Neuromuscular Disease

Question 1

Neuromuscular Diseases (NMD

Answer 1

Primary muscle disease decreases the ability of a normal neural impulse to generate effective muscle contraction

Question 2

Peripheral nerve disorders that cause respiratory muscle dysfunction may be caused by

Answer 2

🔹Inflammatory process
🔹Vascular disorders
🔹Metabolic disorders

Question 3

NMD- Cardiopulmonary consequences may include

Answer 3

🔹Ventilatory insufficiency
🔹Central sleep apnea 
🔹Aspiration PNA
🔹Atelectasis leading to hypoxemia
🔹Cor Pulmonale

Question 4

Pathophysiology of NMD

❗Diaphragmatic paralysis most often diagnosed by PFT

Answer 4

🔹⬇ Decreased VC, FEV1, TLC
🔹Normal or ⬆ increased RV and diffusing capacity
🔹Positional changes suggest diaphragmatic weakness
▶seated to supine ->20% decline in FVE1 and VC
⬇ Decrease MIP and Mep

Question 5

Pathophysiology of NMD

❗ Chief complaint

Answer 5

🔹Exertional dyspnea
🔹Fatigue
🔹 Orthopnea

Question 6

Respiratory muscle weakness leads to

Answer 6

🔹Fatigue and respiratory failure, May meed MV
🔹Monitor MIP, VC and ABG’s
🔹ABG’s: ⬇ PaO2 ⬇ PaCO2, deterioration leads to ⬆PaCO2
🔹 Monitor all respiratory function / nocturnal oximetry

Question 7

Pt with significant muscle weakness are at risk for

Answer 7

🔹 Mucous Plugging
🔹 PNA
🔹 Pulmonary edema

Question 8

Muscle weakness leads to

Answer 8

🔹Respiratory insufficiency

🔹 Retained secretions

Question 9

Other names for (GBS) Guillain-Barre Syndrome

Answer 9

🔹Landry-Guillain-Barre-Strhol syndrome
🔹Acute idiopathic polyneuritis
🔹Postinfectious polyneuritis
🔹Landry's paralysis
🔹Acute post-infectious polyneuropathy
🔹Acute Polyradiculitis 
🔹Polyradiculoneurooathy

Question 10

GBS is a

Answer 10

Autoimmune disorder of the peripheral nervous system

🔹 In which flaccid paralysis of skeletal muscles and loss of reflexes develop in a previously healthy individual.

Question 11

Severe cases of GBS may result in

Answer 11

Ventilatory failure from diaphragmatic paralysis

Question 12

Nerves with GBS demonstrate

Answer 12

🔹Demyelination

🔹Inflammation and edema (microscopically)

Question 13

If GBS is not managed properly ventilatory failure form paralysis may result from

Answer 13

🔹Alveolar consolidation

🔹Atelectasis

Question 14

GBS affects

Answer 14

Male and female equally

Question 15

Grater incidence of GBS in people

Answer 15

🔹Over the age of 50

🔹50-60% more common in whites

Question 16

GBS etiology

Answer 16

🔹Idiopathic
🔹Believed to be an immune disorder that causes inflammation and deterioration of the pt’s peripheral nervous system.
🔹Elevated antibodies (IgM) are found in serum blood test

Question 17

GBS causative agent

Answer 17

🔹Campylobacterjejuni

🔹Cytomegalovirus

Question 18

Other infections that have been implicated to GBS

Answer 18

🔹Mononucleosis
🔹Measles and Mumps
🔹Mycoplasm Pneumoniae
🔹Chlamydia psittaci

Question 19

GBS diagnosis is based in

Answer 19

🔹Clinical history
🔹Abnormal (EMG) Electromyography
🔹 ⬆ Elevated protein levels on cerebral fluid

Question 20

GBS Non-cardiopulmonary clinical manifistations

Answer 20

🔹Paresthesia or dysesthesias (tingling sensation and numbness in extremities).
🔹Pain in BACK, BUTTOCKS, and LEGS
🔹Progressive ascending paralysis
🔹Loss of deep tendon reflexes
🔹Difficulty swallowing

Question 21

GBS recovery % of functional recovery

Answer 21

🔹Functional spontaneous recovery in about 90% of cases

Question 22

GBS cardiopulmonary clinical manifestations

Answer 22

🔹Diminished breath sounds
🔹Crackles and Rhonchi
🔹 ⬇ Decreased flows ⬇Decreased Volumes 
🔹Restrictive disorders
🔹CXR show ⬆ increased opacity

Question 23

GBS Heart rhythms

Answer 23

🔹Tach and Bradycardia

Question 24

GBS BP

Answer 24

🔹Hypotension

Question 25

GBS are in danger of due to immobilization

Answer 25

🔹Thromboembolism

Question 26

In GBS what has shown to decrease morbidity rates? And been proven to reduce antibody titers?

Answer 26

🔹Plasmapheresis

Question 27

Immunoglobulin infusion

Answer 27

🔹Can block damaged antibodies

Question 28

Corticosteroids are contraindicated in GBS because?

Answer 28

🔹They may prolong pt’s recovery time

Question 29

What can RT’s do for GBS?

Answer 29

🔹O2
🔹CPT
🔹Hyperinflation
🔹MV