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NPTE > Neuromuscular and Nervous System Pathology > Flashcards

Neuromuscular and Nervous System Pathology Flashcards

1
Q

What areas of the brain does Alzheimer’s affect?

A

cerebral cortex and subcortical areas

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2
Q

What neurons does Alzheimer’s effect? and what else develops?

A

ones associated with AcH
amyloid plaques
and neurofibrillary tangles show up

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3
Q

Higher incidence of Alzheimer’s in men or women?

A

women

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4
Q

Initial signs and symptoms of Alzheimer’s?
As it progresses what happens physically?

A

higher cortical functions like difficulty learning new things and subtle changes in memory and concentration.

rigidity, bradykinesia, shuffling gait

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5
Q

PT treatment of Alzheimer’s?

A

maximizing patients remaining function and providing family and caregiver education.

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6
Q

ALS involves both…
There is significant loss of …. in the spinal cord and motor cranial nerve nuclei in lower brainstem produces….
Demyelination of corticospinal and corticobulbar tracts produce…

A

UMN and LMN
anterior horn cell
weakness and muscle atrophy
UMN symptoms

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7
Q

Higher incidence of ALS in men or women?

A

men
40-70

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8
Q

LMN signs in ALS

A

asymmetric muscle weakness, fasciculations, cramping and atrophy in the hands. Weakness spreads distal to proximal.

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9
Q

UMN signs for ALS

A

incoordination of movement, spasticity, clonus and positive Babinski

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10
Q

Bell’s palsy is secondary to trauma and demyelination of…

A

facial nerve

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11
Q

Is Bell’s palsy common?
And what ages does it show up in?

A

yes
15-45

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12
Q

What is the associated cause of Bell’s?

A

herpes viral infection
inflammation of auditory canal produces subsequent demyelination and can lead to ischemia which can degenerate the nerve axonally.

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13
Q

PT for Bell’s

A

stimulation of facial nerve
facial massage and/or exercise

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14
Q

Carpal tunnel pressure to be considered CTS.
What is normal?

A

> 30 mmHg

2-10mmHg

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15
Q

Symptoms of CTS

A

may radiate into UE, shoulder and neck
night pain, weakness of hand, muscle atrophy, decreased grip, clumsiness and decreased wrist mobility.

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16
Q

Types of cerebellar disorders

A

congenital malformations
hereditary ataxia
spinocerebellar ataxias
acquired ataxias

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17
Q

Hereditary ataxias
most common

A

recessive
Friedreich’s ataxia
gait unsteadiness begins early in life and followed by UE ataxia, dysarthria and paresis.
Mental function declines and slight tremors may be seen.
Reflexes, vibration, and position senses are impaired.

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18
Q

Spinocerebellar ataxias

A

dominant
commonly present with neuropathy, pyramidal signs, ataxia, restless leg syndrome

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19
Q

Acquired ataxias

A

nonhereditary neurodegenerative systemic disorders
toxin exposure or it can be idiopathic.

Alcoholism, hypothyroidism and vitamin E deficiency.
Toxin causes include carbon monoxide, heavy metals and lithium

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20
Q

Diabetic neuropathy most common types

A

symmetric polyneuropathy and autonomic neuropathy

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21
Q

Diabetic neuropathy symptoms

A

wasting of muscles in feet or hands
stocking glove sensory distribution
orthostatic hypotension
weakness
urinary impairments
significant pain

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22
Q

Guillain-Barre Syndrome is aka

A

acute polyneuropathy

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23
Q

GBS is caused by what they think

A

autoimmune response to previous respiratory infection, flu, immunization or surgery. Viral infections, Epstein-Barr syndrome etc

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24
Q

Seizures a prodromal period is …(things preceding the seizure). But can occur…..and include….

A

rare
days or hours prior
mood changes, lightheadedness, sleep disturbances, irritability, difficulty concentrating
aura minutes before

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25
Q

An aura is

A

simple partial seizure

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26
Q

After someone has a seizure how should you lay them?

A

on their left side until they have fully recovered which is 5-20 min

27
Q

Signs and symptoms of GBS

A

distal to proximal progression, sensory impairment and possible respiratory paralysis.

28
Q

Initially GBS will present with

A

distal symmetrical motor weakness, mild distal sensory impairments, and transient paresthesias that progress to head

29
Q

Level of disability with GBS peaks when?

