Physiological psych

Everything starts mentallyאthen acted out physically 

Descartes Dualism:- I think –therefore I am  

Physical/mental=one unit

How do you differentiate b/w reality and dream?

-in dreams, you do not doubt that it is really

-in reality you can doubt reality 

אfrom logic pt of view, it is hard to prove whether you are in reality or dream

אbut in dreams you don’t fool your senses 

-once an object comes into visual contact  w/ bran, the brain can manipulate it 

2 kinds of dreams:

• a dream in which you know it is a dream
• a dream that you know is a dream

 

Buddha legend

-Only saw death/suffering/handicap at age 18

-Came to the conclusion that ‘reality is in the eyes of the beholder’

      אparents always think that their kids are beautiful 

-we place value on things based on our reality 

-80% of world א pre-arranged marriages

      אLearn to love arbitrarily

-Note: many in W. culture leave home/culture for the love of partner

      אMuch more divorce 

      טin consequence, we affect our happiness

            א$/beauty is irrelevant to happiness

            אmany aids/cancer patients say that they found happiness through disease 

-people punish themselves for things that they cannot change

אneed to relieve pain –but to a point

אif they punish beyond sadness = problems

      אpathological mourning

            -difference b/w pain and repeated reliving of it

Death

People seem to ignore death

-people who buried many people don’t think it could happen to them

      אAllows them to live better 
 

Personality

-People have conscious/unconscious personality ‘masks’

אdifferent masks for different scenarios (i.e. work/family/friends/ourselves)

      אevery psych has to undergo evaluation

            אso he won’t apply his problems to others

                  -therefore, he needs to discover his own mask 

-people choose consciously/unconsciously to reflect messages

Physiological psychology

-also knows as psychobiological

-laws of nature as reflected on the body 

i.e.:

-Blood circulation: hydrodynamics

-Nerves: electrons 

אAlso discusses biology/chemicals that influence body for the better/worse 

Cerotonin –neurotransmitter

אhelps brain cells communicate

Endomorphine –also neurotransmitter

-causes pleasure/relaxation

-caused by exercise/dangerous scenarios 

-also relieves pain 

א those chemicals influence nerve system

November 20, 2000

Physiology: anatomical actions based on physical properties of the world 

Nerves: electro-chemical laws

Cardiovascular system: hydraulic laws

Physiological psychology

Physiological effect on psychology

-->i.e. giving chemicals to person to alter his behavior 

Common name: ‘psycho-biology’ 

-some chemical reactions may be caused by psychology 

---

Some Anatomic actions are automatic -->i.e. heart/lung/digestive 

The automatic system has 2 components

1. sympaticus

-collects energy=fight or flight -->defense 

2. Parasympaticus

-rejuvenates defenses =calm after fight/flight 
 

• During day, we are more sympaticus
• Sometimes one of those 2 states is overworked

Homeostasis

-the conditions which our bodies need, physiologically, to exist

-->a physiological balance 

Example #1: heart can function 40-160 only a limited time.

Homeostasis: 34-42   beats per minute

--> Anything higher/lower -->heart can’t function 

Example #2 Blood vessels could only function under a certain amount of pressure

-->High/low pressure causes problems

      -->sometimes high blood pressure is relieves by small blood vessels in nose.

            -->but sometimes they can erupt in the brain -->Stroke

 

*Sensory/motorical/inhibitory nerves are 2 different kinds of nerves 

Each nerve cable (“pathway”) is a mixture of sensory/Motoric/Automatic nerves

2 Rules of the Nerve system

1. Hierarchy – the higher the nerve center id in the nerve system, the more it controls
2. The control is only in form of inhibition

Examples of inhibition

1. Our brain causes us to block out several stimuli. אi.e. in class, our brain blocks out noise distractions/shoe pressure, etc.
2. Avoiding emptying bladder – (inhibiting the process of a natural reflex which does it), until it is time to do so.

