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Neuro > 4.5- "Other" Neuro Disorders 2 > Flashcards

4.5- "Other" Neuro Disorders 2 Flashcards

1
Q

What is a Basal Ganglion disorder due to death of Dopamine producing cells in the Substantia Nigra and acetylcholine producing cells in the Pedunculopontine nucleus (80% of cells die before any deficits are observed)?

A

Parkinson’s Disease

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2
Q

What disorder effects activation of voluntary movement and automatic/reflexive movement?

A

Parkinson’s Disease

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3
Q

Parkinson’s origin is unknown, may include _______.

More years of education = _____ risk; smoking and exercise = ____ risk

A

toxic exposure

greater risk

less risk

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4
Q

What disorder typically onsets 50-65 yo and increasing frequency with age;
men > women?

A

Parkinson’s Disease

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5
Q

Signs and Symptoms of Parkinson’s

  1. Rigidity- _____ and _____
  2. Difficulty coming from ____ to ___
  3. _____ (___) gait- take very short steps so pt compensates by speeding cadence, may result in running into something or falling
A
  1. trunk & extremities
  2. sitting to standing
  3. Festinating (shuffling)
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6
Q

Signs and Symptoms of Parkinson’s

  1. Postural instability
  2. Resting “_____” tremors- gets worse with tension and exertion
  3. “____” during movement, including gait cycle
  4. ____ and parathesis
A
  1. pill-rolling
  2. Freezing
  3. pain
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7
Q

Signs and Symptoms of Parkinson’s

  1. _____ complications/low breath support- ____ speech
  2. ______ dysfunction causing _____
  3. _____ impairments
  4. ___ of thought processes with decreased ability to ___ & ___
A
  1. respiratory- soft monotone speech
  2. autonomic dysfunction causing orthostatic hypotension
  3. visuoperceptive
  4. slowing of thought processes w/ decreased ability to attend & concentrate
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8
Q

Parkinson’s Rigidity

  • first sign = _________
  • ____ rigidity= jerky response to passive movement
  • ____ rigidity= slow and sustained resistance to passive movement
A

loss of arm swing in gait

cogwheel

lead-pipe

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9
Q

Festinating (shuffling) gait

-flexed posture with ______

A

little to no arm swing

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10
Q

Postural instability

  • flexed posture w/ ↑ ____ causing COG to be pulled forward- pt compensates by _____
  • can’t respond to expected & unexpected postural disturbances- causes ____
A

kyphosis

leaning back

falls

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11
Q 
Visuoperceptive impairment (difficulty moving past visual blocks such as walker, doorway, therapist), or walking on a different surface
- difficulty separating self movement from \_\_\_\_\_
A

movement of environment

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12
Q

Slowing of through processes w/ ↓ ability to attend and concentrate

  • 50% develop ____ due to neurochemical changes
  • ____ and ____ due to chemical changes
A

dementia

depression and apathy

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13
Q

What is the prognosis for someone with Parkinson’s Disease?

What is the medical treatment?

A

progressive, average life span after Dx 13 years

Drug therapy w/ L-dopa (Sinemet)- tends to lose effectiveness over time

Surgical intervention to destroy part of the thalamus or the globus pallidus or implant stimulator

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14
Q

Therapy for Parkinson’s focuses on

1.
2.
3.

A
  1. Gait
  2. Posture
  3. Aerobic conditioning
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15
Q

Parkinson’s Gait

  • ____ cues- step over markers, walk towards a mirror, mentally rehearse long strides
  • ____ cues- rhythmic cues can speed up cadence & stride length
A

visual cues

verbal cues

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16
Q

Parkinson’s Gait

  • break down task so pt can think about ____
  • practice ____, ____, ____, ____
  • mark a spot ahead as a goal
  • if using device, promote ___ rather than ____
A

the parts

practice side stepping, walking backwards, braiding, marching

promote ext rather than flexion

17
Q

Parkinson’s Posture

  • Increase ______
  • Stretch ______ and _____
  • Rotational therex for ____ and ____
  • Postural stability exercises
A
  • increase extension
  • stretch anterior chest and gastroc
  • rotational therex for trunk and limbs (might do better sitting vs. supine)
18
Q

Parkinson’s Aerobic Conditioning

  • decreases ____ and maintains _____ system
A
  • decreases fatigue and maintains respiratory system
19
Q

What disorder is a reduced reciprocal inhibition due to decreased descending inhibition; when in hand, often misdiagnosed as CTS or tennis elbow?

