Week 3

Question 1

Emotion/Mood Regulation: Bottom-up emotion processing (affective network) vs top-down emotion processing (cognitive control network)

• Involved components of the brain.
• General description.

Answer 1

Bottom-up processing: Amygdala and inhibition via Hippocampus + mPFC + ACC => very automatic and quick. Instinctive.

Top-down processing: Dorsalateral PFC (cognitive control focus) + Caudate Nucleus (cognitive control as well). => conscious information processing with conscious strategies.

Question 2

Neurotransmitters involved in depression pathology + effect. (3)

Answer 2

• NE and 5HT = Altering emotional processing bias

- Dopamine = Underlying motivational aspect.

Question 3

Hypothesized neuropathology of Mood dysregulation: Degenerative Cascade (review)

Answer 3

Too much cortisol shuts down hippocampus, which leaves the amygdala uninhibited and therefore continues to spiral out of control.

Question 4

What is the BDNF? What does it do and what affects it?

Answer 4

• Related to hippocampus. BDNF (Brain-derived neurotrophic factor) promotes dendritic sprouting of serotonergic cells.
• Cortisol INHIBITS release of BDNF => degeneration of the neuronal function in the hippocampus.
• Leads to clinically significant mood changes.

Question 5

Mechanism of Cognitive Therapy for Emotion: Top-down approach

Answer 5

Apply intentional strategy for emotional information processing (affects PFC neurophysiology)

Question 6

Premenstrual Dysphoric Disorder: Biochemical Deficiency + which phase to expect it during the ovarian cycle.

Answer 6

• Biochemical deficiency = Serotonin (hence why SSRIs are used for tx.)
• Occurs during. Late literal phase: just before onset of menstruation and ends shortly after.

Question 7

Post Partum Depression: Duration, neurotransmitter etiologies, and risks

Answer 7

• Occurs usually 4 weeks after delivery but can commence up to a year after!
• Serotonin deficiency or Dopamine overdrive
• Risks: mixed feelings about pregnancy, history of etoh and drug abuse, depression, etc.
• Very gruesome case of inanticide

Question 8

Mood disturbances associated with certain medical conditions: what are the 6 conditions mentioned?

Answer 8

Dementia, HIV, Cancer, Dialysis patients, Acute Myocardial Infarction patients, and Stroke.

Question 9

Substance induced mood disorder: What are the specific substances that were “focused” on?

Answer 9

Opioid, Sedative, Cardiac drugs, antiparkinsonian drugs, and antineoplastics.

Question 10

DSM-5 criteria for diagnosis Major Depressive Disorder

Answer 10

5 or more symptoms, present nearly EVERY DAY, for MINIMUM of 2 CONSECUTIVE WEEKS

• Depressed mood, loss of interest, insomnia or hypersonic, change in appetite or weight, psychomotor retardation or agitation, low energy, poor concentration, thoughts of worthlessness or guilt, or recurrent thoughts about death or suicide.

Question 11

Patient comes in diagnosed with Major Depressive Disorder but now has additional movement symptoms. He randomly maintains a very statue like pose of random positions but at other times, he kind of waves his arms and legs around without purpose. Also, He doesn’t follow any instructions from his family members, very needless resistance. He even mocks them sometimes by imitating their movements or repeating words/phrases This patient has ___________

Answer 11

• MDD with Catatonic Features: at least TWO of the following catatonic features
• Motoric immobility (cataplexy or stupor)
• excessive motor activity, peculiarities of volunteer movement, extreme negativism/mutism (motiveless resistance to instructions or maintenance of rigid posture)
• Echolalia or Echopraxia (repeating words or imitating movements)

Note: Mirror neurons may be involved in feelings of empathy.

Question 12

Patient comes in diagnosed with MDD but upon further examination, he also seems very… Apathetic. He has a distinct quality of depressed mood, especially in the morning. Looking at his chart, he also seems to have a lost a lot of weight and when asked about it, he says that he rarely eats. It also sounds like he wakes up quite early. During the exam he got a phone call saying that his investments from a long time ago paid off but he seemed disinterested and didn’t take any pleasure to the news. This patient has ______________

Answer 12

MDD with Melancholic Features: Loss of pleasure and lack of reactivity.

3 or more of the following symptoms

• distinct quality of depressed mood
• depression regularly worse in the morning
• early morning awakening
• marked psychomotor retardation or agitation
• significant anorexia/weight loss
• excessive or inappropriate guilt.

