Neurodegenerative Conditions Flashcards
1
Q
akinesia
A
impairment of voluntary and spontaneous movement initiation leading to freezing
2
Q
bradykinesia
A
slowed motor movements
3
Q
dysmetria
A
decreased coordination of movements
4
Q
rigidity
A
muscle stiffness
5
Q
fasciculation
A
involuntary muscle contraction and relaxation such as muscle twitches
6
Q
festinating gait
A
small rapid steps resulting from forward-tilted head and trunk
7
Q
parasthesia
A
numbness and tingling
8
Q
general eval of neurodegenerative disorders
A
- assess abilities and environment
- motor, sensory, cognition
- how they are affected by variable symptoms and progression of disease
- how well they understand and accept progression
9
Q
ALS etiology
A
- scar tissue replaces motor neurons in spinal cord, bain and peripheral system
- plaques lead to muscle atrophy
10
Q
typical symptoms of ALS
A
- distal to proximal progression
- weakness of small muscles of hands
- assymetrical foot drop with or without night cramps
- tripping or stumbling
11
Q
symptoms of ALS in bulbar tract
A
difficulty breathing, slurred speech, impared swallowing
12
Q
Lower motor neuron symptoms of ALS
A
- focal and multifocal weakness
- muscle atrophy
- cramping
- fasciculation
- twitching at rest
13
Q
corticospinal tract symptoms of ALS
A
spasticity and hyperactive reflexes
14
Q
corticobulbar tract symptoms of ALS
A
dysphagia and dysarthria
15
Q
what is typically not affected with ALS
A
- cognition
- sensation
- vision and hearing
- bowel and bladder control
16
Q
what are the stages of ALS
A
- some weakness, can walk and I with ADLs
- moderate weakness, can walk
- severe weakness can walk
- severe wekaness in legs, w/c for mobility, some assist for ADLs
- sever weakness in UE and LE, w/c for mobility, Dependent for ADLs
- unable to get out of bed, D for ADLS and most self-cares
17
Q
Prognosis of ALS
A
- often progresses rapidly
- 1-5 year life expectancy
- death usually occurs secondary to respiratory failure
18
Q
chorea
A
involuntary, irregular, unpredictable movements
19
Q
OT eval of ALS
A
- home eval and safety assessment
- reevaluation as needed as disease progresses
20
Q
goal focus for ALS
A
minimize symptoms to improve performanc
21
Q
OT intervention for ALS
A
- compensate and adapt to disability
- prevent secondary conditions
- safety, positioning, skin integrity
- voice operated hands free technology
- adress dysphagia
22
Q
w/c considerations for ALS
A
- high back reclining, lightweight, small turn radius
- later on consider PWC with adaptable controls
23
Q
etiology of Alzheimer’s Disease
A
- amyloid plaques and tau protein tangles
24
Q
clinical features of alzheimer’s
A
- impairments in memory, executive funciton, attention, language, visual processing, praxis
- behavioral disturbances
25
early/mild stage of alzheimer's
mostly I with activities, may be aware of memory loss or forgetting words
26
middle/moderate stage of alzheimers
- frequent forgetfulness
- mood changes with social/mental challenges
- poor decision making
- personality changes
- disorientation
- wandering
27
late/sever stage of alzheimers
- unable to engage with environment
- can't carry on conversations
- significant assist with activites
28
describe vascular dementia
cerebrovascular disease often from small strokes leading to focal lesions in brain and neurotransmitter disruption
29
clinical features of vascular dementia
- cognitive decline similar to AD without severe memory involvement
- gait disturbance
- aburpt/stepwise declines rather than continuous
30
medical management of vascular dementia
-immediate emergent treatments
- treatment of cardiovascular factors
31
pathology of frontotemporal dementia
neuronal, intranuclear inclusions
32
clinical features of frontotemporal dementia
- immediate, distinct onset
- progressive
- varied symptom patterns
33
medical management of frontotemporal dementia
treatment of some behaviors with SSRI
34
pathology of lewy body dementia
lewy body protiens in brain usually in limbic or neocortical areas and overall decline in dopamine and acetylcholine
35
clinical features of lewy body dementia
progressive deficits in attention, executive function, memory impairment, fluctuating cognition, hallucinations, parkinsonism, falls, autonomic dysfunction, REM sleep disorders
36
medical management of lewy body dementia
- increase family involvment, safety assessment
- neuroleptics
- cholinesterase inhibitors
37
early stage of dementia occupational performance
- ADLs intact
- memory affects IADLs and community mobility
- language impairments affect communication
-clinging to old habits and repetitive routine
