sleep and arousal • Dopamine: effects movement, coordination, emotions, voluntary judgment, and release of prolactin Monoamines, cont’d • Serotonin: effects sleep, arousal, libido, appetite, mood, aggression, pain perception, coordination, and judgment • Histamine (role not well understood): involved in the immune/inflammatory response appears to be involved in mood Categories of Neurotransmitters, cont’d • Amino Acids – Gamma Aminobutyric Acid (GABA) functions as an inhibitory neurotransmitter (“brain calmer”) • Neuropeptides: endorphins and enkephlins, modulate pain and reduce peristalsis. Also called “natural or endogenous opiates” Neuroendocrinology • Hypothalamus- the “master gland,” has direct control over the pituitary • Hormones: all of these affect health. Our main focus in this course = TSH, Melatonin, ACTH • Circadian Rhythms- implications in many mental illnesses: affect sleep cycles and regulate hormones which influence mood and emotions. Other Factors in Neurobiology • Genetics: research has shown that all major mental illness seem to have genetic markers. (Increases “risk for”) • Psychoimmunology: Normal immune responses are decreased with acute and chronic stress, grief, bereavement, and depression. PART 2 Neurobiology and Mental Illness Neurobiology and Mental Illness • Neuroanatomical Changes (examples) -Enlargement of ventricles: schizophrenia, alcoholism -Atrophy of hippocampus: trauma or severe stress in early life Which one is the schizophrenic brain? Neurobiology and Mental Illness, cont’d • Decreased Cerebral Blood Flow (Some examples) -In Prefrontal cortex: Schizophrenia -In Frontal lobe: Attention-Deficit Hyperactivity Disorder (ADHD) Which one is the schizophrenic brain? Cerebral blood flow (CBF) levels in middle cerebral artery of gray matter Source: Romanian Journal of Psychopharmacology, 2008 Neurobiology and Mental Illness, cont’d • Neurotransmitter Dysfunction Lack of availability or lack of secretion (Some examples) – Too much dopamine: Schizophrenia – Insufficient serotonin: Depression – Insufficient norepinephrine: Depression – Insufficient GABA: Anxiety disorders NB and MI, cont’d • Neuroendocrine Dysfunction (examples) -Altered Hypothalamic regulatory mechanisms: Anorexia Nervosa -Increased Hypothalamic-Pituitary-Adrenal Axis (HPA) activity causing elevated cortisol (stress hormone) levels: Caused by early life deprivation, trauma or stress -Thyroid dysfunction: (Hyper-)Anxiety, (Hypo-) Depression Implications for Nursing • Nature-Nurture dichotomy does not exist. Each affects the other. • Nurses need to take a holistic approach to mental health • Psychiatric/mental health nurses can not “just take care of the mind.” • Medical needs of mental health clients: Physical status, responses to drug effects, and diagnostic/ lab work need to be monitored.