CH 21: Disorders of Movement

Question 1

Disorders associated with movement are some of the most difficult conditions to treat because their

Answer 1

underlying mechanisms span other important systems in the body: the nervous, muscular, endocrine, and skeletal systems.

Question 2

involuntary contractions of a skeletal muscle or group of skeletal muscles. The muscles become tightened and fixed, causing intense pain that usually diminishes after a few minutes. Chronic muscle spasms can impair joint function.

Answer 2

muscle spasms

Question 3

possible causes of muscle spasms

Answer 3

overmedication with antipsychotic drugs, epilepsy, hypocalcemia, dehydration, and neurologic disorders

Question 4

patients with muscle spasms may experience:

Answer 4

inflammation
edema
pain at the affected muscle
loss of coordination
reduced mobility

Question 5

first and second line drugs for muscle spasms

Answer 5

1 - NSAIDs
2 - skeletal muscle relaxants

Question 6

goal for muscle spasm drug therapy

Answer 6

Minimize pain, and discomfort, increase range of motion, improve function

Question 7

treat muscle spasms at the brain and spinal cord level

Answer 7

Centrally Acting Skeletal Muscle Relaxants

Question 8

skeletal muscle relaxants

Answer 8

Baclofen
cyclobenzaprine

Question 9

imidazolines

Answer 9

clonidine

Question 10

benzodiazepines

Answer 10

clonazepam
diazepam

Question 11

condition in which muscle groups remain in a continuous state of contraction. Contracted muscles become stiff with increased muscle tone. Other signs and symptoms include mild to severe pain, exaggerated deep tendon reflexes, localized muscle spasms, scissoring (involuntary crossing of the legs), and fixed joints.

Answer 11

Spasticity

Question 12

Treatment of spasticity

Answer 12

– PT and meds
– meds alone will not work
– regular exercise can decrease symptoms

Question 13

work at the level of the neuro-muscular junction and skeletal muscles.

Answer 13

direct-acting antispasmodics

Question 14

Dantrolene relieves spasticity by

Answer 14

interfering with the release of calcium ions in skeletal muscle.

Question 15

direct acting antispasmodics

Answer 15

neuromuscular junction action
skeletal muscle action - relaxant

Question 16

nicotinic blocking drugs interfere with the binding of

Answer 16

acetylcholine, thereby preventing voluntary muscle contraction.

Question 17

two major classes of nicotinic blocking drugs

Answer 17

nondepolarizing blockers and depolarizing blockers.

Question 18

Nondepolarizing blockers MOA

Answer 18

compete with acetylcholine for the receptor

Question 19

depolarizing blockers MOA

Answer 19

bind to the acetylcholine receptor and produce a state of continuous depolarization.

Question 20

concern of blocker medications is

Answer 20

overrelaxation of muscles (breathing)

Question 21

non-depolarizing blockers ex

Answer 21

vecuronium - long duration

Question 22

depolarizing blockers ex

Answer 22

succinylcholine - short duration

Question 23

rare, life-threatening, anesthetic-related disorder that occurs in susceptible patients following the administration of a triggering agent, such as inhaled halogenated volatile anesthetics or succinylcholine.

Answer 23

Malignant hyperthermia

Question 24

The signs of malignant hyperthermia include

Answer 24

muscle rigidity
rapid heart rate
high body temperature
muscle breakdown
increased acid content.

Question 25

poor blood circulation to the legs

Answer 25

intermittent claudication

Question 26

cylcobezaprine therapeutic effects

Answer 26

relieves muscle spasms of local origin without interfering with general muscle function

Question 27

adverse effects of imidazolines

Answer 27

dry mouth
impotence
sedation
lethargy
orthostatic hypotension

Question 28

bacterium responsible for botulism food poisoning

Answer 28

clostridium botulinum

Question 29

produces effect by blocking the release of ACH from cholinergic nerve terminals

Answer 29

botulinum toxin

Question 30

adverse effects of neuromuscular junction action

Answer 30

Headache
dysphagia
ptosis
local muscle weakness
pain
muscle tenderness
Anaphylaxis, dysphagia, death

Question 31

calcium release blockers MOA

Answer 31

interferes with the release of calcium ions from storage areas inside skeletal muscle cells.

Question 32

skeletal muscle relaxant black box warning

Answer 32

Hepatitis and deaths due to liver failure have occurred with dantrolene.