38
middle stages of dementia occupational performance
- impairments in all occupations and can no longer live alone
- safety is major concern
- diminished orientation
39
late stages of dementia occupational performance
- all areas of occupation lost
- dependent in all ADLS
- no longer ambulate safely or communicate
- no understanding of cultural or social contexts
40
OT intervention of dementia
- emphasize remaining strengths, maintain physical and mental activity
- address cognition and environmental modifications
- behavior managment
41
etiology of guillan barre syndrome
inflammatory disease causing demyelination of axons of peripheral nerves
42
3 phases of GBS
-onset and acute phase
- plateau phase
- progressive recovery phase
43
onset and acute phase of GBS
- weakness in 2+ extremities reaching max 2-4 weeks-
- rapid progression of symptoms in symmetrical ascending pattern
44
plateau phase of GBS
symptoms at most disabling with little change
45
progressive recovery phase of GBS
- remyelination and axonal regeneration up to 2+ years
- recovery is proximal to distal with significant return of function
46
Symptoms of GBS
- pain mostly in BLE
- fatigue
- initial mild sensory loss in hands and legs
- facial pasly
- autonomic system involvement
- bladder dyscfunction
47
Prognosis of GBS
- recovery is variable
- fatigue often persists
- possible minor cognitive difficulties
48
OT intervention during plateau phase of GBS
-modifications are temporary
- comminication tools
- positioning
49
OT intervention during recovery phase of GBS
- resume occupations and roles
- dynamic splinting
50
Describe Huntington's Disease
Progressive loss of nerve cells in brain affecting movement, cognition, emotion and behavior
51
signs and symptoms of Huntington's Disease
- involuntary movements
-slow and uncoordinated movements
- difficulties with fine motor and hand-eye coordination
- Wide based gait
52
etiology of MS
chronic and progressive demyelinating disease of CNS where scar tissues form on myelin sheath interfering with nerve pulses
53
Clinical presentation of MS
- difficult to predict
- visual disturbances initially then dizziness, parasthesia and weakness
54
motor symptoms of MS
- impaired balance nad coordination
- paralysis or spasticity especially in LE
- fatigue
- intention tremors
- dysphagia
55
intention tremor
tremors that occur when a person attempts to engage in a meaningful activitiy
56
sensory changes in MS
- parasthesia
- vertigo
- pain
- diplopia or loss in vision -
57
cognitive changes in MS
- short-term memory loss
-attetion deficits
- impaired executive functioning - impaired
58
emotional changes in MS
- depression or inappropriate eupohria
- mood swings or irritability
59
describe clinically isolated syndrome in MS
first episode of MS
60
describe relapsing-remitting MS
active and nonactive phases
61
describe secondary progressive MS
follows relapsing-remitting MS but worsens progressively
62
describe primary progressive MS
neurologic function woresens progressively with no remission
63
OT eval of MS
- assess pain
- assess cognition, dizziness, sleep
- endurance, strength
- vision and sesnation
- urinary incontinence
64
what should OT goals for MS address
exacerbation and remission stages
65
OT intervention for MS
-home safety and falls assessment
- sensory reeducation
- bladder training
- avoiding stressing joints
- proximal stabilization techniques
66
etiology of Parkinsons
- degenerative changes in basal ganglia
- substantia nigra becomes depigmented affecting dopamine
67
signs and symptoms of Parkinsons
- tremors
- muscle rigidity
- Bradykinesia
- postural instability
68
secondary symptoms of Parkinsons
- gait dysfunction
- fine motor
- cognitive deficits
- communication dificulties
- dysphagia
- mood disturbances
69
describe tremors in Parkinsons
- resting tremor affects one side
- decreasing at rest and increases with stress
- absent with voluntary movement
70
Prognosis of Parkinsons
progression is not always linear and may show occasional improvement
71
Stage 1 of Parkinsons
- unilateral symptoms
- function is maintained
72
stage 2 of parkinsons
- bilateral symptoms
- balance not affected
73
Stage 3
- bilateral symptoms
- balance impaired
- mild to moderate impairments in function
74
Stage 4
- Significantly decreased function
- impaired mbility
- needs assistance iwth ADLs
- Poor fine motor skills and dexterity
75
Stage 5
Total dependence for mobility and ADLs
76
OT Eval of Parkinsons
-observation of symptoms on function
- COPM
- Cognition
77
What affects OT eval of Parkinsons
Eval one day or at one time of day may not be accurate to other times