 

• When people use alcohol\/drugs, their inhibitions are affected אmight not control things like the bladder

 

• Inhibition does not affect automatic nerve system

Brain structure

-Brain is set to skull’s size

-Skull filled w/ liquid which also seeps into the brain

      אTo avoid movement 

-Brain =very soft tissue אonly held together by a membrane 

 

Epilepsy

Paroxysm – comes in attacks

      אproblems in activity in brain 

אdifferent symptoms, based on area of brain affected 

i.e.

-if it is in motoric area of brain =motoric impulsive movements

-sensory: feeling odd things

-vision: distorted vision

-temporal: meaning/attention/perception/speech

      אi.e. absentia 

Primary Epilepsy: inherited

Secondary Epilepsy: received in childhood אdue to brain damage 

Epilepsy could occur from energy imbalance אi.e. lack of sugar 

Local vs. General Epilepsy

Local –epilepsy that occurs in a specific are of the brain

Jacksonial march – when en epileptic attack starts at a local area and then spreads to all of the brain becoming a general attack

General –an epileptic attack that affects all of the brain

אpasses through Corpus Collosum (the thing that attaches both hemispheres) 

Example:

-fast flashing lights can provoke in vulnerable people, an epileptic attack

      אJackson’s March

--

Brains =has many Neurons w/ various diff. paces 

-sometimes 1 cell works alone

-sometimes some neurons work in groups

אbrain-cells don’t work as 1 direction

      אwhen they do אgeneral epilepsy 

-Heartbeat –has an upshot and a relaxing, down-shot. 

Hertz –cycles per seconds 

Alpha 8-23 pulses 

 

Awaking hours, during cognitive functions:

Front of Brain: Alpha

Back of Brain: Beta 

Sleep spindles –higher groups of brainwaves at certain intervals, found during sleep 

Dis-synchronization: the natural way that the neurons of the Brain work

      אno 1 direction of brainwaves 

Synchronization: localized epilepsy

Hyper-synchronization: general epilepsy

General Epilepsy

-several kinds

‘Petit Mal’

-underdevelopment of the brain אusually found in kids

-kids freezes for a few moments אunable to be ‘woken up’, though he is partially conscious אhe senses things from ‘far away’

            אcould happen many times an hour 

-could be detected in recurring series of an upshot and regular waves:

      -small upshot/regular waves

      -regular upshot/regular waves

      -big upshot/regular brainwave 

-called ‘poly-spike activity’

‘Grand mal’

-the kind of epileptic attack that is externally seen

Stage 1

Aura

-the sense that preludes the attack

      אdifferent aura for diff. attacks 

Aura –sensation

      אi.e. the aura for a migraine is: distorted vision/flashes 

-aura is only present in some epileptic patients 

אappears in strange ways

      אsmell of sulfur/rotten eggs

            אspecific to some temporal epileptic attack. 

-another aura is a metallic taste

Centro-encephalic epilepsy

-thalamus =pacemaker of the brain

אif the problems starts in thalamus, it spreads to both sides of brain

      אusually, no aura 

[hearing/balance =also in temporal אhearing could also be an aura]

      אas opposed to Tillitum –a constant sound –which is not an aura 

Aura –the locolaized part of the eclipse 

Stages of a general epileptic attack.

Stage 1 –aura

-aura doesn’t always take place

      אif it lasts less than 10 seconds, he doesn’t remember it 

Stage 2 –tonus

Tonus –hyper-synchronization of the brain cells

אall muscles contract

• sometimes urine, as bladder muscle contracts as well.
• tongue gets into teeth/jaw bites down אbite tongue

      אbleeding could occur

• breathing stops אb/c blue אsome brain damage could occur if not enough oxygen

      אstops neural metabolism

      אtemporary brain damage could occur

• after stop of metabolism אend of muscle contraction as brain cells shuts down

 

אin the beginning, there could be a yell as the muscles constrict as you breath out.