Question 13

Patient comes in diagnosed with MDD but upon further examination he seems… Excessively tired. Looking at his chart, he has significant weight gain and he admits to an increase in appetite. He also mentions that he has excessive sleepiness these days even though it’s summer. Sometimes, his arms and legs feel so heavy that he just doesn’t want to move around. This patient has ________

Answer 13

MDD with Atypical Features: Modd DOES brighten in response to positive events.

2 or more of the following features

• Significant weight gain or increase in appetite
• Hypersomnia
• Laden Paralysis (arms/legs feel like lead or sandbags)

Question 14

Patient comes in complaining of decrease energy, decreased appetite, and increased appetite and weight gain. She also has decreased libido and seems more depressed and irritable. She does admit that this happens every year around the same time, especially during the winter. Patient has ____________

Answer 14

Seasonal Affective Disorder (SAD)

Question 15

20 year old patient presents with depression that last for most of the day and more days than not. This feeling has lasted for at least 2 years. Associated symptoms include low self-esteem, fatigue, and poor concentration with feelings of hopelessness. Her younger brother also presents with similar symptoms but it’s been going on for about 1 year. Both these patients have ____________

Answer 15

Persistent Depressive Disorder: Dysthymia

While depressed, presence of 2 or more of following sx:

• Poor appetite or overeating
• insomnia or Hypersomnia
• low energy or fatigue
• low self esteem
• poor concentration
• feelings of hopelessness.

Duration: for more than 2 months at a time.

• Adults = at least 2 years
• Adolescents = at least 1 year.

Question 16

Serotonin Pathways in Depression: These two areas of the brain orchestrate serotonin delivery to the cerebellum, hippocampus, and cerebral cortex.

Answer 16

Caudal Raphe Nuclei and Rostral Raphe Nuclei

Question 17

Treatment for MDD:

Answer 17

Psychotherapy, Pharmacology (esp. SSRIs since there is a def. in serotonin), Phototherapy, EXERCISE, and….
- Electroconvulsive Therapy (ECT) IF UNRESPONSIVE to pharmacotherapy or cannot tolerate it.

Question 18

Treatment for Dysthymia:

Answer 18

Psychotherapy, pharmacology, and EXERCISE

Question 19

Note: If reaction is due to grief (depression stems from a tangible loss such as a loved one or a job) then __________ do not help.

Answer 19

Antidepressant therapy.

Question 20

Manic Episode: Duration of ________ and ___ number of symptoms

Answer 20

Must last at least 1 week and have 3 or more of the following symptoms.

• Inflated self esteem
• Decreased need for sleep
• More talkative
• Flight of ideas
• Distractibility
• Increase in goal-directed activity
• Excessive involvement in pleasurable activity

Question 21

Hypomanic Episode: Duration of ________ and ____ number of symptoms

Answer 21

Must last at least 4 days and have 3 or more of the symptoms in Manic Episode.

• In general, compared to manic episode: it is slightly shorter and generally less intense.

Question 22

Bipolar I vs Bipolar II

Answer 22

Bipolar I: Presence of Manic episode as well as possibly past Major Depressive episodes

Bipolar II: Presence of one or more Major Depressive episodes and presence of at least one HYPOmanic episode.

Both usually have depressive episodes but bipolar II usually doesn’t have a crazy manic episode.

Question 23

Cyclothymia: Diagnosis via symptoms and duration.

Answer 23

HYPOmanic sx and depressive symptoms that lasts at least 1 year in adolescents and 2 years in adults (basically fail to be dx as MDD due to duration of time.) Person has had Criteria A symptoms (elevated, expansive mood for at least 4 days) FOR MORE THAN 2 months at a time.
- Chronic mood disorders with milder symptoms. Essentially bipolar LIGHT.

Question 24

Bipolar Tx vs Cyclothymia Tx

Answer 24

Bipolar: Mood stabilizers, antipsychotics, combo drugs, and ECT

Cyclothymia: Debate on whether or not to tx.

