Neuro 2 study cards Flashcards
1
Q
Myasthenia Gravis: hereditary or Autoimmune disorder?
A
Autoimmune disorder
2
Q
Define myopathy
A
neuromuscular disorders in which the primary symptom is muscle weakness due to dysfunction of muscle fibers.
3
Q
What is Myasthenia Gravis
A
Neuromuscular disease of the neuromuscular junction, Skeletal m. weakness that worsens with activity and improves with rest.
4
Q
Symptoms of Myasthenia Gravis?
A
- Diplopia (double vision)
- Facial weakness
- Ptosis- (eyelid drooping)
- SOB
- Weakness in neck, UE, LE
- Fatigue
5
Q
Interventions fro Myasthenia Gravis?
A
- Interval training
- Fatigue intervention/ conservation
- Physical and behavioral training
- Resistance, Aerobic, and balance.
6
Q
Precautions of Myasthenia Gravis?
A
• MG Crisis
o Medical emergency where breathing stops and the individual requires ventilation.
o Not always related to exercise .
7
Q
Limb Girdle Muscular Dystrophy (LGMD): hereditary or Autoimmune disorder?
A
Hereditary
8
Q
What does Limb Girdle Muscular Dystrophy (LGMD) affect?
A
Affects proximal muscles, Some may have cardiomyopathy
9
Q
Early stages of Limb Girdle Muscular Dystrophy presents what symptoms? (early and late)?
A
- Early stage: changes in walking, hands on knees to transition.
- Late Stage: may require a w/c
10
Q
Interventions for Limb Girdle Muscular Dystrophy?
A
- Resistance training
- Aerobic training
- Work more on functional tasks
11
Q
Age for male and women to get Myasthenia Gravis?
A
Women< 40 yrs
men >60 yrs
12
Q
Fascioscapularhumeral Muscular Dystrophy % of type 1 vs type 2?
A
type 1 : 95%
type 2: 5%
13
Q
Fascioscapularhumeral Muscular Dystrophy: hereditary or Autoimmune disorder?
A
hereditary
14
Q
When do symptoms come about (age) for Fascioscapularhumeral Muscular Dystrophy?
A
before 20
15
Q
Number one symptom or presentation of Fascioscapularhumeral Muscular Dystrophy?
A
Mask-like appearance
16
Q
Interventions for Fascioscapularhumeral Muscular Dystrophy?
A
- Pulmonary function test
- Speech therapy
- Hamstring and trunk muscles early onset
- Maintain flexibility
- Manage pain
- Orthotics
- Gait aid
- w/c
17
Q
are thick or thin myelin faster?
A
Thicker the faster conduction
18
Q
are thick or thin myelin slower?
A
thin is slower conduction
19
Q
Shwann cells make?
A
Myelin in the PNS
20
Q
oligodendrocytes make?
A
Myelin in the CNS
21
Q
How is Bell’s palsy acquired?
A
after a viral infection
22
Q
What does Bells palsy affect?
A
Half of the face
23
Q
What nerve does bells palsy affect ?
A
CN 7 (facial nerve)
24
Q
What percent of Bell’s palsy patients have a full recover?
A
71%
25
How does Trigeminal Neuralgia present?
Really bad facial pain: brief, intense bursts of pain within a distribution of pain.
26
How does one get Trigeminal Neuralgia?
compression of trigeminal nerve (CN5)
27
What is Poliomyelitis? what causes it?
Epidemic in the 1950s
Caused by a virus that is highly infectious especially in children <5 y.o
28
Symptoms of Poliomyelitis?
* Fever
* Fatigue
* Headache
* Vomiting
* Stiffness of the neck
* Pian in the limbs
29
What is Postpolio Syndrome (PPS)
New neuromuscular symptoms that occur decades after recovery
30
Who develops Postpolio Syndrome (PPS) ?
¼ to ½ with childhood polio develop PPS.
31
What symptoms do Postpolio Syndrome (PPS) have?
Deterioration in the LE, predispose individuals to overuse of UE m. for compensation.
32
Interventions for Postpolio Syndrome (PPS)?
```
Non-exhaustive exercises.
General body conditioning
Lifestyle modifications/ energy conservation
Compensation
Prevention
```
33
Charcot-Marie-Tooth Disease: Hereditary or autoimmune?
Hereditary motor and sensory neuropathy.
34
What does Charcot-Marie-Tooth Disease symptoms look like?
Distal limb muscle wasting and weakness,
abnormalities in DTRs and skeletal deformity.
Begins with affecting ankle DF and EV (peroneal n.)
35
Which type of Charcot-Marie-Tooth Disease is axonal?
* CMT1: Dysmyelinating
* CMT2: Axonal
* CMT3: Dysmyelinating
* CMT4: Dysmyelinating or axonal
* CMT5: Dysmyelinating
36
Diabetic Peripheral Neuropathy (DPN) Affect what cells?
