Hypokinesia and Hyperkinesia

Question 1

where is degeneration seen with Huntington’s?

Answer 1

striatum and cerebral cortex

Question 2

what can an OT do for Tourette’s?

Answer 2

stress management

Question 3

what structure does the GPi act on?

Answer 3

thalamus

Question 4

involuntary, jerky, rapid movements

Answer 4

chorea

Question 5

with Parkinson’s, an excessively inhibited thalamus leads to what?

Answer 5

excessive inhibition of descending motor tracts by M1

Question 6

when the putamen lacks dopamine, what can it not adequately regulate? (Parkinson’s)

Answer 6

globus pallidus internus

Question 7

which disorders involve an abnormal accumulation of protein deposits in neurons?

Answer 7

progressive supranuclear palsy and dementia with Lewy bodies

Question 8

what are examples of hypokinetic disorders?

Answer 8

Parkinson’s, Parkinson’s plus, Parkinsonism

Question 9

what can an OT do for multiple system atrophy?

Answer 9

fall prevention, address postural hypotension, exercise program

Question 10

what can an OT do for freezing of gait?

Answer 10

auditory cueing, visual targets

Question 11

these symptoms indicate what disorder?: Early onset of gait instability (tendency to fall backward), Supranuclear gaze palsy, Unable to control gaze (vertical gaze affected first), Affects UMNs that synapse with cranial nerve nuclei in brainstem controlling eye movement, Rigidity, Freezing of gait, Depression, Psychosis, Rage attacks

Answer 11

progressive supranuclear palsy

Question 12

type of dystonia: most common, limited to one part of body

Answer 12

focal dystonia

Question 13

Spontaneous (sometimes uncontrollable) activities resulting from a lesion. Words such as “new”, “spontaneous” may be used (e.g., tremors, tics)

Answer 13

positive sign

Question 14

Excessive inhibition of motor structures by the BG; negative signs

Answer 14

hypokinetic disorders

Question 15

when the GPi isn’t adequately regulated by the putamen, what does it do? (Parkinson’s)

Answer 15

excessively inhibits motor structures

Question 16

what can an OT do for dementia with Lewy bodies?

Answer 16

establish routines, eliminate distractions, provide familiar environment

Question 17

side effect of drugs that treat psychosis or digestive problems (usually dopamine blockers)

Answer 17

drug-induced Parkinsonism

Question 18

what can an OT do for Huntington’s?

Answer 18

adaptive equipment, environmental modification, alter routines

Question 19

functional deficits/losses of fx resulting from a lesion. Words such as “reduced”, “diminished” or “lack of” may be used (e.g., memory loss, hemiparesis)

Answer 19

negative sign

Question 20

what can an OT do for PSP?

Answer 20

fall prevention, visual adjustments for vertical gaze palsy

Question 21

these symptoms indicate which disorder?: Chorea, Decreased executive functioning, Impulsivity, Sexually inappropriate behavior

Answer 21

Huntington’s

Question 22

Disorders with signs that mimic Parkinson’s, but are toxic, infectious or traumatic in nature; also lesions to lentiform nucleus

Answer 22

Parkinsonism

Question 23

what does the substantia nigra send to the putamen?

Answer 23

dopamine

Question 24

when does dystonia increase?

Answer 24

during activity and emotional stress

Question 25

what are the types of Parkinson’s?

Answer 25

akinetic/rigid, mixed, tremor-dominant

Question 26

Inadequate inhibition of the motor structures by the BG; positive signs (generally)

Answer 26

hyperkinetic disorders

Question 27

Parkinsonism disorder associated with: disordered thinking, executive dysfunction, disinhibition; Usually history of multiple incidents of head trauma, Decreased short term memory

Answer 27

chronic traumatic encephalopathy

Question 28

With Huntington’s, the _______ provides too much inhibition to the GPi

Answer 28

putamen

Question 29

these are red flags for what class of condition: early postural instability, rapid progression, respiratory dysfunction, abnormal postures, cerebellar or corticospinal dysfunction, voluntary gaze dysfunction?

Answer 29

Parkinson’s Plus syndromes

Question 30

what can an OT do for dystonia?

Answer 30

pain reduction, ROM, mental practice, CIT, environmental modification

Question 31

type of Parkinson’s: Muscular rigidity, Shuffling gait, Postural instability, Resting tremors (sometimes), Mask-like facial expression, Dementia, Decreased planning, executive function

Answer 31

akinetic/rigid

Question 32

when there is lack of inhibition to the motor thalamus and PPN, what do you see?

Answer 32

excessive movement

Question 33

Inadequate inhibition of PPN and M1/thalamus by the basal ganglia

Answer 33

hyperkinesia

Question 34

what are 2 examples of Parkinsonism disorders?

Answer 34

drug-induced Parkinsonism, chronic traumatic encephalopathy

Question 35

these symptoms indicate what disorder?: Motor signs indistinguishable from akinetic/rigid Parkinson’s; Early generalized cognitive decline, Confusion, Reduced attention, Memory loss, Visual hallucinations

Answer 35

dementia with Lewy bodies

Question 36

when is dystonia absent?

Answer 36

during sleep

Question 37

Excessive inhibition of PPN, midbrain locomotor region and M1/thalamus by the BG

Answer 37

hypokinesia

Question 38

these symptoms indicate which disorder?: Akinetic/rigid motor symptoms, Corticospinal tract dysfunction, Cerebellar signs, Dysarthria, Truncal and gait ataxia, Autonomic dysfunction, Postural hypotension, Impotence, incontinence of bowel & bladder, Respiratory dysfunction, Decreased goal-oriented cognition, difficulty directing attention

Answer 38

multiple system atrophy

Question 39

With Parkinson’s, where is the death of dopamine-producing neurons?

Answer 39

substantia nigra

Question 40

what is the result when the GPi is too inhibited by the putamen? (Huntington’s)

Answer 40

inadequate inhibition of motor structures

Question 41

when this structure is inadequately inhibited by Gpi, it leads to excessive activity in descending motor tracts by M1 (Huntington’s)

Answer 41

thalamus

Question 42

with Huntington’s, decreased signals from BG nuclei leads to what?

Answer 42

lack of inhibition to motor thalamus and PPN

Question 43

what are the 3 Parkinson’s Plus syndromes?

Answer 43

dementia with Lewy bodies, progressive supranuclear palsy, multiple system atrophy

Question 44

what are examples of hyperkinetic disorders?

Answer 44

Huntington’s, dystonia, Tourette’s

Question 45

Involuntary, sustained muscle contraction causing abnormal postures or twisting, repetitive movements

Answer 45

dystonia