NMD Part 1 Flashcards

1
Q

what is neuromuscular disease

A

disorders of the motor neuron (ant horn cells and peripheral nerves), neuromuscular junction, and ms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what dx are encompassed by the term NMD

A

dx that directly (myopathy) or indirectly (neuropathy) impair function of skeletal ms (primarily)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is myopathy

A

disorder of ms cells & fibers may be inherited or acquired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is Duchenne’s

A

genetic problem affecting dystrophin production which impacts the ms itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are 4 inherited types of myopathies
* don’t need to memorize*

A

mitochondrial
congenital
metabolic
muscular dystrophies*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are 6 acquired types of myopathies
don’t need to memorize

A
  1. autoimmune/inflammatory myopathy
  2. toxic myopathy
  3. endocrine myopathies
  4. infectious myopathies
  5. electrolyte imbalance
  6. critical illness myopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is neuropathy

A

damage or disease of motor neurons in spinal cord and/or neuromuscular junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the etiology of neuropathies in NMD

A

genetic mutation OR spontaneous mutation that becomes genetic

no environmental component

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

age of onset for dystrophies/neuropathies

A

infancy to adulthood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the motor function of dystrophies/neuropathies

A

range from complete dependence to complete independence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the progression of dystrophies/neuropathies

A

months to many years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the heterogenous presentation of dystrophies/neuropathies

A

prox -> distal
distal -> prox
prox = distal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are 3 common s/sx (impairments) of dystrophies/neuropathies

A
  1. weakness (dec strength)
  2. exercise intolerance (dec endurance)
  3. fatigue easily (ms fatigue)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are 4 secondary impairments to weakness d/t dystrophies/neuropathies

A

dec tone
atrophy
dec coordination
contractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are 5 characteristics/sx of dystrophies/neuropathies

A

ms cramping
twitching
atrophy
joint pain
hypotonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

dystrophies/neuropathies: progressive?

A

yes - varying rates

17
Q

what are 3 factors that the prognosis depends on

A

age of onset
type of NMD
motor function @ time of dx

18
Q

what is an activity that many patients will lose the ability of

A

ambulate (globally)

19
Q

what is the life expectancy

A

short to normal
- varies by dz & severity

20
Q

what is the cause of death typically in NMD

A

cardiopulmonary complications

21
Q

what is the goal of treatment

A

no cure - treatment to prolong life

22
Q

what are 6 red flags when screening NMD in children

A

CK levels elevated
tongue fasciculations
absent DTRs
(+) Gower’s sign
lack of development of major motor milestones
loss of motor milestones

23
Q

what is one of the first signs of NMD in children that is a red flag

A

tongue fasciculations

24
Q

what is the definition of the red flags identified when screening for NMD in children

A

related to a prompt referral, urgent (vs emergent)
- put a call to PCP when with them

does depend on presentation

25
what management is required for NMD
multi-system management via multidisciplinary team
26
what is the primary ongoing goal
maximize function over course of dz
27
why are these patients seen in acute care setting
hospitalized w flare of sx or unknown dx
28
what is the role of PT w these patients in a multidisciplinary clinic & frequency of visits
eval patient w other providers for a holistic approach - once every 4-12mo
29
why are these patients seen in a subacute rehab setting & frequency of PT sessions
typically following hospitalization - ongoing nursing needs couple wks duration - ~3hr /day
30
what are the 7 settings that NMD pts could see PTs in
acute care multidisciplinary clinic subacute rehab outpatient center school based services home based early intervention
31
what ages are early intervention services provided
birth to 3mo
32
why is PT implemented in a school-based setting
allow accessibility to academic setting
33
what does outpatient center PT look like for these pts
cased dependent - traditional - aquatic therapy