Stage 3 –Clonus

-wiggling stage –since brain cells have stopped functioning, the muscles loosen up

      אsome breathing אbut breathing is related to contraction/loosening of muscles 

Stage 4 –Coma

Neurons cells stop working אgeneral shut-down

      אthey don’t have any more energy within them אComa 

-the Coma could last between minutes to several hours

      אrehabilitation on cells

• body might still be fatigued by the amount of energy spent

      אstill unconscious 

Stage 5 -sleep

-coma ends, but sleep continues b/c of fatigue

      אcould be woken up

• when woken up אlarger frequency of teta waves

א‘post-attack state’

Kinds of damage from lack of oxygen

Anoxia –lack of oxygen in cells

Ischemia –lack of oxygen causes temporary brain damage

Infarctions –lack of oxygen which causes permanent brain damage 

-usually, within anoxia/ischemia takes place

אin epileptic attacks, it could take up to 24 hours for brain to reverse the temporary damage 

Cerebral vascular Accident (CVA)

-blockage of vain leading to cerebral regions אthe region dies

Continuous epilepsy

-with/after sleep, he gets another attack

      אcould be a vicious cycle

Epileptic state

-the next attack starts b/f epileptic attack is over

      אi.e. within the coma stage 

-this is a medical emergency which must be arbitrarily stopped

      אthis kind of epilepsy cycle causes infarctions. 

-if unable to be stopped: general anesthetics

      אtreatment includes oxygen giving

      אmetabolism treatment 

-epileptic states could be caused w/ epileptic medicines being arbitrarily stopped fast

      אan epileptic must be taken off drugs w/ medical help/in a controlled/slow way

Something could spark epilepsy

-over-breathing/hyperventilation אhaving too much oxygen vs. body use

-flashing lights

Hystero-epilepsy

Hysterical –when people un/consciously don’t want to deal w/ things 

Malingering: consciously avoiding things by pretending to be something

      אi.e. consciously pretending to be sick

Conversion/hysteria: unconscious pretending to avoid a conscious or unconscious fear

      Primary reward: decrease of fear

      Secondary reward: environmental benefits

אi.e. some people might be quadriplegic, b/c of an unconscious psychological motive rather that a physiological problem 

-when the primary reward is fulfilled, but the secondary reward makes them maintain the benefits

      אi.e. being disabled to get tax benefits

            -it is not a show!!!

                  אit is a neural thing since they aren’t showing reflexes!!!

                        אsome epileptic attacks are fake!!!

א a person might have both real and hysteric epileptic attacks

-very easy to find out on an EEG

      אhystero epilepsy doesn’t show on EEG 

Way to find out if problem is physiological or psychological:

-hypnotize them and see if they can move what they consciously can’t to.

-if they move those organs while they sleep.

Mar 19 class

Amnesia

Amnesia – lack of memory

Transient Global amnesia

-sudden forgetting of everything that they know

      i.e. what/whom I know

      אthey remember simple language

      אunderstand simple things 

      Possible reasons:

• lack of blood-flow (i.e. lack of oxygen)
• electrical problems in temporal problem

            אcalled fuga

• medicine/drug influence

 

-usually transient –over  w/I 24 hours 

Fuga=localized temporal epilepsy that effects memory

Occipital Hemisphere

After visual input, info goes to recording part (visual memory), and only there to awareness

      אyet at the same time, there is a direct path from visual cortex to awareness

      אthis path doesn’t go through memory 

2 parts of the system

Visual sensory area= visual awareness

Associative visual senses  (psych) =a specific visual stimuli is remembered

            אi.e. we associate a face w/ a  person

The Calcarinian Sulcus – the clack in bthe back of the brain running R/L

      -above =visual memory אclose to speech sensory (parietal) 

Note: brain damage is defined by a non-function of a previously acquired ability

--

Gnosis: knowledge 

Agnosia: no knowledge

• visual agnosia: can’t recognize several things
• object agnosia: can’t connect b/w parts of the objects to make it thw whole, therefore not recognizing it
• Colognosia: inability to recognize colors

