phlt 304 exam 2

addiction

compulsive and seemingly pleasurable activity linked to brain reward

• hard to overcome despite adverse outcomes

• drugs, alcohol, nicotine, gambling, food, risky behavior, social media

substance use disorders

considered a disorder when recurrent use results in functional or clinical impairment

• commonality: potentially activating the brain’s reward pathway so intensely that normal activities are neglected, or clinical impairment

• behavior addictions

• DMS-5 identifies over 50 addictive disorders

midbrain reward pathway***

addictive agents bind to specific receptors or transporters in the brain and activate the midbrain reward pathway

• morphine and heroin bind to opiate receptors and produce dopamine release

• cocaine binds to dopamine receptors and blocks the removal of dopamine so it accumulates

• nicotine binds to nicotinic receptors, increases dopamine levels

common effect of addictive agents

artificially enhance the rewards pathway by increasing amount of dopamine (neurotransmitter)

• presynaptic is sending, post synaptic is receiving

THC (delta-9-tetrahydrocannabinol)

responsible for main psychosis-like effects of marijuana

• can activate receptors in the brain and change communication in the brain, altering emotions

• reduces the amount of inhibitory neuro transmitter BAGA, increasing the release of dopamine ***

cannabidiol (CBD)

works against effects of THC, antipsychotic proteins in humans

• high level of THC and low levels of CBD is associated with increased risk of psychotic disorder

Marijuana

approximately 1 in 10 teenagers who start smoking marijuana before 18 become addicted

• 1 in 6 people become addicted

health effects of marijuana

high THC low CBD is bad for you

• don’t know all the consequences of exposing the brain (esp developing brain) to high concentrations of THC

• associated to depression, anxiety and suicide in teens

opioids

class of drugs that includes heroin, synthetic opioids (fentanyl) pain relievers such as oxycodone and hydrocodone

tolerance

reduced response to the same dose of a drug, a person who develops tolerance may use increasing doses to gain same effect

policies to address opioid use disorder

prioritize use of non-addictive pain relievers

• insurance should provide long-term care under 90 days

• cover medication-assisted treatment (MAT (much more effective than abstinence, only at preventing deadly relapses

xylazine (tranq)

not approved for human use and may be mixed within illicit fentanyl

• blue or grayish skin, losing consciousness, unresponsive, reduced or slow breathing, slow heart rate, low blood pressure, necrotic skin ulcer

• non treatable with narcan

• non FDA-approved xylazine overdose medication

somatic nervous system

controls voluntary muscle actions and receives sensory input

autonomic nervous system

controls glands and involuntary muscles

• ex) cardiac muscle

sensory (afferent) neurons

carry impulses from receptors to CNS

efferent neurons

carry impulses from CNS to effectors

individual neurons carry impulses…

only in one direction

dendrites

extensions that transmit electrical impulses towards the cell body (pointy part)

axon

extension of the cell that transmits impulses away from cell body

ex) to an effector cell of muscle or to another neuron

myelin sheath

speeds up impulse transmission

• multiple sclerosis comes from a problem with this

oligodendrocyte

produce the segments of the myelin sheath to electrically insulate neurons

action potential

nervous system impulse transmission, impulses only go one way in a specific neuron

• individual neuron can transmit hundreds of action potentials per second

• myelin sheath increases velocity of action potential

parkinson’s disease

physical brain disorder, 50-80% also experience dementia

alzheimer’s

memory loss and cognitive difficulty

multiple sclerosis

affects CNS

• destroys CNS cells that forms myelin

• plaques of scar tissue are formed that don’t function like myelin, deterioration of myelin sheath and damage and death of axons

• plaques of scar tissue are formed that don’t function like myelin, deterioration of myelin sheath and damage and death of axons

  • symptoms include muscle weakness or paralysis, numbness

  • no cure

    • risk factors: epstein-barr virus infection

    • VItamin D deficiency

parkinson’s disease

nerve cells that release neurotransmitter dopamine are lost

onset age 60, worsens over time

• symptoms include tremor, rigidity, extreme slowness of movement, impaired balance, swallowing and speaking difficulties

epilepsy

broad term for rain disorder that causes seizures (short change in normal brain activity)

• stroke, brain tumor, traumatic brain injury, central neurosynaptic infection

• not contagious

  • 10% of people will have seizure during their lives

  • over 500 genes are associated with epilepsy

tetanus (lockjaw)

occurs due to exposure to spores of bacterium Clostridium Tetani (soil)

• strong muscle contractions

bacterial meningitis

bacteria on college campuses: N. meningitidis

• acute onset fever, headache, neck stiffness, confusing, seizures

aging information

changes in global demographics, adults ages 65+ are now estimated to outnumber children under the age of 5

caregiving

caregivers are subjected to mental health disorders

neurodegenerative diseases

incurable debilitating conditions caused by progressive degeneration of nerve cells

ataxia

movement problems

trouble walking, speaking, swallowing, hand coordiation

MS, stroke, thyroid problem, head trauma, excess exposure to lead, mercury, paint thinner, medications

dementias

impaired mental function

not a specific disease, refers to “impaired ability to remember, think, or make decisions that interfere with doing everyday activities” -CDC