Schwann cells and neurons
37
Diabetic Peripheral Neuropathy (DPN) is under what classification?
metabolic
38
Guillain-Barre Syndrome (GBS) & AIDP Acute Inflammatory Demyelinating Polyneuropathy presents?
most common cause of rapidly evolving motor paresis, paralysis, and sensory deficits.
39
Guillain-Barre Syndrome (GBS) & AIDP Acute Inflammatory Demyelinating Polyneuropathy is motor or sensory?
either motor and sensory
or
Just motor
40
Name the peripheral nervous system disorders?
```
o Myasthenia Gravis
o Limb Girdle Muscular Dystrophy
o Fascioscapularhumeral Muscular Dystrophy
o Bell’s Palsy
o Trigeminal Neuralgia
o Poliomyelitis
o Postpolio Syndrome (PPS)
o Charcot-Marie-Tooth Disease
o Diabetic Peripheral Neuropathy
o Guillain-Barre Syndrome (GBS)/ AIDP
```
41
ALS- Amyotrophic Lateral Sclerosis is most common in men or women?
Men
42
When does ALS typically present? (age)
40+
43
Define: ALS- Amyotrophic Lateral Sclerosis
Progressive NM disease characterized by degeneration and eventual death of upper motor neurons and LMN causing weakness of the limb, respiratory, and bulbar musculature.
44
Pathology of ALS
Dysfunction of the EAAT2
Loss of
brainstem CN nuclei and
anterior horn cells in spinal
cord
45
For GBS/AIDP what do we want to avoid?
fatigue exercises
46
When would you see foot deformities?
Charcot foot deformities
47
What percent of people with DM will develop Diabetic peripheral neuropathy?
50%
48
Who are most likely to get ALS
White males
49
ALS scale to diagnose
EI Escorial Criteria
Presence of all three:
o LMN degeneration by exam.
o UMN degeneration by exam
o Progression of the motor syndrome within a region or to other regions by Hx and exam.
50
ALS survival rate for 3, 5 and 10 years
3 years: 50%
5 years: 20%
10 years: 10%
51
What are negative progonistic factors for ALS?
* Negative prognostic factors:
* Bulbar onset
* Weight loss
* Cognitive impairment
* Impaired respiratory function
52
what are the two staging outcomes we use for ALS? and score ranges
King’s Clinical Staging (0-5)
&
MITOS Functional Staging (0-5)
53
For ALS what gets affected first distal or proximal extremities?
Distal to proximal
54
Weakness, low tone (hypotonia) and decreased/absent reflexes are signs of what?
LMN lesion
55
Hyperrelexia would be result of?
UMN lesion
56
Clonus, babinski, Hoffmans is a ___ lesion?
UMN lesion
57
Largest gene in the body?
Dystrophin
58
Whats apraxia?
It’s when you can’t do learned movements on command
59
true or false: you can do a prenatal screen for Duchenne’s muscular dystrophy
False
60
What can you do a prenatal screen for?
SMA
61
What is the 2nd most common type of dementia
Vascular dementia
62
What are the cardinal signs of PD?
```
TRAP
• T: tremor: resting.
• R: rigidity
• A: Bradykinesia (Akinesia)
• P: Postural instability
```
63
What type of tremor is associated with PD
resting tremor
64
Age and percentage of boys that lose ambulation with DMD?
age 10-12: >70% of boys lose ambulation
65
What age do boys present Prominent muscle weakness with DMD ?
5 years old
66
Signs of SMA (spinal muscular atrophy)
```
Smart
Kind
they can slip through your arms
hand tremor
tongue fassiculations
```
67
What part of the brain does Parkinson’s affect?
Substantia nigra (in the basal ganglia)
68
most common form of hereditary ataxia in the US?
Fredrick’s Ataxia
69
What part of the brain is damaged With ATAXIA
Cerebellum
70
Are the impairments from guillaine barre permanent?
NO
71
GB symptoms
Tingling
numbness
weakness
starting distal to proximal
72
Name the two Subcortical Dementias?
1. Dementia with Lewy bodies (DLB)
| 2. Huntington’s disease
73
Scales used for dementia?
global deterioration scale 1-7
| GEMS
74
Can you do blood work tests for Parkinson's?
NO
75
medications for PD
dopamine replacement and deep brain stimulator
76
how long do deep brain stimulators work for?
3-5 years
77
How long does Dopamine replacement for PD last?
5 years
78
whats the gold standard diagnostic test thing for PD?
UPDRS (united parkinsons disease rating scale)
79
Whats the 2nd used scale diagnostic test thing for PD?
Hoehn and Yahr
80
Parkinson’s has too much or too little dopamine?
not enough
81
Which disease is characterized by choreic (dance) movements?
HUNTINGTONS
82
what stages of Hoehn and Yahr involve unilateral deficits ?
1, 1.5 and 2
83
Stocking glove pattern neuropathy is associated with that?
Diabetes
84
Why is MS considered an autoimmune disease ? what attacks what ?