      אproblem association color w/ name

• alexia agnosia: inability to recognize words out of the letters

   אseen as a mere chain of letters

• Facial agnosia: also called Aprosognosia

                  -Can’t take parts of face and put them together

                        אhave to rely on other familiar things, like sound of voice 

Note: the diff. b/w face and object agnosia is where the memory is stored 
 

Ventricles

-have CSF

-in each hemisphere, there is a ventricle (1^st/2^nd ventricle) 

Monroe- an opening in the bottom side of the top arm of the 1^st/2^nd ventricle אleads to 3^rd ventricle

Plexus choroids –small mounts in the Monroe which secrete the CSF

-at one end –artery, at the other end: vain. Plexus filters out blood for several components that are needed to make the CSF 

• Semi permeable:-allows small molecules (antibodies) but doesn’t allow complex/big molecules to exit (i.e. blood molecules)

 
 

      CSF – sugar level: 2/3 of sugar-level of blood. Has-Salts/antibodies

      אimmune defense/Homeostatic/protection of the brain 

Blood-brain barrier – the defensive system in the capillaries of the brain that avoids having chemicals that are unnecessary for brain 

• Some brain-infections make the capillaries expand אentry of ‘foreign’ substances (i.e. molecules that should be in the brain.)

   אmight lead to brain tumors 

-the main nutrition source of brain is NOT CSF but rather the blood – the CSF merely protects its.

Auto-regulation

-ensures that brain gets enough blood

      אif not enough blood to brain אgoes into emergency state

      אopens up arteries in the brain while the rest of the body’s arteries contract. 

i.e. w/ an injury, say a car-crash, where there is massive bleeding: all the body’s arteries contract while brain’s arteries open. 

-b/c of brain’s need for massive amount of blood

      אbrain is 4-5% of normal body weight

      אyet needs 20% of blood!!! 

• cortex can only live 3 minutes w/o oxygen!!!

אmore than 3 minutes of oxygen-deprivation creates irreversible brain damage, in the cortex)

• brain stem – 6-7 minutes w/o oxygen

 

אbrain-dead is defined as death of brainstem. 
 

 

-a tube connects the ventricles in both hemispheres.

      אthat tube has a ventricle midway through, called 3^rd ventricle 

-a tube sticking downwards from 3^rd ventricle –called Sylvius Aqueduct

      ->leads to the 4^th ventricleאb/w  

4^th ventricle

-b/w midbrain/cerebellum

-has stringy space which allows the CSF to go to the outside protective layer of the brain א(i.e. Pia mater) 

-Sylvius Aqueduct eventually b/c spinal tube 

-Lushka/Madenie = the spaces that attach 4^th ventricle to the outside of brain (Pia mater/arachnoid) 

• Pressure in ventricles is slightly higher in ventricles than in Arachnoid

 

Down to up: Pia matter אarachnoid אdura

-blood-vessels b/w the 2 layers of dura.

אsome small capillaries go into arachnoid (through the bottom layer of dura/arachnoid.

      -Called: Villiarachnoidalis

-has barriers to make them one way:

-they have a slanted thing called, to make sure that if pressure from behind it, then it opens and blood goes through. If pressure from the other side, the flow will not reverse, but rather it will block the blood-flow in that vain.

אif there is too much CFS, it enters the villiarachnoidalis and mix w/ the blood. (after all, CSF made from components of the blood)

      אtherefore, there is never a situation w/ too much CSF in the ventricles

            אas it’s constantly being made 

• The reason why there is a constant creation of CSF is b/c it does gives important nutrients to areas of brain inaccessible to blood-vessels. (i.e. sugars/antibodies)

-this is a closed system. The CSF is made in one place (ventricles) and absorbed in another (arachnoid –in the Superior-arachnoid-s? [SAS])

Class, Mar 26 2001

 

-There was an article written by Karasso over the weekend in Yediot Acharonot.

