Lecture Flashcards
Progressive disorder of the CNS with both motor and non-motor Sx
Parkinson’s Disease
What are the other names of Parkinson’s Disease?
(SIP)
S- Shaky Paralysis
I- Idiopathic Parkinsonism
P- Paralysis Agitans
Among the neurodegenerative disorders, what is before PD?
Alzheimer’s Disease
Average age of onset in PD
50-50 years old
How many percent are diagnosed with early-onset PD?
4-10%
Classified as beginning between 21 and 41 y.o.
Young-onset PD
PD that occurs at age <21 y.o.
Juvenile-onset PD
Generic term used to describe a group of disorders with primary disturbances in the dopamine system of basal ganglia
Parkinsonism
What are of the brain is the dopamine system?
Substantia Nigra
Other name for PD?
Idiopathic Parkinsonism
What is the most common type of PD?
Idiopathic Parkinsonism
What are the two distinct clinical subgroups of PD?
- (PIGD) Postural Instability Gait Disturbed
* Tremor Predominant
Dominant Sx includes postural instability and gait disturbances
PIGD
A clinical subgroup that has a main feature: tremor
Tremor predominant
Typically demonstrates few problem with bradykinesia or postural instability
Tremor Predominant
What are the different severe gene mutation?
- PARK1
- PINK1
- LRRK2
- DJ-1
Give one example of a sever gene mutation PD
Glucocerebrosidase
Other names for gene mutated PD
- Genetic PD
* Familial PD
PD that covers 10% of overall PD cases
Glucocerebrosidase/ Genetic PD/ Familial PD
What are the causes of secondary Parkinsonism?
- Viruses
- Toxins
- Drugs
- Tumor
Give an example of a virus that causes secondary Parkinsonism
Postencephalitic Parkinsonism/ Encephalitis Lethargica (more specific term)
What toxin greatly causes secondary Parkinsonism?
Manganese
It it the most common type of toxin that represents a serious occupational hazard to many miners from prolonged exposure
Manganese
What part of the brain wherein it grows a tumor which then leads to secondary Parkinsonism
Basal Ganglia
Give some example of metabolic conditions that may cause Parkinsonism
(HHHD) 1. Disorders of calcium metabolism A. Hypothyroidism B. Hyperparathyroidism C. Hypoparathyroidism D. Wilson’s Disease
Conditions that mimic PD in some respects, but the symptoms are caused by other neurodegenerative disorders
Parkinsonism-Plus Syndrome
Group of nuclei situated in the deep parts of the cerebrum & upper part of the brain stem
Basal Ganglia
It can control muscular movements by influencing the cerebral cortex
Basal Ganglia
What are the components of Corpus Striatum?
- Caudate Nucleus
* Lentiform Nucleus
What are the components of Lentiform Nucleus?
- Putamen
Globus Pallidus
What are the components of the substantia nigra?
Pars Compacta
Pars reticularis
Explain the difference of pars compacta and pars reticularis
Pars compacta- inhibition
Pars reticularis- facilitation
Neostrium is made of__
Caudate nucleus et Putamen
It is for facilitation of movement
Direct Pathway
If the direct pathway is destroyed what happens?
Hypokinetic Disorder
If the indirect pathway is destroyed, what happens?
Hyperkinetic disorder
For inhibition of movement
Indirect Pathway
Give some examples of hyperkinetic disorders
- chorea
- athetosis
- ballysmus
- dystonia
Loss of the ____ containing neurons produces characteristic changes in depigmentation in the substantia nigra with a characteristic pallor
Melanin
What stage of PD is where lesions are found in the medulla oblongata (dorsal IX/X nucleus or intermediate reticular zone)?
Stage 1
What stage of PD is where Pathology is expanded to involve lesions of the caudal raphe nuclei, the gigantocellular reticular nucleus, and coeruleus- subcoeruleus complex
Stage 2
Stage of PD where there is an Involvement of the nigrostriatal system is apparent (pars compacta of the substantia nigra)
Stage 3
Stage of PF where Lesions are also found in the cortex (temporal mesocortex and allocortex)
Stage 4
Stage of PD where Pathology is extended to involve the sensory association areas of the neocortex and prefrontal neocortex
Stage 5
Stage of PD where Pathology is extended to involve the sensory association areas of the neocortex and premotor areas
Stage 6
What are the cardinal signs of PD?
- Rigidity
- Postural Instability
- Bradykinesia
- Resting Tremor
What is the common Sx among the cardinal signs of PD?
Resting Tremor
What is the frequency of resting tremor
4-6 Hz
Where is the Inc site in resting tremor?
Hand
It is the most disabling manifestation
Bradykinesia
Slowness of movement
Bradykinesia
Bradykinesia is associated with?
Akinesia Bradyphrenia Hyponimia Freezing of gait Hypokinesia
indicator of advanced PD
Postural Instability
Small hand writing
Micrographia
What are the motor performance of a person with PD?
- Decreased torque production
- Fatigue
- Contractures and deformity common
- Masked face
- Micrographia
What are the motor planning of PD?
- Start hesitation
- Freezing episodes
- Poverty of movement
Sudden stops on movement
Freezing Episodes
What is the posture of a PD patient?
- kyphosis c forward head
- Leaning to one side c tonal asymmetries
- increased fall risk
What are the presentation of sensation if pt with PD?
- paresthesia
- pain
- akathisia
What are the cognition function and behavior of pt c PD?
- Dysmetria
- Bradyphrenia
- Visuospatial deficits • Depression
- Dysphoric mood
What are the autonomic nervous system fxn of pt with PD?
- Excessive sweating
- Abnormal sensations of heat and cold
- Seborrhea
- Sialorrhea
- Constipation
- Urinary bladder dysfunction
What is the cardiopulmonary fxn of pt c PD?
• Low resting BP
• Compromised cardiovascular response
to exercise
• Impaired respiratory function
What state is more benign progression to pt c PD?
- young age at onset
- tremor predominant
Most common cause of death to pt c PD
- cardiovascular disease
- Pneumonia
What is the gold standard neurologic assessment for PD?
Unified Parkinson’s Disease Rating Scale (UPDRS)
Provides a broad measure for charting the progression of the disease using motor signs and elements of functional status
Hoehn-Yahr Classification of Disability Scale
Enumerate the PT examination et evaluation done to the PD patient
- Cognitive function
- Psychological function
- Sensory function
- Musculoskeletal function
- Motor function
- Autonomic function
- Integumentary function
- Functional status