A

2-4 weeks after onset

30
Q

How can GBS be life threatening?

A

respiratory paralysis, absence of DTRs and inability to speak or swallow

31
Q

PT for GBS?

A

pulmonary rehab, strengthening, mobility, w/c and orthotic training

32
Q

Huntington’s is what?
Genetic how?
age it affects?

A

degeneration and atrophy of basal ganglia and cerebral cortex

autosomal dominant
35-55

33
Q

MS occurs when?
Initial symptoms of MS

A

20-35
visual problems, paresthesias and sensory changes, clumsiness, weakness, ataxia, balance dysfunction and fatigue

34
Q

Myasthenia Gravis is what?

Defect is specifically in the…

A

autoimmune disease with neuromuscular junction pathology.

transmission of nerve impulses to the muscles at the neuromuscular junction. Antibodies block or destroy receptors needed for AcH uptake and this prevents muscle contraction

35
Q

What are some potential causes for myasthenia Gravis?

A

enlarged thymus
diabetes, RA, lupus and other immune disorders

36
Q

Cardinal signs of Myasthenia Gravis?

A

extreme fatiguability and skeletal muscle weakness that can fluctuate within minutes or over an extended period. Ocular muscles are affected first and approx half of patients experience ptosis and diplopia. Dysphagia, dysarthria and cranial nerve weakness also are common

37
Q

Myasthenia Gravis is cyclical?

A

yes there are periods of remissions and exacerbations

38
Q

Myasthenia gravis crisis

A

is a medical emergency where respiratory muscles are affected and ventilator is required.

39
Q

Parkinson’s affects what part of the brain

A

substantia nigra of the basal ganglia

40
Q

Average age of diagnosis with parkinsons

A

50-79

41
Q

Myasthenia gravis can fluctuate in severity from…

A

hour to hour

42
Q

Myasthenia gravis proximal or distal muscles affected more?

A

proximal

43
Q

What do those with myasthenia gravis have difficulty with?

A

speech, swallowing, and chewing

44
Q

Involvement of cranial nerves in myasthenia gravis results in…

A

eyelid weakness, diplopia, ptosis

45
Q

Remissions with mysathenia gravis are typically not…

A

complete or permanent

46
Q

PT for myasthenia gravis

A

acquire baseline for respiratory and neurological status
monitor respiratory function continually
positioning to prevent aspiration
educate on osteoporosis using corticosteroids
strength for those with mild to moderate symptoms using moderate to max isometrics

47
Q

What should you avoid for those with myasthenia gravis?

A

strenuous exercise and stress
excessive hot or cold

48
Q

Pos-polio is a ….disease. Affects…. after polio.
PPS occurs when compensated reinnervation from polio…
When does PPS show up?
Signs?
Treatment?

A

LMN
anterior horn cells
fails
25 years after initial recovery
slow and progressive weakness, fatigue, muscle atrophy, pain and swallowing issues.
no pharmacological intervention. Should focus on lifestyle modifications and symptom managment.

49
Q

Agnosia

A

inability to interpret info

50
Q

Agraphesthesia

A

inability to recognize symbols, letters, or numbers traced on skin

51
Q

Agraphia

A

inability to write

52
Q

Aelxia

A

inability to read or comprehend written language

53
Q

Anosognosia

A

denial or unawareness of ones illness often associated with unilateral neglect

54
Q

Apraxia

A

inability to perform purposeful learned movements or activities even though there is no sensory or motor impairment

55
Q

Constructional apraxia

A

inability to reproduce geometric figures and designs

56
Q

Decerebrate rigidity

A

corticospinal lesion at brainstem that results in extension of trunk and extremities

57
Q

Decorticate rigidity

A

corticospinal lesion at diencephalon where trunk and lower extremities are in extension and UE in flexion

58
Q

Dysprosody

A

impairment and rhythm of speech

59
Q

Fluent aphasia

A

speech is functional but lacks content

60
Q

Ideational apraxia

A

inability to formulate an initial motor plan and sequence tasks

61
Q

Ideomotor apraxia

A

personal plans a movement or task but cannot volitionally perform it. Automatic movement may occur

62
Q

Neologism

A

substitution within a word that is so severe that it makes the word unrecognizable

63
Q

Non-fluent aphasia

A

non functional speech

64
Q
A

NPTE (54 decks)

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