Class, April 2, 2001

Melatonin –2^nd week of may

Up to 10 pages

-general description

-no biochemics

-no formulas 

field of vision

-about 160 degrees

-about 130 w/1 eye 

-eyes always move, even w/ looking at 1 thing 

-humans see 1 thing.

      אother animal see 2 images 

-The nasal part of visual field אis contralateral אgoes to the diff. side of the brain

-Temporal part of the visual field: goes homolaterally אsame side of the brain

אthis allows humans to see 1 visiom 

Optic chiasm אabove hypophase (pituitary gland) אwhere the visual nerves cross

            אdamage to it: outside of visual field will not be seen

                  אvisual field will be limited by 30 degrees on each side.

Hemianopsia –blind in ½ of visual field. אw/ damage of  one of the optic radiation

 
 

-W/ damage to hemianopsia: can’t drive אcan’t see peripherally

      אI could w/ only 1 eye 

-the inverting the retinal image back from up-down happens in the hardware: the optic nerve twists  

• the sideways turning is also neurological

 
 

-quadrabtanopsia – damage in ¼ of visual field

April 23, 2001

 

Endocrinology

-deals w/ that glands secretes hormones

-->outside/inside body

      -->in reality, it is part of nervous system

            -->neuroendocrinology

                  -->centered around hypothalamus, which controls all of the glands 

Inside

-if you think about it, digestive system is outside the body

-sweat

-spit 

-->called *** 

Inside

-to the blood

-called Hormone 

Hormone – an enzyme which has receptors distant from where it is released

      -->transported in blood

            -->receptors all around body in neurons, or not? *** 
 

-hormone can deal w/ diff areas concurrently

      -->nerve deals w/ 1 place

Example of hypothalamus control

Hypothalamus releases ‘releasing hormone’ which goes to hypophase, which in turn releases ‘stimulating hormone’ which in turn affects a diff gland to release a diff. hormone 

First one is called: X releasing hormone

Second one called:  X stimulating Hormone 

-->then the last one feedbacks both to primary and secondary stations of hormonal communication mentioned above.

Positive feedback

-too much of a hormone leads to ceasing of its production 

Negative feedback:

-When a lack of hormone induces hypothalamus to make more 

 

Hypophesa –pituitary gland

Mutations

• in hypophase: too much release of TSH -->to much T hormone, yet low TRH
• In Thyroid: too much T-oxine -->too little TRH/TSH

Neuro-hormone

-almost only in nerves b/w hypothalamus and pituitary gland 

-released into axon

      -->axon is like a gland 

Double Message -->neurohormone also gets to blood/pulse comes to pituitary gland.

Glands

-some always release hormones

-others release after nerves contract the layer of muscle layer outside the gland. 

Pituitary gland: is really a set of glands, some of which are independent and some are released only after a message.

      Neuro-pituitary gland (neurohypopphese):controlled by the nerves (i.e. TSH)

            ADH (Antidehoretic hormone)

      Adeno-pituitary gland (adeno-hypoohese): regular hormones 
 

-Some glands have their own feedback, i.e. kidney measures blood-levels by itself, independently of the brain. -->adeno-gland 

thyroid gland:

-deals w/ exchange of chemicals in brain. I.e. fats/sugars/proteins 

-t-oxine –made form iodine 

-we need to get various things from outside our body, including t-oxine

      -->lack of iodine -->lack of t-oxine

Foods w/ =iodine include

• fish
• sea-plants
• pants which grow near the sea
• sea eater ender, in small quantity our drinking waters

 

-lack of iodine –disease called cretinism

      -inherited lack of thyroid horomones

            -->sometimes impotent/lack of growth/retarded

                  -->b/c of lack of iodine supported 

-Thyroid is able to concentrate iodine quite well -->much better than blood.

April 30, 2001

-kidney: filters the blood of wastes. 95% of the wastes get reentered into the blood, and gets reused by the body. This will change in correlation to factors like amount of drinking/sweating.

-->a lot of the homeostasis is keeping the proportion of salts to liquids in the body.

