MS, Parkinsons, Stroke Flashcards
1
Q
What is Multiple Sclerosis and what does it result in?
A
Autoimmune disease where T-cells of the immune system attacks myelin in CNS causing:
- Inflammation
- Degeneration of myelin = lesion
- Scar tissue = Sclerotic plaque
- Conduction of impulses is altered and slower
2
Q
Which types of MS are there?
A
- Relapse-remitting MS: Peeks of autoimmune responses in CNS causing symptoms during peeks but normal functions in between
- Secondary progressive MS: Peeks but with progressive function loss (do not go back to normal in between)
- Primary progressive MS: Exponentially worsening after first appearance with no recovery in between
3
Q
Name some risk factors for MS
A
- Genetics
- Gender: women more affected
- Lack of sun exposure (lower vitamine D)
4
Q
What symptoms are present in MS?
A
Symptoms depend on location of the lesions and plaques
- Sensory:
1. Numbness
2. Fatigue
3. Pain
4. Parasthesia (tingeling sensation) - Motor:
1. Poor balance and coordination, and clumsiness (cerebellum)
2. Poor motor control like inhibited gait, increased muscle tone, and shaking (upper motor neuron) - Autonomic (ex. medulla):
1. Vessel dialation
2. Heat regulation
3. Bladder
4. Respiratory and cardiac rhythm affected
5
Q
MS cosequences:
A
- Contractures
- Spasticity
6
Q
How is MS diagnosed?
A
- Must have at least to plaques/lesion seperated in time and location
- MRI to confirm diagnosis, show active MS or not, and exclude other diagnosis
- Cerebralspinal fluid
7
Q
What are the goals with treatment of MS?
A
- Restrict acess for immune system by slowing down demyelinsation
- Maintain and improve functional status by symptomatic treatment since there is no cure:
1. Maintain ROM
2. Improving quality of life
3. Decrease symptoms like depression, pain, and fatigue
4. Prevent consequences (spasticity and contractures)
8
Q
Explain treatment options for MS
A
- Medication like immune suppressant to inhibit T-cells and slow down progression
- Mobility exercises to reduce contractures and worsening of spasticity, but it increases inflammation
- Physical activity to reduce mental problems and pain
- Orthotics to maintain ROM, prevent contractures, and help walking with less energy cost and pain
9
Q
What is parkinson and its pathophysiology?
A
Degenerative disease of CNS affecting grey and white matter resulting in function loss
- Degeneration due to insufficient protheinsynthesis when adapting to changes which causes dopamine deficiency
10
Q
How does parkinson progress and which functions are affected?
A
- Stage 1-2 is quite slow progression and usually asymptomatic
- Stage 3-4 great severety of symptoms
- Motor functions related to basal nucleis - VAR: Voluntary movements, Autonomic movements, Reflexive movements
- Autonomic motorfunctions becom dependant on cortical controle instead (have to think to do)
11
Q
Which symptoms are present in parkinsons?
A
It depends on affected area
- Debute symptoms - CPO:
1. Changes in smell and sight
2. Problems with orthostatic hypotension (low blood pressure when standing up) - Clinical symptoms - THR:
1. Tremor - initially asymmetric and resting tremor
2. Hypokinesia - less activity of motor functions causing slurred speach, reduced mimicking, shuffling gait with no arm swing
3. Rigidity - stiffness, cogwheel phenomenon - Later stages IDDC:
1. Increased salvation
2. Difficulties swallowing
3. Dementia and depression
4. Constipation
12
Q
Name some common consequences of parkinsons
A
- Balance problems due to reduced control of posture
- Abnormal gait pattern = shorter step length, no arm swing, narrow gait due to reduced ROM of trunk and pelvis
- Contractures
13
Q
Explain briefly how parkinsons can be diagnosed
A
- Clinically observing symptoms ex. writing with hypokinesia - bid letters first then smaller
- Imaging tests to exclude other diagnosis
14
Q
How is parkinsons treated?
A
- Mainly pharmacological to increase dopamine levels like L-DOPA (can get through blood-brain barrier)
- Rehabilitative treatment to prevent contractures by ROM exercises with or without orthotics
- Surgical treatments like cut off tracts and transplantation of dopamine producing neurons
15
Q
What is stroke?
A
- Cerebrovascular disease caused by inhibited oxygen and glucose supply resulting in different symptoms depending on affected brain artery
Collective name describing symptoms when brain tissue is damaged due to inhibited oxygen and glucose supply
