Disorders of Neuromuscular Function Flashcards
Problems with the nerve cell body are referred to as….
Lower Motor Neuron Disorders
Problems with the nerve axon are referred to as…
Peripheral Neuropathies
Problems with muscle fibers are referred to as…
Myopathies
Why do most motor neuron disorders cause muscle weakening and wasting?
Because the muscle cells are not being used therefore atrophy
What is Muscular Dystrophy?
group of muscle diseases that weaken the musculoskeletal system and hampers locomotion (movement)
What is Muscular Dystrophy Characterized by?
progressive musculoskeletal weakening
What is Duchene Muscular Dystrophy (DMD)?
-Inherited as a recessive single-gene on the X chromosome (Primarily Affects Males)
- the muscle protein Dystrophin is virtually ABSENT
- leads to pseudohypertrophy which leads to muscle weakness.
What is Becker Muscular Dystrophy (BMD)?
- inherited as a recessive single-gene on the X chromosome (primarily affects males)
- Diminished amounts of Dystrophin
What is the most common form of Muscular Dystrophy?
Duchene Muscular Dystrophy
What is the difference between DMD and BMD?
DMD - virtually absent dystrophin (muscle protein)
BMD- diminished amounts of dystrophin (muscle protein)
What can we do to treat Muscular Dystrophy?
unfortunately nothing
What is Myasthenia Gravis?
an Autoimmune Disease
Clinical Manifestations: muscle weakness and fatigability
What is the patho behind Myasthenia Gravis ?
caused by antibody-mediated destruction of Acetylcholine receptors
How is Myasthenia Gravis diagnosed?
- history and physical
- Anticholinesterase Test
- nerve stimulation studies
What is the treatment for Myasthenia Gravis?
- immunosuppressants
- lost of REST after a flare up because the muscle groups gets very fatigued
-pay close attention to Respiratory system (respiratory muscles can be affected)
What is Carpal Tunnel Syndrome?
- a compression type mononeuropathy in the wrist/palm area
What is Carpal Tunnel caused by?
by compression of the media nerve as it travels with flexor tendons trough a canal made by carpal bones and ligaments
pathology behind carpal tunnel is not well understood
What is the main S/S of Carpal Tunnel Syndrome?
intermittent numbness of the thumb
other S/S: paresthesia, pain, numbness
What are the risk factors for carpal tunnel?
diabetes, hypothyroidism, heavy manual work involving hands, vibrating machines
What is the treatment for Carpal Tunnel Syndrome?
steroid injections, splints, surgery to cut ligaments and to relieve pressure (surgery could result in precision grip weakness)
What is Guillain-Barre Syndrome?
- acute immune-mediated polyneuropathy (many nerves involved)
- Rapid progression of limb weakness and loss of tendon reflexes
- affects the peripheral nervous system
What is the most common cause of acute Flaccid Paralysis?
Guillain-Barre Syndrome
What is Guillain-Barre Syndrome characterized by?
Bilateral Ascending Paralysis
Rapid onset (compared to the other disorders)
What can cause Guillain-Barre Syndrome?
not really sure why but seems to occur with the following
- sever trauma
- bad infections
- flu vaccine
- severe illnesses
Is Guillain-Barre Syndrome life threatening?
most people fully recover from Guillain-Barre with supportive care (ventilators, turning them periodically, feeding tube). Guillain-Barre could be fatal if the ascending paralysis makes it to the respiratory system and the person is not put on a ventilator
What are some Peripheral Nerve Disorders?
Carpal Tunnel Syndrome
Guillain-Barre Syndrome
Back Pain - Geriatrics
What is the 2nd most common reason for visiting a health care provider?
backpain
*highest cost in treatment and lost wages
How can you hurt your back?
Biomechanical: strenuous work, repetitive lifting, stooping, vibration
Destructive: infection, tumors, rheumatoid changes
Degenerative: Osteoporosis and Spinal Stenosis
What are the S/S of nerve damage in the back?
Sciatic Nerve pain, groin pain, muscle spasms
- pain aggravated by straining, bending, lifting, prolonged sitting
- movement of the lower extremities = pain and involuntary resistance
What is the treatment for Peripheral Nerve disorders in the back?
reduce pain and muscle spasms (medications), improve mobility (physical therapy), repair structural damage
Herniated Intervertebral Disk
- annulus fibrosus tear
- nucleus pulposus then bulges out
Related to: trauma and lifting straining
When is a disk most vulnerable to herniation?