Question 25

Cluster A personality traits are predominantly:

Answer 25

Odd or Eccentric - Paranoid PD - Schizoid PD - Schizotypal PD

Question 26

Cluster B personality traits are predominantly:

Answer 26

Emotional or Dramatic - Antisocial PD - Narcissistic PD - Borderline PD - Histrionic PD

Question 27

Cluster C personality Traits are predominantly:

Answer 27

Inhibited or anxious - OCPD - Avoidant PD - Dependent PD

Question 28

What Personality Disorder is this case from and which Cluster? A 47-year-old man is referred to a psychiatrist at his employment assistance program because of continuing conflicts on the job. This is the third time the patient has been referred to a psychiatrist under just such circumstances. He lost two previous jobs because of conflicts with coworkers. The patient states that people do not like him and would like to see him fail. He cites as an example an instance in which one of his colleagues was late in sending him some material he needed, resulting in the patient being unable to complete the assignment in a timely fashion. Although the colleague apologized for the mistake, the patient says that he knows that this man is “out to get me fired”. He has since broken off all contact with this coworker and refuses to speak with him directly, preferring to use only written communication. On a mental status examination the patient appears somewhat angry and suspicious. He glares intently at the interviewer and sits with his back to the wall. He repeatedly requests a clarification of questions, often asking, “What will this material be used for—I bet you are going to use it against me so that I will be fired.” When the interviewer’s pager goes off, the patient accuses him of trying to shorten the time allotted to him by arranging to have the pager interrupt them. The patient’s mood is described as “fine” but his affect is constricted and he appears suspicious and ill at ease. The patient’s thought processes and thought content are both within normal limits.

Answer 28

Paranoid PD from Cluster A: Mad Eye Moody Tx: Psychotherapy is tx of choice, pharmacotherapy can be used for agitation or anxiety. (benzodiazepines mostly) 4 or more Sx to DX

Question 29

What Personality Disorder is this case from and which Cluster? A 36-year-old man visits his primary care physician complaining that he has been “stressed out” since a job change 2 months ago. The patient states that he was doing well in his job as a software developer until he was told that his position was being phased out and that in order to stay with the company he would need to switch to the sales department. The patient agreed because he did not want to lose his insurance benefits and retirement plan but now states that “he can’t stand all those people”. He notes that his previous position allowed him to be on his own for most of the work week. However, the new job requires almost constant interaction with colleagues and clients, something he hates. The patient says that he has almost no friends, except for a cousin that he has been close to since childhood. He claims that he has never had a sexual encounter but does not miss not having had this experience or not having friends. He states that he most enjoys spending hours surfing the Internet or playing computer games by himself. He has never seen a psychiatrist and saw no reason to do so before the recent job change occurred. On a mental status examination the patient appears notably detached and aloof toward the examiner. His mood is reported as “stressed” but his affect is not congruent with this – he looks emotionally calm, and his range is flat. No other disorders are noted during the mental status examination.

Answer 29

Schizoid PD from Cluster A: Severus Snape TX: Group Therapy /family intervention may be helpful but prognosis is poor. No effective pharmacologic agent. Four or more Sx to DX

Question 30

What Personality Disorder is this case from and which Cluster? A 24-year-old woman was admitted to the obstetrical service for the delivery of a full-term baby boy. One day after the delivery, the obstetrics service requests consultation from the psychiatrist on duty to “rule out schizophrenia.” The psychiatrist interviews the patient and finds out that the pregnancy was the result of a rape the patient suffered 9 months previously. The patient is planning to give the baby up for adoption. She claims that she has never seen a psychiatrist and has never felt a need to do so. She speaks at length about how the rape was “written in the stars” for all to see; she is an avid astronomer. She denies having recurrent thoughts or nightmares about the rape itself. She states that she has very few close friends, preferring to study astronomy and astral projection at home by herself. She believes strongly in reincarnation, although she knows that her family thinks this belief is strange. She admits that she has worked intermittently as a ‘crystal ball gazer’ but has never held a steady, full-time, paying job. During the mental status examination the patient sits upright in her hospital bed dressed in three hospital gowns and a robe, which she is wearing backward. Her hair is neatly combed, although one side is in braids and the other is not. She is cooperative with the interviewer. She states that her mood is good, and her affect is congruent although constricted. She has tangential thought processes and ideas of reference but no suicidal or homicidal ideation, hallucinations, or delusions.