• vascular dementia, alzheimer’s disease, lewy body dementia, Parkinson’s disease

vascular dementia

results from injuries toblood vessels that provide blood to brain

mixed dementia

combination of two or more types of dementia occurring in one person, for example alzheimer’s and vascular dementia

alzheimer’s disease is the

6th leading cause of the death in the US

• loss of brain tissue

• modifiable risk factors: depression, diabetes, head trauma, alcoholism, hypertension, obesity

primary prevention for alzheimer’s

stay active, healthy balanced diet, engage the brain, manage blood pressure

secondary prevention for alzheimer’s

diagnosis, check for underlying relatable conditions, awareness, patient and caregiver support

mental health

a state of well-being in which an individual

• realized his or her own abilities

• can cope with the normal stresses of life

• can work productively

• is able to contribute to his or her own community

mental illness

mental, behavioral or emotional disorder, with impact ranging from no impairment to severe impairment

• impairment can include disruption of a person’s thinking, feeling, mood, and/or ability to relate to others and daily functioning

• over 50% of people in the US will be diagnosed with a mental health problem in their lifetime

• 20% of Americans experience mental health problems

• 1 in 25 Americans live with a serious mental illness (schizophrenia or major depression)

risk factors for mental health disorders

• early life trauma

• loneliness or social isolation

• alcohol or drugs

• experiences related to ongoing chronic medical issues

• biological factors or chemical imbalances in the brain

categories of mental health disorders

• neurodevelopmental

• schizophrenia and psychotic

• bipolar

• anxiety

• OCD

• trauma

• eating/feeding

• substance addiction

  • higher rates of mental health in 18-25 and biracial people

generalized anxiety disorder

persistent anxiety or dread

difficulty controlling worry

difficulty concentrating

multiple symptoms including difficulty sleeping

panic disorder

recurrent, unexpected panic attacks with sudden, intense fear

• heart palpitations

• increased heart rate

• sweating

• trembling

• chest pain

• feeling of lack of control

  • significantly interfere with quality of life

risk for anxiety disorders

history of anxiety

exposure to stressful and difficult events

childhood shyness

can worsen your thyroid and heart problems

• caffeine effects

depressive disorders

caused by a combination of genetic, biological, environmental, and psychological factors

can happen at any age

risk factors: personal or family history of this, major life changes, certain physical illness

symptoms include:

• persistent sad, anxious, or empty “mood”

• feelings of hopelessness or pessimism

• irritability

• guilt, worthless

• lack of concentration, sleep, appetite

• suicide and bodily problems

post traumatic stress disorder (ptsd)

develop after shocking, frightening, or dangerous event

• lasts more than a month, sever enough to interfere with functioning in relationships or work

• may become chronic but treatments exist

autism spectrum disorders

problem with social communication and interactions

repetitive behaviors, limited interests

• produces behavior and communication problems

• appears by age 2

risk factors for autism spectrum disorders

siblings born with autism

born to older parents

mother took valproic acid or thalidomide during pregnancy

genetic or chromosomal conditions (fragile x syndrome)

• not effected by vaccines

schizophrenia

persistent and severe

onset age late 20s to early 30s

.25% to .64% prevalence in the US

treatable but don’t receive care********

genetic factors for increased risk

15th of leading causes of disabilities globally

symptoms include:

• hallucinations

• delusions

• unusual ways of thinking

• abnormal body movements

• reduced emotional expression and motivation

• difficulty socially and attention

suicide

important cause of death in US ages 10-34

suicide ideation: contemplating suicide ******

study design, studies don’t include

• people with no fixed address

• military

• prison

• sped disorders

biology of mental illness

some disorders show structural/functional abnormalities in brain (schizophrenia, autism, bipolar disorder)

• some disorders run in families (major depression)

emotional wellness

ability to successfully handle life’s stresses and adapt to change and difficult times

6 strategies for improving emotional health

• build resilience

• reduce stress

• be mindful

• get quality sleep

• cope with loss

• strengthen social connections

how many calories do adults need daily

approx 1,800 to 3,000

macronutrients

carbohydrates, lipids, proteins

carbohydrates

sugar, starches, bulk of your energy

lipids

fats, waxes, oils (butter, lard liquid cooking oils) most energy (calories) per gram, 9 kcal

• better option is monoUNsaturated fats (liquid at room temp) (kinky)

• worse option is saturated and trans fat

proteins

humans need 9 essential amino acids from food (found in beans, nuts, meat, seafood)

• amino acids combine to form proteins

micronutrients

vitamins: water and fat soluble

• fat soluble (KADE) must be eaten with dietary fat in order to be absorbed

minerals (inorganic elements)

minerals

major (need a decent amount): potassium, calcium, magnesium

trace (need very small amounts from food, too much can be harmful): iron, iodine, zinc

