Basal Ganglia Disorder - Parkinson's Sx

Question 1

What is the function of the basal ganglia?

Answer 1

Helps the motor cortex in running well learned motor skills

Lets skilled movements to run with minimal attention requirements

Question 2

Where does the output of motor skills come from?

Answer 2

1. supplemental motor cortex for internal cueing of movement sequences
2. premotor cortex for motor readines

Question 3

What happens when the basal ganglia is defective?

Answer 3

• degrades the normal control movement
• has a hard time with well learned complex tasks
• slow adapting response in changing environment
• decreased amplitude of the movement
• hard time switching from one task to another
• imprecise release of sub-movements
• Inaccurate terminations

Question 4

What is indicated by the SNpc regarding parkinson’s?

Answer 4

When neurons die, the color fades from a dark color

Question 5

What are the four cardinal signs of Parkinson’s diease?

Answer 5

Tremors
Rigidity
Akinesia-bradykinesia
Postural instability

Question 6

What is the frequency of tremors?

Answer 6

4-5 hz and a larger amplitude at rest

Question 7

What is the characteristic of rigidity?

Answer 7

Usually a cog-wheel in the UE

Question 8

What are the sx of akinesia/bradykinesia?

Answer 8

Patient hestiates
slow movement
impaired repetitive movement
freezing
diminished arm swining
facial masking (no emotion)

Question 9

Other than the 4 cardinal sx, what are other signs and sx?

Answer 9

Can’t voluntarily control all ADLs
gait (slow, shuffling and festination)
speech is monotone with ↓ volume

Question 10

What is rhythmic tremor?

Answer 10

Happens in one hand at first where it looks like they are rolling a pill between the thumb and index finger

Question 11

What shows in muscle rigidity?

Answer 11

shows as the cogwheel phenomenon
- when pushing the arm, it moves in a jerky increments instead of all smooth

Question 12

What is seen in PD’s regarding postural instability?

Answer 12

they either lean forward or backwards
- this affects when they are upright since they have problems with balance and coordination

Question 13

How is the functional sit to stand for PD patients?

Answer 13

They have a hard time getting up from sitting
- they have disordered control over the movement
- some patients report feeling weak and being tied down

Question 14

What is hypokinesia?

Answer 14

↓ movement amplitude and speed
↓ step length
changes in rate and movement timing

Question 15

What is freezing in PD?

Answer 15

they are not able to start the walking process

sudden stop during motion because of changes in environment or distraction

having a hard time restarting the sequence once it happens

Question 16

What is gait festination?

Answer 16

involuntary shortening of the steps and faster cadence part way of a task

Question 17

What is a movement set in PD?

Answer 17

preparing the brain in order to do a movement sequence

Question 18

What are the sx of autonomic dysfunction?

Answer 18

orthostatic hypotension
flushing
sweats
constipation
sphincter and sex dysfunction

Question 19

What are the sx of sensory manifestations?

Answer 19

paresthesia
pains
akathisia: visual, olfactory, vestibular dysfunction

Question 20

What are some other non-motor manifestations?

Answer 20

seborrhea
edema
fatigue
weight loss

Seborrhea - a common, noncontagious, easy-to-manage skin condition

Question 21

What are some behavioral abnormalities?

Answer 21

• personality changes
• dementia
• paranoia, psychosis, hallucination
• depression
• sleep distrubance

Question 22

What are some sx regarding personality changes for PD?

Answer 22

• apathy
• lack of confidence :(
• fear
• anxiety
• emotional lability
• social withdraw
• dependency
• slow though process
• loss of concentration
• hard time with concept formation