      -->this takes place in the kidney

-->the hormone that makes sure that the liquids cleaned in the kidneys is not wasted is the ADH 

Diabetis mellitus: diabetes too much sugar in the urine [/too little urine?]

Diabetis encipidus: too diluted urine -->too much urine -->lack of ADH 

When you urine often, but little:

• Prostate enlargement
• Pregnancy

 

When you urine a lot, often: (often diluted urine)

• Stress

 

-Caffeine and alcohol repress ADH -->people go to the washroom soon after they have it. 

-growths in pituitary gland/after accidents, where the stem (Pedunculus)of pituitary gland is torn

-in the Sella Turcica, the bone, where the pituitary gland exists. The stem of pituitary gland goes out of the bone and goes to the hypothalamus. A growth/tumor in the pituitary gland might break the thin bone on top of it, and might squeeze onto the nasal optic nerve, and disable them. They will limit/disable the nasal field of vision.

-->limited field of vision might be a symptom of a broken bone/growth/tumor in pituitary gland 

-a tear on the root of the pituitary gland root does not stop completely the bloodflow to pituitary gland, but it does stop the ADH.

            -->could cause diabetis encipudus 

Oxitocine: the hormone that is responsible contraction of the womb -->start of labour

      -->sometimes used to induce labour 

Growth Hormone (GH)

-responsible for out upwards growths

-->works on several plains:

• influences the bones to grow.

 

-a length bone is the one which usually grows

-->the top part separates and the in-between part is where the bone growth takes place.

      -->once it hardens, the bones can’t grow anymore

-->the GH separates the bone into 2 and builds the in-between and then re-separates it 

-growing pains might be b/c a kid grows too fast and it stretch his muscles/nerves/blood vessels 

• if there is a lack of GH, the kid might not reach his potential, since by the time his bones will have harden, he would not have grown enough.
• On the other hand, if he has reached his potential, extra GH won’t do anything.

 

Puberty:

1) might have some psychological effects, if you’re early starter and you are the only one in your class 

2) usually, correlation b/w sexual and growth development

-->if not, and puberty starts early, you might want to hinder it so that he will have more years to grow to his appropriate height. 

-Lack of GH or GH receptors (which are in the bones) -->low person

-too much GH/GH receptors -->very high/big person

-->for unknown reasons, we do not know why when we inject extra GH it won’t affect kid beyond potential, yet naturally made GH/extra receptors will. 

-height is also affected by nutrition 

• Genotype –the genetic makeup that we have

            -->i.e. if the parents are certain height/haircolor, it is passed on genetic

• Phenotype –the environmental factor that either allow or inhibit genotype from actualizing itself.

I.e.: the Yemenites who came to Israel: didn’t eat fattening foods/sugars -->they didn’t develop diabetes, even though they had it in their genotype. 

-Melatonin at night sleep induces GH

      -->Sleep disorders might hider GH

GH in adults

-reduced in adulthood, yet is still has a role

-->responsible for proportion b/w fat and muscle in body/elasticity of the skin

-->it might also have a life-elongating effect  

-->in adults, too much GH (in pathological amounts) has a detrimental effect

      -->usually from growths in pituitary

            -->acromegalia 

Acromegalia: too much GH in adulthood

• large chin
• large jaw
• large fingers
• people complain that they increase in show/glove/hat size

 

-medicines could hinder that

Hormones –May 7, 2001

TSH

-Tiroxine stimulating horomone

      -released by TRH

ACTH

-Adrenocorticotriophic hormone

-released by pituitary gland -->causes adrenal-cortex to release cortisol/steroids

-->induced by CRH (cortisol-releasing hormone)

LH/FSH

-gonad hormone: make the sexual organs make sexual actions 

/Follicle stimulating hormone 

Gonad: general name for sexual-related hormone

Trophic hormone: the hormones released by the pituitary gland. They are the ones that make another gland produce its hormone 

Gonadotrophic Releasing Hormone: GNRH

-->induces things like release of eggs in women

GH

-induced by Growth Releasing Hormone 

-Feeling: the specific sense

-Cognitive: appraisal as a dangerous situation 

-sometimes, pain and pleasure is the same thing.