1st thing in the morning
What is the treatment for Herniated Intervertebral Disks?
- anti-inflammatory medications
- therapy to help get disk back in place
- if severe enough a surgical intervention may be required
What is Parkinson Disease?
Movement disorder that results from degeneration of nerve cells in the basal ganglia (results from death of dopamine cells)
What are the S/S of Parkinson Disease?
- tremor, rigidity, loss of reflexes, mask-like facial expression
- Bradykinesia : slowness of movement/classic symptom
What are the early S/S of Parkinson Disease?
shaking, rigidity, trouble with Gait
What are the symptoms associated with later stages of Parkinson Disease?
dementia, depression, sleep and sensory problems
What is given to people with Parkinson’s? Why?
Medications that increase Dopamine levels because dopamine is the affected neurotransmitter with this disease
When does Parkinson’s usually start to show symptoms?
after age 50
What is the cause of Parkinson Disease?
Unknown
environmental factors, in particular undetected viruses are highly suspected
What is Amyotrophic Lateral Sclerosis (ALS)?
“Lou Gehrig’s Disease”
-a chronic, terminal, neurological disease in which there is a progressive loss of motor neurons
-disturbances in motility and atrophy of muscles of the hands, forearms, and legs because of degeneration of motor neurons
What is the cause of ALS?
unknown
What is ALS characterized by?
rapidly progressive weakness, muscle atrophy, muscle spasticity, trouble speaking, trouble swallowing and trouble breathing
What is the treatment for ALS?
- requires early education of the patient and the patient’s family so that a proper management system may be provided to anticipate and prevent certain hazards
- prevention of upper airway obstruction and pathologic aspiration, drawing of vomitus or mucus into the respiratory tract, is the main focus
What is the most common of the disorders in this chapter?
ALS
What is Multiple Sclerosis (MS)?
a chronic, progressive disorder of unknown origin
-between attacks they could lose symptoms completely but as it progresses their symptoms stay
What gets damaged in MS?
the myelin sheaths (nerve conduction impaired)
What are myelin sheaths?
covers the nerves
purpose: to help contain conduction in the nervous system
What are the possible causes of MS that have been studied?
viruses, immunologic reactions to a virus, bacteria, trauma, autoimmunity, and heredity, but the findings of this research have remained inconclusive
-linking to vitamin D deficiency (not proven)
What is the life expectancy of MS?
5-10 years less than those unaffected with MS
-can live a long life with this
Who is MS mainly seen in?
women
What is the treatment for MS?
- No Cure
- physical therapy
- muscle relaxants to help reduce spasticity
- corticosteroids to suppress inflammation and shorten exacerbations
- supportive care for symptomatic relief
What are we worried about with cervical injuries that are higher up?
the ability to breath (respiratory muscles)
What is the #1 cause of Spinal cord injury?
Trauma (MVC, GSW, knife wounds, falls, sports)
Who are spinal cord injuries seen in most?
young adults ages 16-30
males
people above the age of 60
Of all the spinal cord injuries about how many are Cervical?
50% Cervical (other types would be lumbar and thoracic)
Is damage to the spinal cord more commonly resulted from hyperflexion or hyperextension?
Most common : Hyperflexion
Hyperextension spinal cord injuries usually result from what?
falls
What are some Non-traumatic causes of spinal cord injury?
degenerative (osteoporosis)
infection
tumors
vascular (clot)
What is the most common site for compression injuries to the spinal cord?
lumbar and lower thoracic
*compression injuries result from falls or jumps
Complete Transection
flaccid paralysis below injury
Edema with Spinal Cord Injuries
- occurs at injury site within 1 hour
- lasts about 7 days
- need to wait for edema to subside to determine true level of disability (usually a year to two years)
Give high doses of Steroids to reduce inflammation because inflammation can cause even more damage
Spinal Cord Injuries are determined by what?
by both skeletal level and neurological level
-neuro level determined by lowest spinal segment with bilaterally intact motor sensation
What two things can be impaired with Spinal Cord injuries?
movement and sensation
