Jardins Myasthenia Flashcards
__________ is the most common chronic disorder of the neuromuscular junction.
Myasthenia gravis
The disorder interferes with the chemical transmission of _________ between the axonal terminal and the receptor sites of voluntary muscles
acetylcholine (ACh)
The hallmark clinical feature of myas- thenia gravis is ___________ , often with true muscle fatigue.
fluctuating skeletal muscle weakness
The fatigue and weakness usually improves following ____
rest
There are two clinical types of myas- thenia gravis:
ocular and generalized
In ________, the muscle weakness is limited to the eyelids and extraocular muscles.
ocular myasthenia gravis
In ___________ , the muscle weakness involves a variable combination of (1) muscles of the mouth and throat responsible for speech and swallowing (called bulbar muscles), (2) limbs, and (3) respira- tory muscles.
generalized myasthenia gravis
Neck extensor and flexor muscles are com- monly affected, producing what is called a “___________”
dropped head syndrome
The facial muscles are often involved, causing the patient to appear _______.
expressionless
Generalized myasthenia gravis may, or may not, involve the ________. Because the disorder affects only the ______ (motor) junction, sensory function is not lost.
ocular muscle / myoneural
The abnormal weakness may be confined to an isolated group of muscles (e.g., the drooping of one or both eyelids), or it may manifest as a generalized weakness that in severe cases includes the _______.
diaphragm
When the diaphragm is involved, ventilatory failure can develop—producing what is called a “ _________”
myasthenic crisis
myasthenic crisis.” In these cases, mechanical ventilation is required. If the patient is not properly managed (e.g., via the Bronchopulmonary Hygiene Therapy Protocol, and Mechanical Ventilation Protocols, may develop
• Mucous accumulation
• Airway obstruction
• Alveolar consolidation
• Atelectasis
The cause of __________ appears to be related to ACh receptor (AChR) antibodies (IgG antibodies) that block the nerve impulse transmissions at the neuromuscular junction.
myasthenia gravis
It is believed that the _________ disrupt the chemical transmission of ACh at the neuromuscular junction by (1) blocking the ACh from the receptor sites of the muscular cell, (2) accelerating the breakdown of ACh, and (3) destroy- ing the receptor sites
IgG antibodies
The disease usually has a peak age of onset in females of _______,
15 to 35 years
compared with ______ years in males.
40 to 70
The clinical manifestations associated with ________ are often provoked by emotional upset, physical stress, exposure to extreme temperature changes, febrile illness, and pregnancy.
myasthenia gravis
Screening methods and tests used to diagnose myasthenia gravis include
(1) clinical presentation and history, (2) bedside tests, (3) immunologic studies, (4) electrodiagnostic studies, and (5) evaluation of conditions associated with myasthenia gravis.
The hallmark of myasthenia gravis is chronic _______
muscle fatigue
Signs and symptoms include
facial muscle weakness; ptosis (drooping of one or both eyelids); diplopia; ophthalmoplegia, difficulty in breathing, speaking, chewing, and swallowing; unstable gait; and weakness in arms, hands, fingers, legs, and neck brought on by repetitive motions.
(drooping of one or both eyelids);
ptosis
(double vision);
diplopia