      -->i.e. sadomasochistic sex. 

-i.e. some kids who their main relation with their parents is through abusive behavior

      -->therefore they associate abuse w/ love

-in sadomasochistic sex, there is no association b/w pain and danger

      -->as well as regular sex.

-->but some levels of pain are tolerable and even pleasurable -->i.e. massage. 

-Self-mutilation- there is a lack of association b/w pain and danger

-->or at least it is their only way for them to feel reality, since they could not feel reality in any other way 
 

-in pain, there is no correlation b/w intensivity of pain and reaction

      -->depends on if it reached the cognition or not.

-->if it didn’t, the person will keep on doing whatever he is doing and only then realize that he is hurting, once he realized that he was hit/injured, and then start limping 

-->diff. b/w  stimulation/reaction/behavior of pain

Stages

• Stimulation: the painful event. I.e. the pain is the small breach into the skin, regardless of whether you are piercing a little bit or taking out CSF from inside skull
1. Note: internal organs’ nerves don’t feel the way skin does -->in a surface kind of way., that is why if you stick a cord into the stomach and pull out a tumor, it won’t be felt the way cutting a skin tumor does
• Reaction: reflexive reaction, such as a contraction
• Behavior: i.e. limping
1. could also be w/o pain -->if pain is anticipated

 

Stress-produced analgesia: i.e. that is why soldiers don’t feel as much pain. 

Question: What is pain?

Answer: a stimulus that when it reaches the brain, it is understood as dangerous. 

2 kinds of Pain:

1. Somatic –comes from the receptors of the surface of the tissues, mostly skin/tendons/blood-vessels
2. Visceral  -from the organs

 

-huge diff in perception of pain b/w Somatic/Visceral pains

      -in visceral pains, it is mostly b/c contraction/expansion of an organ

            אi.e. migraine: contraction of blood-vessels in brain.

                  אdiff. in quality of the pain. (diff. kind)

                        אwe can usually tell the diff. 

-Auto-regulation: a system that regulates the amount of blood that gets into brain

Boundaries of pain

1. Threshold –border b/w uncomfortable and painful feeling

אphysiological change אvery universal

2. Tolerance –the border b/w painful feeling and pain that we are not able to deal w/ any more.

אpsychological limit of pain אdiff., based on culture

      אin some cases, people won’t feel the pain

Psychoneuroimmunology

      אthe psychological state enhances the immune system’s state 

-during stress, body releases endorphins

Spine

-sensory enters in the back (caudal?) side of the spinal nerve

-motoric nerves exit the front lobe of the spinal nerve 

-gelatinose substance- the area where the sensory nerves enter the spine into the spinal nerve

      א‘the gate of pain’

            אthat is where the peripheral and Central nerves synapse

                  אthe ‘gate’ to pain’

The gate control theory of pain

-deals w/ the rules of the neurons which pass on the pain from the peripheral nerves to central nerves in the gelatinose substance

      אthose neurons decide when to report the pain and when not to pass on the pain. 

The theory of specificity of neurons:

-each feeling has a separate neuron (dendrites) w/ specific receptors for that feeling

אassumption: if there is a certain receptor for heat/cold אthen there must be one for pain

      אFree nerve ending: thought it was the pain receptor

אbut in the end, they discovered that a free-nerve ending is just a growth that will grow into a receptor

אthe pain of the stimulation of the nerve ending was just what happens if you over-stimulate any nerve: Pain

      אIntensity of stimulation +# of receptors affected.

Gate cells

-the cells which senses come to.

