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UNIT 1: THERAPEUTIC MODALITIES, PSYCHOSOCIAL SKILLS AND NURSING

STRATEGIES

NEUROTRANSMITTERS
Are the chemicals which allow the transmission of signals from one neuron to the next
across synapses. They are also found at the axon endings of motor neurons, where they
stimulate the muscle fibers.

ACETYLCHOLINE- It is responsible for much of the stimulation of muscles, including the

muscles of the gastro-intestinal system. It is also found in sensory neurons and in the
autonomic nervous system, and has a part in scheduling REM (dream) sleep.
NOREPINEPHRINE- Strongly associated with bringing our nervous systems into “high
alert”. It is prevalent in the sympathetic nervous system , and it increases our HR and BP,
along with its close relative epinephrine (aka adrenalin). It is also important for forming
memories. Stress tends to deplete our store of adrenalin, while exercise tends to increase it.
Amphetamines (“speed”) work by causing the release of norepinephrine, as well as other
neurotransmitters called dopamine and serotonin.
DOPAMINE- It is an inhibitory neurotransmitter, meaning that when it finds its way to its
receptor sites, it blocks the tendency of that neuron to fire. Dopamine is strongly associated
with reward mechanisms in the brain. Drugs like cocaine, heroin, opium, and alcohol
increases the levels of dopamine as it does with nicotine. If it feels good, dopamine neurons
are probably involved. On the other hand, low dopamine may related not only to the
unsociability of schizophrenics, but also to unsocial anxiety.
GABA (gamma aminobutyric acid)- Which is also usually an inhibitory neurotransmitter.
GABA tend to suffer from anxiety disorders, and drugs like Valium work by enhancing the
effects of GABA. Lots of other drugs influence GABA receptrors, including alcohol and
barbiturates. If GABA is lacking in certain parts of the brain, epilepsy results.

GLUTAMATE- Glutamate is an excitatory relative to GABA. It is the most common

neurotransmitter in the CNS-as much as half of all neurons, and an excess will kill them.
Sometimes, brain damage or a stroke will lead to an excess and end with many more brain
cells dying from the original trauma.
SEROTONIN- Serotonin is an inhibitory neurotransmitter that has been found to be
intimately involved in emotion and mood. Too little serotonin has been shown to lead to

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depression, problems with anger control, OCD, and suicide. Too little also leads to an
increased appetite for carbohydrates (starchy foods) and trouble sleeping, which are also
associated with depression and other emotional disorders. It has also been tied to
migraines, irritable bowel syndrome, and fibromyalgia. Prozac and other recent drugs help
people with depression by preventing the neurons from “vacuuming” up excess serotonin,
so that there is more left floating around in the synapses. It is interesting that a little warm
milk bedtime also increases the levels of serotonin. As mom may have told you, it helps
you to sleep. Serotonin is a derivative of tryptophan, which is found in milk. On the other
hand, serotonin also plays a role in perception. Hallucinogens like ecstasy work by
attaching to serotonin receptor sites and thereby blocking transmissions in perceptual
pathways.
ENDORPHIN- Endorphin Is Short for “endogenous morphine”. It is structurally similar to
the opioids, (opium, morphine, heroin, etc.) and has similar functions: Inhibitory, it is
involved in pain reduction and pleasure, and the opioid drugs work by attaching to
endorphin’s receptor sites. Consider; heroin slows HR, respiration, and metabolism in
general- exactly what you would need to hibernate.
NEURON

A typical neuron has all the parts that any cell would have, and a few specialized structures
that set it apart. The main portion of the cell is called the soma or cell body. It contains
the nucleus, which in turn contains the genetic material in the form of chromosomes.

Neurons have a large number of extensions called dendrites. They often look likes

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branches or spikes extending out from the cell body. It is primarily the surfaces of the
dendrites that receive chemical messages from other neurons.

One extension is different from all the others, and is called the axon. Although in some
neurons, it is hard to distinguish from the dendrites, in others it is easily distinguished by
its length. The purpose of the axon is to transmit an electro-chemical signal to other
neurons, sometimes over a considerable distance. In the neurons that make up the nerves
running from the spinal cord to your toes, the axons can be as long as three feet!

Longer axons are usually covered with a myelin sheath, a series of fatty cells which have
wrapped around an axon many times. These make the axon look like a necklace of
sausage-shaped beads. They serve a similar function as the insulation around electrical
wire.

At the very end of the axon is the axon ending, which goes by a variety of names such as
the bouton, the synaptic knob, the axon foot, and so on (I do not know why no one has
settled on a consistent term!). It is there that the electro-chemical signal that has travelled
the length of the axon is converted into a chemical message that travels to the next neuron.

The synapse

When the action potential reaches the axon ending, it causes tiny bubbles of chemicals
called vesicles to release their contents into the synaptic gap. These chemicals are
called neurotransmitters. These sail across the gap to the next neuron, where they find
special places on the cell membrane of the next neuron called receptor sites.

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Types of Neurons

While there are many different kinds of neurons, there are three broad categories based on
function:

1. Sensory neurons are sensitive to various non-neural stimuli. There are sensory neurons
in the skin, muscles, joints, and organs that indicate pressure, temperature, and pain. There
are more specialized neurons in the nose and tongue that are sensitive to the molecular
shapes we perceive as tastes and smells. Neurons in the inner ear are sensitive to vibration,
and provide us with information about sound. And the rods and cones of the retina are
sensitive to light, and allow us to see.

2. Motor neurons are able to stimulate muscle cells throughout the body, including the
muscles of the heart, diaphragm, intestines, bladder, and glands.

3. Interneurons are the neurons that provide connections between sensory and motor
neurons, as well as between themselves. The neurons of the central nervous system,
including the brain, are all interneurons.

Most neurons are collected into "packages" of one sort or another, sometimes visible to the
naked eye. A clump of neuron cell bodies, for example, is called
a ganglion (plural: ganglia) or a nucleus (plural: nuclei). A fiber made up of many axons
is called a nerve. In the brain and spinal cord, areas that are mostly axons are called white
matter, and it is possible to differentiate pathways or tracts of these axons.

C. M. D. Hamo-ay