• minerals serve for structural purpose (calcium in bones)

• component of enzymes

• help maintain osmotic gradients that are needed for fluid balance in body

fiber

make half your grains whole

• soluble fiber: lowers cholesterol

• insoluble fiber: good for bowels (no effect on cholesterol)

salt

present in processed foods and cured meats

we may eat more than we should

• use iodized salts, helps prevent iron deficiencies and thyroid problems

dietary guildelines

needs to includes whole fruits and vegetables, avoid juices

whole grain foods whenever possible

• limit alcohol, salt, highly processed or preserved foods

diet diversity****

important to eat a large variety of healthy food to get all the nutrients you need, more fruits and vegetables!

• 1.5-2cups of fruit

• 2-3 cups of vegetables per day

  • 2 cups of raw leafy greens = 1 cup

national health and nutrition examination survey (NHANES)

primary source of data on american diet

• americans tend to exceed daily recommendations for calories, added, sugars, saturated fats, refined grains, products, salt

• tend to not meet recommedations for fruits, vegetables, whole grains, dietary fibers, calcium, vitamin D

fortification

adding nutrients into foods that were taken away during process

• health successes with food fortification in USA: vitamin D in milk, reduced rickets, folic acid in grains, substantial reduction in neutral birth defects

  • whole foods remain better than fortified ones

guidelines for food health

eat vegetables that are red, dark green, and orange

• darker colors: more phytochemically dense

why is nutrition so important?

keep you healthy and prevent chronic diseases like

• CVD/CHD (hypertension and atherosclerosis)

• diabetes mellitus (type 2)

• cancer

food, your microbiome, and the gut-brain axis

• gut-brain axis: bidirectional communication between the gut and the central nervous system

exercise and health

guidelines for children and adolescents

• ages 3-5: be active throughout day, variety of activity types

• ages 6-17, minimum 60 mins per day, at least moderate physical activity

Importance of exercise

skeletal muscles release cytokines and myokines into the blood muscle contractions, which reduces inflammation

• excess visceral adipose tissue (VAT) triggers inflammation, but exercise produces loss of VAT= less inflammation

Body Mass Index (BMI)

a person’s weight in kilograms divided by the square of height in meters

chronic inflammation

process by which the immune system recognizes and removes harmful stimuli to start healing, but lasts for several months to years and is detrimental

• can exist without obvious symptoms

  • obesity

  • physical inactivity

  • diet

  • dysbiosis: messed up microbiome

  • isolation and chronic stress

  • disturbed sleep

  • xenobiotics

    • signs of chronic inflammation include pain, chronic fatigue and insomnia, depression and anxiety

soluble fiber

lowers cholesterol

insoluble fiber

good for bowels (no effect on cholesterol)

how much fruit a day

1.5-2 cups

how many vegetables per day

2-3 cups

• 2 cups of raw leafy greens: 1 cup

trace minerals

need very small amounts from food,

too much can be harmful: iron, iodine, zinc

major minerals

need a decent amount: potassium, calcium, magnesium

natural selection

process that results in the survival and reproductive success of individuals or groups best adjusted to their environment, and that leads to the perpetuation of genetic qualities best suited to that particular environment

kin selection

self-sacrificial behavior that improves reproductive success of genetic relatives

• grandmother taking care of kids

• creches (bird daycare)

social support improves…

survival and reproductive success

physiological mechanisms promote…

social interaction

hypothalamic-pituitary-adrenocortical (HPA) axis

hormonal system in the body

important stress response pathway

help control physiological and behavioral change through controlling circulating glucocorticoid levels

glucocorticoids influence

glucose regulation

metabolism

inflammatory control

cardiovascular effects

reproductive effects

neuronal effects

poor social relationships are associated with

29% increase in risk of incident coronary heart disease

32% increase in risk of stroke

loneliness

the discrepancy between a person’s desired and actual social relationships

• meaningful v superficial connections

  • linked to poorer health

higher glucocorticoid levels indicate

more stress

mediators

also known as mechanisms or pathways. the factors that help explain how social isolation or loneliness affects health outcomes

moderators

the factors that can influence the magnitude or direction of the effect of social isolation or loneliness on health

social connection

an umbrella term that encompasses the structural, functional, and quality aspects of how individuals connect to each other

social isolation

the objective lack of (or limited) social contact with others

social support

the actual or perceived availability of resources (information, tangible, emotional) from others, typically one’s social network

in the peripheral nervous system, myelin sheath is formed by

layers of schwann cell membrane, electrically insulates neurons from each other

nodes of ranvier

spaces between segments of myelin sheath

myelin sheath

greatly speeds up nerve impulse conduction

how are nerves repaired

axons and dendrites may regenerate through the tunnels that are formed by myelin

brain disorders

epilepsy, parkinson’s disease, alheimer’s

morphine and heroin bind to

opiate receptors and produce dopamine release