T cell and B cells are overproduced and attack oligodendrocytes.
85
What chemical imbalance causes HD?
Chromosome 4 produced a protein called huntingtin which caused neuronal degeneration and death.
86
Whats the most common type of MS ?
Relapsing-remitting
87
What the most effective way to manage heat with MS?
Spray bottle with fan
88
what a cardinal sign of ATAXIC DYSARTHRIA?
“scanning speech” slurred "drunk"
89
Where does PICA come off of ?
vertebral artery
90
Where does AICA come off of ?
basilar artery
91
Where does most of the blood supply in brain come from?
Superior cerebellar A
92
Where is the big dentate nucleus located?
cerebellum
93
Can someone with stage 4 Huntington’s live independently ?
No
94
Most primitive (vestibular nuclei) is in the ?
BRAINSTEM
95
blank percent of MS patients will require an aid to walk within blank years?
50% within 10 years
96
Whats the best type of MS to get?
relapsing-remitting
97
Where is MS more common?
In US and Europe, places where there is less sunlight (VITAMIN D)
98
What type of medication is used for MS
corticosteroids
99
What is the number one important thing to ppl with MS?
Walking is generally the most important function to people. (70%)
100
Biggest symptom for ppl with MS?
fatigue
101
If someone can walk 500 meters With MS what general range EDSS are they on?
0-3.5: Mild Disability
102
If someone can walk 100-500 meters With MS what general range EDSS are they on
4-5.5: Moderate Disability
103
If someone cant walk 100 meters Without assistance with MS what general range EDSS are they on.
6+
104
Name some non motor signs of Parkinson’s ?
Olfactory loss, sleep dysfunction, autonomic dysfunction, hallucinations, dementia
105
Older age, lower BMI, cigarette smoking, being a professional athlete, and repeated head injuries are all risk factors for what ?
ALS (lou gertis)
106
Most important intervention for patients with dementia
exercises
107
What progresses faster: postural instability and gait disorder or tremor predominant PD
PIGD
108
What is the gold standard for measuring PD impairments ?
UPDRS (higher the score the worse)
109
Is ALS an UMN or LMN disease ?
Both
110
Most ppl with MS will not be working within ____ years?
10
111
A scared look is a characteristic of what disease ?
Progressive Supranuclear Palsy (PSP)
112
PD plan of care, emphasize what 4 things
Flexibility, strength, aerobic conditions and task specific training?
113
Describe what happens with SMA if the novel treatment isn’t given
mm atrophy until eventual respiratory/cardiac failure
114
SMA's novel treatment lets them?
gene therapy: lives a full life
115
What is a common gait abnormality in patients with CMT
stomping
116
True or false: there is novel treatment for CMT
False
117
Describe common gait abnormalities in DMD
Extended, closed-packed and trendelenberg
118
Too much or too little dystrophin in DMD?
little
119
True or false: SMA is an autosomal recessive disease?
true
120
Which is most common type of CMT: dysmyelinating or axonal ?
dysmyelinating
121
Lewy body and huntingtons are what types of dementia
subcoritcal
122
What type of memory is best to train w dementia ? implicit or explicit
implicit
123
What type of memory do you train with cerebellar disorders? implicit or explicit
explicit
124
Are fruits and vegetables helpful in protecting yourself against dementia?
true
125
What serious medical complication comes from bell’s palsy ?
eye can dry out
126
Whats the difference between stroke and bells palsy sx?
Bell’s palsy is complete paralysis, Stroke can raise their eyebrows.
127
Explain why a pes cavus happens with CMT?
Something to do with the DF/EV losing control first. (peroneal n damage)
128
Whats dysmetria?
Impaired ability to scale movement distance
129
A cerebellar tremor is also called what kind of tremor?
action tremor
130
When do Fredricks ataxia symptoms start?
5-15 YO
131
Are Focal lessions better or worse prognosis
better
132
idiopathic disease? (no known cause)
multiple systems atrophy (MSA)
133
DO blood supply zones and functional zones correlate?
No
134
Name the functional zones
Cerebrocerebellum
Spinocerebellum
Vestibulocerebelum
135
What is the largest functional zone?
cerebrocerebellum
136
What is cerebrocerebellum zone?
Largest and in charge of planning and initiating voluntary movement
137
What is spinocerebelar zone?
comparator, regulation of muscle tone and coordinates skilled voluntary movement, postural tone
138
Vestibularcerebellum where is the nuclei
in brain stem
139
What does vestibularcereebelum do?
balance, eye movement VOR
140
How do we treat cerebellar disorders implicit or explicit learning?
explicit
141
What is deep in the cerebellum?
Fastigial nucleus anf Dentate nucleus
| both nucleus
142
Where is vestibular nuclei?
brainstem
143
where are purkinji cells
white matter
144
What can you do to test Dysmetria?
heel to shin, finger to nose test
145
Scale for ataxia
BARS, SARA, ICARS
