Disorders of Neuromuscular Function Flashcards

1
Q

Problems with the nerve cell body are referred to as….

A

Lower Motor Neuron Disorders

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2
Q

Problems with the nerve axon are referred to as…

A

Peripheral Neuropathies

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3
Q

Problems with muscle fibers are referred to as…

A

Myopathies

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4
Q

Why do most motor neuron disorders cause muscle weakening and wasting?

A

Because the muscle cells are not being used therefore atrophy

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5
Q

What is Muscular Dystrophy?

A

group of muscle diseases that weaken the musculoskeletal system and hampers locomotion (movement)

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6
Q

What is Muscular Dystrophy Characterized by?

A

progressive musculoskeletal weakening

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7
Q

What is Duchene Muscular Dystrophy (DMD)?

A

-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.
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8
Q

What is Becker Muscular Dystrophy (BMD)?

A
  • inherited as a recessive single-gene on the X chromosome (primarily affects males)
  • Diminished amounts of Dystrophin
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9
Q

What is the most common form of Muscular Dystrophy?

A

Duchene Muscular Dystrophy

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10
Q

What is the difference between DMD and BMD?

A

DMD - virtually absent dystrophin (muscle protein)

BMD- diminished amounts of dystrophin (muscle protein)

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11
Q

What can we do to treat Muscular Dystrophy?

A

unfortunately nothing

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12
Q

What is Myasthenia Gravis?

A

an Autoimmune Disease

Clinical Manifestations: muscle weakness and fatigability

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13
Q

What is the patho behind Myasthenia Gravis ?

A

caused by antibody-mediated destruction of Acetylcholine receptors

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14
Q

How is Myasthenia Gravis diagnosed?

A
  • history and physical
  • Anticholinesterase Test
  • nerve stimulation studies
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15
Q

What is the treatment for Myasthenia Gravis?

A
  • 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)

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16
Q

What is Carpal Tunnel Syndrome?

A
  • a compression type mononeuropathy in the wrist/palm area
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17
Q

What is Carpal Tunnel caused by?

A

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

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18
Q

What is the main S/S of Carpal Tunnel Syndrome?

A

intermittent numbness of the thumb

other S/S: paresthesia, pain, numbness

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19
Q

What are the risk factors for carpal tunnel?

A

diabetes, hypothyroidism, heavy manual work involving hands, vibrating machines

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20
Q

What is the treatment for Carpal Tunnel Syndrome?

A

steroid injections, splints, surgery to cut ligaments and to relieve pressure (surgery could result in precision grip weakness)

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21
Q

What is Guillain-Barre Syndrome?

A
  • acute immune-mediated polyneuropathy (many nerves involved)
  • Rapid progression of limb weakness and loss of tendon reflexes
  • affects the peripheral nervous system
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22
Q

What is the most common cause of acute Flaccid Paralysis?

A

Guillain-Barre Syndrome

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23
Q

What is Guillain-Barre Syndrome characterized by?

A

Bilateral Ascending Paralysis

Rapid onset (compared to the other disorders)

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24
Q

What can cause Guillain-Barre Syndrome?

A

not really sure why but seems to occur with the following

  • sever trauma
  • bad infections
  • flu vaccine
  • severe illnesses
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25
Q

Is Guillain-Barre Syndrome life threatening?

A

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

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26
Q

What are some Peripheral Nerve Disorders?

A

Carpal Tunnel Syndrome
Guillain-Barre Syndrome
Back Pain - Geriatrics

27
Q

What is the 2nd most common reason for visiting a health care provider?

A

backpain

*highest cost in treatment and lost wages

28
Q

How can you hurt your back?

A

Biomechanical: strenuous work, repetitive lifting, stooping, vibration

Destructive: infection, tumors, rheumatoid changes

Degenerative: Osteoporosis and Spinal Stenosis

29
Q

What are the S/S of nerve damage in the back?

A

Sciatic Nerve pain, groin pain, muscle spasms

  • pain aggravated by straining, bending, lifting, prolonged sitting
  • movement of the lower extremities = pain and involuntary resistance
30
Q

What is the treatment for Peripheral Nerve disorders in the back?

