NM PD Flashcards
Chronic progressive disorder of CNS with degeneration of ________ ______ _____ neurons and nigrostriatal pathways
Dopaminergic substantia nigra
Etiology includes:
Infection/postencephalic Atherosclerosis Idiopathic Toxic Drug induced
Decrease of _________ within basal ganglia corpus striatum with degeneration to ______ ______
Dopamine
Substantia nigra
Loss of ______ ________ which causes excess excitatory output from ______ system of basal ganglia
Inhibitory dopamine
Cholinergic (ACh)
What are the classic symptoms?
Bradykinesia
Rigidity (cogwheel or leadpipe)
Resting tremor
Postural instability/impaired postural reflexes
Hoehn and Yahr: stage 1
Minimal/absent disability
U/L symptoms
Hoehn and Yahr: stage 2
Minimal B/L or midline involvement
No balance involvement
Hoehn and Yahr: stage 3
Impaired balance
Restrictions in activity
Hoehn and Yahr: stage 4
All symptoms present and severe
Cannot walk or stand without assistance
Hoehn and Yahr: stage 5
Bed bound or W/C bound
Exam:
1) History
2) cog status: ______ in advanced stages, _____ deficits, ________, and _________
Dementia
Memory
Bradyphrenia (slow thought processes)
Depression
Exam:
3) communication: what are you looking for?
Dysarthria
Hypophonia
Mask like face
Writing gets smaller
Exam:
4) oromotor control: _________
Dysphagia
Exam:
5) cardioresp. Function: decreased _______, decreased ______ expansion, ______ ______
Endurance
Thoracic
Ortho hypo
Exam:
6) ROM/deformity: contractures common in _____ and ______.
Thoracic ______ and ______
Increased risk for _____
Flexors, adductors
Kyphosis, FHP
Fractures
Exam:
7) sensation: problems in ______ organization, extreme _______ (akathisia)
Spatial
Restlessness
Exam:
8) Vision: blurring, _____ eye pursuit, and eye irritation due to what?
Cogwheeling
Decreased blinking
Exam:
9) skin integ
10) autonomic changes: increased ______/______
Drooling, sweating
Exam:
11) Muscle tone: ________
12) strength: weakness due to ______
13) Motor function: ______/________ — look at ability to _____ movement, and _____ episodes
Rigidity
Disuse
Bradykinesia/akinesia, initiate movement, freezing
Exam:
14) involuntary movement: ________ _______, especially ____ _____
Resting tremor, pill rolling
Exam:
15) Balance: impaired postural reactions, decreased trunk ______
Rotation
Exam: 16) Gait: lack of \_\_\_\_\_\_, \_\_\_\_\_\_\_\_ \_\_\_\_\_ And \_\_\_\_ \_\_\_\_\_
Extension
FOG
Festination
Fall risk
Exam:
17) fatigue: increased with _____ or ____ ______
Stress
High effort
Medications: Sinemet (Levadopa/carbidopa): provides ________, crosses the ______, decreases the effects of ______
Effects prolonged with ____ _____ diet
Dopamine
BBB
PD
Low protein
Medications: Sinemet (Levadopa/carbidopa):
What are the ADRs?
N/V Ortho hypo Cardiac arrythmias Involuntary movements Psychoses Abn behaviors (hallucinations)
Dopamine agonists do what?
Examples?
Enhance the effects of sinemet
Bromocriptine, pergolide mesylate
Anticholinergic drugs control ______
Tremor
Amantadine increases what?
Dopamine release
Selegiline is a ______ _____ _____ that increases ______
Monoamine oxidase inhibitor
Dopamine
Deep brain stimulation in ______ or ______ ______
Thalamus
Subthalamic nuclei
Teach ______ strategies to unlock ________ such as using _____ stimulation’s
Compensatory
Freezing
Auditory
Improve strength, especially ______
Rotation