3 kinds of sensory cells

• A cells: -Wide –myelinated
1. Alpha
2. Beta
3. Gama
4. Delta –both motoric and sensory (somatic)

אeach one is descendingly thinner 

 -speed: 300 meters a second 

• B cells -Wide, but not as wide/myelinated as A

אrelated to autonomic system

אvisceral senses 

                  -speed: 30 meters a second

• C cells. thin/unmyelinated

אpurely somatic sensory 

-speed: 3 meters a second 

Somatic pain:

-could travel on A delta/C cells 

-A delta cells closes the pain gate (inhibiting nerve)

      אcloses it almost completely

            אrelated to serotonin and endorphin

-C cells opens  pain gate 
 

אB-cells enter only when gate is open/doesn’t enter when gate = open

אthat is why when say, our hand gets cut [אwe press on out cut in order to innervate A-Delta cells which inhibit the gelatinose substance אcloses the gate] 

-B cells get combined w/ A/C cells אsometimes hard to tell if pain is somatic or visceral. 

-Visceral: sensitive to changes in pressure/volume

-Somatic: various surface/external changes. 

Experiment: tried to reduce pain in animals

      אstimulate the preaquaductal gray (PVG) of Sylvius aqueduct/preventricles

      אthe process is called SPA (stimulus producing analgesia) 

 
 

-Brainstem/preventrical/preaquaductal gray is also more sensitive to morpheme

      אanalgesia

            אthen we can assume that the brain has morphium receptors/synapses 

-you can also produce analgesia by hypnosis

Endorphin/Serotonin

Serotonin: relaxing hormone

      אlacking of it could lead to pain diseases or depression 

Endorphin: lack of it =pain. 

      אboth inhibit pain 

-More of serotonin/Endorphin אmore pain inhibitor. 

-person w/ serotonin medication – more sensitive to pain

      אusually, antidepressants also raise endorphins 
 

-stress-producing analgesia, such as in a war, there are stress hormones in the blood, but there are also endorphins in the blood to reduce pain. That is why a bullet might hit people and they won’t know that they’re hurt or bleeding. 
 

-Naloxon is an antagonist of endorphin (an analgesic) 

-homunculus –feels the visceral but not the somatic pain.

      אalso has a motorical area though. 

Acute vs. chronic pain

-Acute pain is strong pain, i.e. after breaking a leg

      אContinues w/o stop until about 3 months. 

-Chronic pain: more than 6 months

      אor alternatively pain beyond the expected/normal duration 

For example: after stomach operation: 3-4 weeks are painful. That is normal

      אbeyond  that is considered chronic 

Note: pain is an emergency signal saying that something in the body is not normal. That is why it is not always good to neutralize it, since it is a sign of where the problem exactly is or how urgent it is? 

-Ischemia: lack of blood אcould cause pain 

-Sometimes a strong pain covers over a weaker pain 

Note: no one can get used to pain!!! 

-Strong Acute pain leads to anxiety

אWhich in turn fortifies and increased the pain (i.e. by contacting the muscles which stimulates the painful area/less blood flow/alters chemical composition)

            אVicious cycle

אthough one can minimize the anxiety and reduce the vicious cycle. 

            אw/o treating the anxiety: anxiety b/c feeling of helplessness

                  אthen to depression (usually by state of chronic pain 

Series of event:

-Acute pain (anxiety) אsemi-chronic pain (helplessness) אchronic pain (depression)

• One can’t deal w/ acute pain w/o dealing w/ the anxiety
• Can’t deal w/ the chronic pain w/o dealing w/ the depression

 
 

Mask depression: depression that is hidden as a somatic pain.

      אi.e. somatization 

Somatization: moving emotional pain to the body (many cultures do this)

      אi.e. people feel pain in their joint (really b/c they feel useless)

אi.e. pain in the spine could be b/c they feel lack of stability in family/economic life

      אnote: the pain occurs in the brain. Not in the peripheral nerve. 

-Not all somatization is mask depression, but stems from other things like anxiety

      אi.e. parents had a knee-operation, so the kid has knee-pain, b/c of anxiety

            אpsychosomatic issues.

                  אneeds psychological therapy

      אb/c it all stems from psychological reasons 

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**-read about GABA/endorphin/serotonin