A

reduce pain and muscle spasms (medications), improve mobility (physical therapy), repair structural damage

31
Q

Herniated Intervertebral Disk

A
  • annulus fibrosus tear
  • nucleus pulposus then bulges out

Related to: trauma and lifting straining

32
Q

When is a disk most vulnerable to herniation?

A

1st thing in the morning

33
Q

What is the treatment for Herniated Intervertebral Disks?

A
  • anti-inflammatory medications
  • therapy to help get disk back in place
  • if severe enough a surgical intervention may be required
34
Q

What is Parkinson Disease?

A

Movement disorder that results from degeneration of nerve cells in the basal ganglia (results from death of dopamine cells)

35
Q

What are the S/S of Parkinson Disease?

A
  • tremor, rigidity, loss of reflexes, mask-like facial expression
  • Bradykinesia : slowness of movement/classic symptom
36
Q

What are the early S/S of Parkinson Disease?

A

shaking, rigidity, trouble with Gait

37
Q

What are the symptoms associated with later stages of Parkinson Disease?

A

dementia, depression, sleep and sensory problems

38
Q

What is given to people with Parkinson’s? Why?

A

Medications that increase Dopamine levels because dopamine is the affected neurotransmitter with this disease

39
Q

When does Parkinson’s usually start to show symptoms?

A

after age 50

40
Q

What is the cause of Parkinson Disease?

A

Unknown

environmental factors, in particular undetected viruses are highly suspected

41
Q

What is Amyotrophic Lateral Sclerosis (ALS)?

A

“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

42
Q

What is the cause of ALS?

A

unknown

43
Q

What is ALS characterized by?

A

rapidly progressive weakness, muscle atrophy, muscle spasticity, trouble speaking, trouble swallowing and trouble breathing

44
Q

What is the treatment for ALS?

A
  • 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
45
Q

What is the most common of the disorders in this chapter?

A

ALS

46
Q

What is Multiple Sclerosis (MS)?

A

a chronic, progressive disorder of unknown origin

-between attacks they could lose symptoms completely but as it progresses their symptoms stay

47
Q

What gets damaged in MS?

A

the myelin sheaths (nerve conduction impaired)

48
Q

What are myelin sheaths?

A

covers the nerves

purpose: to help contain conduction in the nervous system

49
Q

What are the possible causes of MS that have been studied?

A

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)

50
Q

What is the life expectancy of MS?

A

5-10 years less than those unaffected with MS

-can live a long life with this

51
Q

Who is MS mainly seen in?

A

women

52
Q

What is the treatment for MS?

A
  • No Cure
  • physical therapy
  • muscle relaxants to help reduce spasticity
  • corticosteroids to suppress inflammation and shorten exacerbations
  • supportive care for symptomatic relief
53
Q

What are we worried about with cervical injuries that are higher up?

A

the ability to breath (respiratory muscles)

54
Q

What is the #1 cause of Spinal cord injury?

A

Trauma (MVC, GSW, knife wounds, falls, sports)

55
Q

Who are spinal cord injuries seen in most?

A

young adults ages 16-30
males
people above the age of 60

56
Q

Of all the spinal cord injuries about how many are Cervical?

A

50% Cervical (other types would be lumbar and thoracic)

57
Q

Is damage to the spinal cord more commonly resulted from hyperflexion or hyperextension?

A

Most common : Hyperflexion

58
Q

Hyperextension spinal cord injuries usually result from what?

A

falls

59
Q

What are some Non-traumatic causes of spinal cord injury?

A

degenerative (osteoporosis)
infection
tumors
vascular (clot)

60
Q

What is the most common site for compression injuries to the spinal cord?

A

lumbar and lower thoracic

*compression injuries result from falls or jumps

61
Q

Complete Transection

A

flaccid paralysis below injury

62
Q

Edema with Spinal Cord Injuries

A
  • 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

63
Q

Spinal Cord Injuries are determined by what?

A

by both skeletal level and neurological level

-neuro level determined by lowest spinal segment with bilaterally intact motor sensation

64
Q

What two things can be impaired with Spinal Cord injuries?

A

movement and sensation