A

Dystonia

20
Q

Dystonia is idiopathic: 66% of cases are ____, remaining cases are due to _______.

Focal dystonia found in musicians may be result of abnormal or repetitive mechanics.

A

66% are genetic, remaining cases are due to scarring in small areas of the cortex

21
Q

What population/demographics are diagnosed with dystonia?

A

idiopathic dystonia onset 8 yo

focal dystonia onset 30-50 yo

male equal to female

22
Q

Signs and Symptoms of Dystonia

  • involuntary sustained muscle contraction causing abnormal ___ or ____ limited to one part of the body
  • often limited to a particular activity
  • can also be more generalized affecting multiple muscle groups/body segments
A

postures or twisting repetitive movements

23
Q

Prognosis of Dystonia- earlier onset=greater likelihood it ____

A

will progress

24
Q

Medical treatment of Dystonia= medication that affects acetylcholine or ____ levels, surgery on ____, or Botox into affected muscles in severe cases

A

dopamine

surgery on thalamus

25
Q

Therapy Treatment of Dystonia

  • limit _____
  • avoid _____
  • sensory retraining, biofeedback, mental rehearsal of target movement
A
  • limit abnormal movements

- avoid heavy gripping of the offending object/instrument

26
Q

What disease affects synaptic transmission at the neuromuscular junction by producing antibodies to the nicotinic receptors on the muscle cell?

A

Myasthenia Gravis

27
Q

Myasthenia Gravis is ____ and affects women ages 20-30 and men ages 60-70.

A

autoimmune

28
Q

Signs and Symptoms of Myasthenia Gravis

  1. ↑ ____ with repetitive muscle use
  2. muscles that ____ frequently will be more affected- eye lids, eyes, facial expression, swallowing, proximal limb movement, respiration
  3. Worse in the ____ than ____
A
  1. weakness
  2. contract
  3. worse in the afternoon than morning
29
Q

What is the prognosis of Myasthenia Gravis?

What is the therapy treatment?

A

stable with treatment

gentle strengthening
stretching
aerobic activity w/o working client to significant fatigue

30
Q

Medical treatment of Myasthenia Gravis

  • drugs that ___ breakdown of acetylcholine
  • removal of the _____
  • ______ drugs
  • plasmapheresis
A

inhibit

thymus gland

immunosuppressive

31
Q

What disease is a viral infection attacking anterior horn cells leading to muscular paralysis?

Found in 20-40% of survivors.

A

Post-Polio Syndrome (PPS)

32
Q

_____ - giant motor units were made as pt originally recovered; as pt ages, motor units are lost- loss is compounded in this situation b/c they are larger than normal but fewer in number than typical person

A

PPS (Etiology)

33
Q

Signs and Symptoms of PPS

  1. ____- overuse and deconditioning can contribute
  2. ____- sweating, HA
  3. ____- occurs in previously involved and new muscles
A
  1. fatigue
  2. autonomic distress
  3. new weakness
34
Q

Signs and Symptoms of PPS

  1. Pain can occur __ days after activity
  2. ____-due to sympathetic involvement
  3. ↑ ____- often have compensated to past deficits, but w/ new changes the compensations may no longer work
A
  1. 1-2
  2. cold intolerance
  3. increased fall risk
35
Q

PPS- new weakness- occurs in previously involved & new muscles

  • asymmetric, ___>___, slowly progressive
  • responds well to ___ & ___ activity
A
  • proximal > distal

- rest and pacing activities

36
Q

What is the prognosis of PPS?

What is the medical treatment?

What is the therapy treatment?

A

slowly progressive

meds not effective

lifestyle changes & exercise

37
Q 
Therapy Treatment of PPS
Lifestyle changes
1. ↓ \_\_\_& \_\_\_ stress
2. Protect \_\_\_
3. Modify \_\_\_\_\_\_
4. \_\_\_\_\_ aids
5. Weight loss & \_\_\_\_\_
A
  1. decrease physical and emotional stress
  2. protect joints (esp if decreased strength of surrounding muscle)
  3. modify work/home environment
  4. mobility aids
  5. energy conservation
38
Q

Therapy Treatment of PPS
Exercise
1. ____, but avoid pushing past fatigue & pain
a. ____- do not exceed 70-75% Max HR or 13 on BORG scale
b. _____

A
  1. strengthen

a. conditioning
b. aquatics

Neuro (30 decks)

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