Answer 30

Schizotypal PD from Cluster A: Luna Lovegood Tx: Group Therapy is best but can be given some low doses of neuroleptics or antipsychotics. Five or more sx to DX

Question 31

What Personality Disorder is this case from and which Cluster? Russell, age 18, was admitted for evaluation of antisocial behavior. His early childhood was chaotic and abusive. His alcoholic father had married 5 times and abandoned his family when Russell was 6. Because his mother had a history of incarceration and was unable to care for him, Russell was placed in foster care until he was adopted at age 8. Russell had a criminal streak from early childhood. He lied, cheated at games, shoplifted, and stole money from his mother’s purse. Because of continued law-breaking, he was sent to a juvenile reformatory for 2 years at age 16. While in the reformatory, he slashed another boy with a razor blade in a fight. Russell had his first sexual experience before his peers and after leaving the reformatory had several different sexual partners. Russell’s IQ was measured at 112. He was discharged after a 16-day stay and was considered unimproved. He was poorly cooperative with attempts at both individual and group therapy. Russell was followed up 30 years later. He used an alias and lived in an impoverished area of a small Midwestern community. Now 48, Russell looked physically ill and was haggard in appearance. He admitted to over 20 arrests and 5 felony convictions on charges ranging from attempted murder and armed robbery to driving while intoxicated. He had spent more than 17 years in prison. While in prison, Russell had escaped with the help of his biological mother, with whom he then had a sexual relationship. He was returned to prison 2 months later. His most recent arrest occurred within the past year and was for public intoxication and simple assault. Russell reported at least 9 hospitalizations for alcohol detoxification, the latest occurring earlier that year. He admitted to past use of marijuana, amphetamines, tranquilizers, cocaine, and heroin. He had never held a full-time job in his life; the longest job he had held lasted 60 days. He was currently doing bodywork on cars in his own garage to earn a living but had not done any work for several months. He had lived in 6 different states and in the past 10 years had moved >20 times. Russell reported that his common-law wife took tranquilizers for emotional problems and that the marriage was unsatisfactory. He reported occasionally attending Alcoholics Anonymous at a local church but otherwise did not socialize. Russell admitted that he had not yet settled down and told us that he still spent money foolishly, was frequently reckless, and got into frequent fights and arguments. He said that he got a “charge out of doing dangerous things.”

Answer 31

Antisocial PD: Tom Riddle (Young Voldemort) - 3 or more Sx for DX. - Must be at least 18 yo and evidence of conduct disorder with onset - Tx: on top of psychotherapy is VALPROATE.

Question 32

What Personality Disorder is this case from and which Cluster? heart attack. 24 hours after admission, the consultation psychiatrist is called in to make an evaluation because the patient is trying to sign himself out against medical advice. When the psychiatrist enters the patient’s hospital room, she finds him getting dressed and yelling at the top of his lungs, “I won’t be treated in this manner! How dare you!” The patient does agree to sit down and speak with the psychiatrist, however. He tells the psychiatrist that staff members are simply rude and do not treat him “in the manner to which he is accustomed.” He says that he is a small business owner, but that he is on the way up and “as soon as people realize my full potential, I will be a millionaire.” He cannot understand why the staff will not bring food up from an outside cafeteria for him because the food in the hospital is so bad. He asks the psychiatrist whether, after the interview, she will get some food for him, and he becomes angry when she declines. He then eyes her new expensive watch enviously. On a mental status examination, the psychiatrist finds no disorders of thought process or content, and the patient is found to be oriented to person, place and time.

Answer 32

Narcissistic PD: Professor Lockhart - 5 or more sx to DX Tx: Psychotherapy with long term goal: to increase capacity to tolerate disappointments, appreciate needs of others and develop healthy self esteem - Characterized especially by hypersensitivity!

Question 33

What Personality Disorder is this case from and which Cluster? 23 yo woman is admitted to the inpatient psychiatric unit after slashing both wrists when her therapist left for a week’s vacation. The cuts were superficial and did not require stitches. The patient says that she is angry with her psychiatrist for “abandoning her”. She claims that she is often depressed, although the depressions last “only a couple of hours.” When she was first admitted to the hospital she told the admitting psychiatrist that she heard a voice telling her that “she will never amount to anything”, but she subsequently denies having heard the voice. This is the patient’s 4th hospital admission, and all of them have been precipitated by someone in her life leaving. After 3 days in the unit the patient’s psychiatry resident gets into an argument with the nursing staff. He says that the patient has been behaving very well, responding to his therapy, and is deserving of a pass. The nurses claim that the patient has not been following unit rules, sleeping through her group meetings and ignoring the limits set. Both parties go to the unit director complaining about the other.

