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PHTH 544 -Neuro > MOTOR NEURON DISEASES > Flashcards

MOTOR NEURON DISEASES Flashcards

1
Q

Where are the cell body of LMN’s

A

Anterior/Ventral horn

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2
Q

What occurs in amyotrophic lateral sclerosis

A

unknown aetiology; progressive degeneration of corticospinal tracts, anterior horn cell (UMN and LMN)

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3
Q

What is polyneuropathies

A

Damage occuring to axon, myelin sheath, cell body, supporting CT, nutrient blood supple to nerves, and effect sensory or motor nerves

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4
Q

What is an examply of polyneuropathies

A

Guillain Barre Syndrome

HIV/AIDS

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5
Q

What is mononeuropathies? ex?

A

Damage of a single peripheral nerve; motor and sensory
Peripheral nerve injury
Nerve entrapment

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6
Q

what is guillain-barre syndrome?

A
  • Rare rapid-onset autoimmune disorder, attaching the myelin sheath and axons themselves of the peripheral nerve system
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7
Q

What nerve types are affected in guillain-barre syndrome?

A
  • Peripheral sensory and LMN
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8
Q

guillain-barre syndrome Cause?

A

unknown

often preceded by an infectious illness

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9
Q

guillain-barre syndrome presentation?

A

Weakness and tingling in your extremities (1st) eventually paralyzing your whole body

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10
Q

guillain-barre syndrome treatment?

A

Plasmaphoresis and high dose immunoglobulin therapies

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11
Q

When does point of greatest weakness or paralysis occur in guillain-barre syndrome?

A

days or weeks after first symptom

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12
Q

guillain-barre syndrome prognosis?

A
  • Better in <40
  • ~1/5 individual unable to walk unaided after 6month
  • Chronic pain and fatigue
  • ~30% have residual weakness after 3 years
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13
Q

Poliomyelitis cause?

A

Viral infection of the PNS leading to destruction at the anterior horn and in turn muscle weakness (most often in legs)

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14
Q

in Poliomyelitis __% have minor symptoms that remain

A

25%

Many recover completly

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15
Q

relevance of Poliomyelitis?

A

rare 37 cases in 2016

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16
Q

cure Poliomyelitis?

A

no cure prevention through vaccine

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17
Q

Post Polio Syndrome prevalence

A

affects 25-40% of individuals who suffered an acute attach of poliomyelitis

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18
Q

When do symptoms appear in Post Polio Syndrome

A

15-30 years after original disease

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19
Q

Post Polio Syndrome presentation

A

slow, progressive onset of lasting muscle weakness

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20
Q

ALS cause?

A

unknown

21
Q

ALS? whats happening?

A

Progressive, ultimately fatal disorder that disrupts signals to all muscles
UMN and LMN signs
Symptoms notices first in arms and hands, legs or swallowing mscles
Bilateral distribution of muscle weakness + atrophy
Speech and respiratory muscles effected
Sensation + bladder + ocular muscles is spared

22
Q

Average survival of ALS

A

2-5 years. 25% of cases survive 5-10 years especially if ventilated

23
Q

ALS Incidence

A

40-60 yr old men (2:1 to women

24
Q

How many stages in ALS

A

1-6
1 least progression
6 most

25
Q

which stages of ALS are wheelchair dependent

A

4,5,6

26
Q

which stages of ALS are ventilated

A

6

27
Q

is PD UMN or LMN

A

UMN

28
Q

Cardinal features of PD

A

Rigidity
Bradykinesia
Tremor
Later stages: postural instability

29
Q

PD is the ___ most common neurodegenerative disorder

A

2nd

30
Q

Average age of onset for PD

A

50-60 years

31
Q

PD PT management

A
  • Medications - treat when on
  • CV fitness
  • Posture
  • Use of external cues (visual, auditory, tactile)
  • Use of internal cues
  • Momentum
  • relaxation
    Minimize mm inbalance/maintain strenth
  • Movement reeducation - reinforce biomech essentials
  • Maintain PROM/extensibility
  • Educate
32
Q

What is multiple sclerosis

A

An autoimmune disease of the CNS of unknown cause

33
Q

What occurs physiologically in MS

A

Damage targeted to myelin sheath causes inflammation and interruption of nerve impulses

34
Q

Is MS Progressive? Reversible?

A

yes

no

35
Q

4 types of MS

A
  • Progressive relapsing
  • Secondary progressive
  • Primary progressive
  • Relapsing remitting
36
Q

Does canada have a high incidence rate of MS?

A

Yes on of highest in world

1000 new cases each year

37
Q

Incidence of MS increases with…

A

Distance from equator

38
Q

Age of onset for MS?

A

20-40 3:1 ratio of women>men

39
Q

Symptoms of MS

A
  • Variable
  • Chronic, disabling, unpredictable
  • May efect mental function, strength, sensation, balance, functional mobility, ADLs
  • Visual, vestibular, and cerebellar disturbances
40
Q

First symptom reported in MS

A

Sensory
Motor
Visual
Fatigue

41
Q

How do we intervene with degenerative disease

A
  • Be sensitive to client’s health care status and prognosis
  • Be aware of course of disease/progression
  • be aware of where client is at mentally/physically/emotionally
  • Client-centered goal setting
  • QOL
  • Activity and participation goals
  • Maintenance of function for as long as appropriate
  • CV health, positioning, comfort in later stages
  • Be aware of medication and timing of intervention
42
Q

PT management of later stage chronic deteriorating neurological conditions is similar to …

A

the earlier stage management of acute recovering neurological conditions

43
Q

PT management of earlier stage chronic deteriorating neurological conditions is similar to …

A

later stage management of acute recovering neurological conditions

44
Q

UMN in the facial nerve (CNVII) lesion above the pons leads to…

A

paralysis of the inferior 1/4 of the face contralateral to the lesion

45
Q

LMN lesion in the facial nerve below the pons leads to

A

paralysis of the ipsilateral half of the face (upper + lower quadrants) ipsilateral to the lesion

46
Q

What is the treatment for complete peripheral nerve lesions of the facial nerve

A 
Recovery not possible 
Maintain range 
Maintain circulation 
Mouth care 
Eye care
47
Q

What is the treatment for a incomplete peripheral nerve lesion of the facial nerve

A 
recovery possible 
Maintain range 
Maintain circulation 
Mouth care 
Eye care 
Muscle retraining exercises 
Goal = symmetry
48
Q

What is the treatment for a upper motor neuron lesion of the facial nerve

A

Recovery cannot be predicted

Incorporate treatment from complete/incomplete peripheral nerve lesions

PHTH 544 -Neuro (5 decks)

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