Answer 33

Borderline PD: Moaning Myrtle - 5 sx or more to dx: - Motive: to avoid real or imagined abandonment! Tx: Psychotherapy is tx of choice as well as Dialectical Behavior Therapy (DBT) and Systems Training for Emotional Predictability and Problem Solving (STEPPS)

Question 34

What Personality Disorder is this case from and which Cluster? 42 yo man comes to see a psychiatrist stating that his life is “crashing down around his ears.” He explains that since his girlfriend of 2 months left him, he has been “inconsolable.” He says that he is having trouble sleeping at night because he is mourning her loss. When asked to describe his girlfriend, the patient states, “She was the love of my life, just beautiful, beautiful.” He is unable to provide any further details about her. He says that they had 5 dates, but that he simply knew that she was the one for him. His speech is of normal rate, although at times somewhat loud. The patient describes his mood as “horribly depressed.” His affect is euthymic the majority of the time, and full-range. His thought process and thought content are all within normal limits.

Answer 34

Histrionic PD = very dramatic: Movie Bellatrix - 5 or more sx to dx - Characterized by endless need for reassurance! - Dx: psychotherapy is helpful and tx of choice, antidepressants if symptomatic. Psychotherapy as well of course.

Question 35

What Personality Disorder is this case from and which Cluster? A 21-year-old woman comes to the student counseling center with complaints of being depressed and feeling anxious. She states that 2 weeks ago, while in class, she was called on by the teacher and gave the wrong answer. She says that she felt “humiliated” and has not gone back to the classroom since then. She describes a lifelong history of being painfully shy. She admits that she would like to have a boyfriend but that she is afraid to meet anyone because “I’ll get dumped.” She describes herself as “socially retarded” and avoids going out with anyone new. She has two close friends and does go out to dinner with them weekly, which she enjoys. She denies trouble sleeping or with her appetite, although she does admit to feeling ashamed of her social ineptitude. She is worried that she will be unable to finish college because of her problems. Note the hypersensitivity

Answer 35

Avoidant Personality Disorder - 4 or more sx to DX Tx: Psychoanalytic therapy, group therapy, pharmacotherapy (but only for short periods)

Question 36

What Personality Disorder is this case from and which Cluster? A 32-year-old man comes to a psychiatrist with a chief complaint of being depressed since he broke up with his girlfriend 2 weeks previously. The patient explains that although he loves his ex-girlfriend, he broke up with her because his mother did not approve of her and would not allow him to marry her. He says that he cannot go against his mother because she “has taken care of me all these years.” He states he could never fend for himself without his mother and alternates between being angry with her and feeling that “maybe she knows best”. The patient states that his own judgment is “shaky”. He has lived at home his entire life except for one semester away at college. He returned home at the end of the semester because he was homesick, and did not go back. The patient reports no loss of appetite, concentration or energy. The patient claims that he performs “adequately” at work and has no job-related problems. He works for an accounting firm in an entry-level position even though he has been there for several years. He says that he has turned down promotions in the past because he knows that he “couldn’t possibly supervise anyone or make decisions for them”. The patient has two close childhood friends whom he talks to on the telephone nearly every day and says he “feels lost without them”. The results of his mental status examination are normal except for revealing a depressed mood (although the affect is full-range).

Answer 36

Dependent Personality Disorder: - 5 or more sx to DX Tx: Anxiolytic meds during crises but in general, group therapy and assertiveness training.

Question 37

What Personality Disorder is this case from and which Cluster? A 36-year-old man is referred to his employment assistance agency because he has trouble making timely decisions and is often late with important work. The patient has angrily complied with this request although he does not believe that anything is wrong with him. He describes himself as “so devoted to my work that I make others look bad,” believing that this is why he has been singled out for attention. The patient says that he has worked at the company for 4 years and during that time has put in anywhere from 10 to 12 hours of work per day. He admits that he often misses deadlines but claims that “they are unreasonable deadlines for the quality of work that I provide.” He states, “If more people in the country were like me, we would get a lot more done-there are too many lazy slobs and people who don’t follow the rules.” He points out that his office is always perfectly neat, and he says, “I know where every dollar I ever spent went.” On a mental status examination the patient does not reveal any abnormalities in mood, thought processes, or thought content. His manner is notable for its rigidity and stubbornness. Note his reaction indicating his belief these traits are desirable.

Answer 37

Obsessive Compulsive PD: Percy Weasley - 4 or more sx to DX Tx: Group therapy is difficult, Clonazepam reduces symptoms in severe OCPD.

Question 38

Williams Syndrome: | - Definition

Answer 38

Rare natural genetics: 25+ genes missing from chromosome 7 (not sure if important)

Question 39

Williams Syndrome: | - Physical Deficits

Answer 39

- CARDIOVASCULAR and other health problems

Question 40

Williams Syndrome: | - Cognitive Profile

Answer 40

- POOR VISUOSPATIAL ability and mental retardation but at least average lang. skills.

Question 41

Williams Syndrome: | - Related Neuroanatomy (theory)

Answer 41

- underdeveloped dorsal visual pathways (visuospatial abilities) but relatively intact rostral/ventral visual pathways (visual recognition)

Question 42

Williams Syndrome: | - Personality Profile + related neuroanatomy

Answer 42

Extreme sociability and empathy BUT lacks social fear and saavy = aka GREGARIOUS BRAIN - Deficit in perceiving social fear: perhaps dysfunction of Amygdala

Question 43

Big Five Model: 5 separate dimensions used to to describe personality disorders (applying normal personality dimensions)

Answer 43

OCEAN - O: Openness - C: Conscientiousness - E: Extroversion - A: Agreeableness - N: Neuroticism Note: Neuroticism and Extroversion are the most extensively studied and appear to correlate more with mental disorders.

Question 44

Neuroanatomy associated with extroversion-introversion dimension

Answer 44

Amygdala - Personality differences determine amygdala sensitivity to positive emotions - Amygdala activation to positive facial expressions is higher when a person scores higher on the extroversion dimension. BUT act. to negative expressions is universal

Question 45

Neuroanatomy associated with Neuroticism

Answer 45

mPFC/ACC (Error and Conflict Detection): feedback-related negativity indicates neural response to feedback about one's behavior.

Question 46

Cycle from Awake to non REM to REM

Answer 46

1 to 2 to 3 to 4 to 3 to 2 to REM (Note that it jumps to REM from 2)

Question 47

In young adults, most of the sleep time is in phase ____ vs in new borns

Answer 47

Phase 2, in newborns as much as 50% of sleep is REM. This decreases more as you age.

Question 48

Cells that create the Circadian Rhythms

Answer 48

Suprachiasmatic nucleus near the hypothalamus: coordinate endogenous clock.

Question 49

Genes indicated in the internal mechanism of regulating release of hormones by the SCN and how they regulate.

Answer 49

Period (PER) and timeless (TIM) genes produce proteins which regulate hormone release. PER and TIM proteins bind together to inhibit transcription of their gene in the nucleus (neg. feedback loop). - Dawn: TIM protein is degraded by light therefore inhibition diminishes. - During the Day: Increase of PER and TIM (TIM levels still limited) - Dusk: PER and TIM form a complex and enter the nucleus to supress PER/TIM transcription. Can't enter unless made into complex.

Question 50

2 important factors that determine sleep drive (sleepiness)

Answer 50

Time since the last full sleep and the circadian rhythm.

Question 51

Location of wakefulness center

Answer 51

Above the Pons (midbrain reticular formation) - stimulation of the midbrain leads to wakefulness. - Cut above the pons leads to oscillatory EEG: sleep state because still connected to medulla (?)

Question 52

Location of Sleep Center (inhibits wakefulness)

Answer 52

Below the pons, in the medulla - Therefore medulla inhibits midbrain reticular formation and causes sleep. - Cut between the pons and medulla = EEG patterns of awake state due to loss of inhibition.

Question 53

Other location of wakefulness and sleep areas

Answer 53

Posterior Hypothalamus: Stimulation leads to arousal Anterior Hypothalamus: Stimulation induces sleep.

Question 54

REM sleep: what happens.

Answer 54

Cells from locus ceruleus and raphe nuclei project to thalamus and brain stem. - Thalamus: ACh depolarizes GABAergic cells which essentially awakens the thalamus: seemingly awake state -> high freq. and low voltage EEG. - Brain Stem: Inhibition to the motor neruson in the spinal chord.

Question 55

Benefits of Sleep:

Answer 55

Conservation of Metabolic Energy, Cognition, Thermoregulation, and Neural maturation and mental health.

Question 56

Dreams occur in...

Answer 56

non REM and REM sleep, they are not affected by external stimuli.

Question 57

REM OFF cells are _____, _______, and ________

Answer 57

Histaminergic, Nonadrenergic, and sertonergic

Question 58

REM ON cells are __________

Answer 58

Cholinergic