Parkinson, Dementia, Stroke

Question 1

Pyrimidal (Direct) Pathway

Answer 1

-Pathways from the motor cortex to corticobulbar fibers
-Spasticity and paralysis disorders
-Stroke

Question 2

Extrapyramidal (indirect) Pathway

Answer 2

-Project from the basal ganglia to the brain stem reticular formation
-Involuntary movements, rigidity, and immobility without paralysis Disorders
-Parkinson’s Disease

Question 3

Parkinson’s Disease

Answer 3

-Progressive destruction of the nigrostriatal pathway and reduction in striatal dopamine.

Know that:
-Dopamine facilitates initiation of movement
-Acetylcholine inhibits initiation of movement

Question 4

Lewy Bodies

Answer 4

Abnormal aggregate of protein (alpha-Synuclein) that cause degeneration of the nerves that produce dopamine.

-La demencia en la enfermedad Lewy Bodies puede presentarse dentro de un año o menos. Demencia en Parkinson puede tomar más de un año en presenciarse.

Question 5

Parkinson’s Disease Clinical Manifestation

Answer 5

-Tremor (common)
-Disappears with movement and
sleep
-Rigidity
-Bradykinesia (affects daily tasks)
-Most limiting/debilitating
-Sweating and salivation
-Cognitive Dysfunction

Question 6

Pathophysiology of PD

Answer 6

Imbalance in neurotransmitters
-Dopamine levels are lower than Acetylcholine (ver foto en ppt)

Question 7

Target treatment for PD

Answer 7

-Increase dopamine levels
-Stimulate dopamine receptors
-Inhibits breakdown of dopamine
-These three helps with bradykinesia
-Inhibits acetylcholine effect
-Helps with tremors/rigidity

Question 8

Stroke

Answer 8

-Acute focal neurologic deficit from a vascular disorder that injures the brain tissue
-Leading cause of mortality and morbidity in the US
-Risk factors (smoking, diabetes, heart disease, etc)

Question 9

Ischemic Stroke (80% prevalence)

Answer 9

-Interruption of blood flow in cerebral vessel by thrombosis or emboli.
-Many types (see other flashcards)

Question 10

Hemorrhagic (13% prevalence; most fatal)

Answer 10

-Spontaneous Blood vessel rupture cause by hypertension, aneurysm, or arteriovenous malformation.

Question 11

Infraction core

Answer 11

The tissue that died in the stroke

Question 12

Penumbra

Answer 12

In a stroke, Cells are asleep but it can be restored.

Question 13

Thrombotic Stroke (Large Vessel Stroke)

Answer 13

-Most common
-Affects the cortex
-Cause Aphasia (language disorder) and visual field defects

Question 14

Embolic Stroke (Cardioembolic Stroke)

Answer 14

-Most cerebral emboli originate from a thrombus in the left heart
-Causes Atrial Fibrillation, Rheumatic Heart Disease, MI, ventricular aneurysm, bacterial endocarditis.

Question 15

Lacunar stroke (Small vessels stroke)

Answer 15

-Small infarcts
-Usually do not cause cortical deficits like aphasia or apraxia (Unable to move when instructed to)

Question 16

Transient Ischemic Attacks (TIA)

Answer 16

-Minis Strokes sin daños permanentes porque se arreglo antes de que muriera las neuronas.
-Temporary
-There is a high risk of early stroke after a TIA

Question 17

Stroke-Related motor deficits

Answer 17

-Hay muerte de tejido si ocurre a largo plazo pero no necesariamente de manera aguda.
-Motor deficits are most common.
-Symptom of Babinski sign (flexión de los dedos del pie)

Question 18

Stroke-Related Dysarthria and Aphasia

Answer 18

-Dysarthria is imperfect articulation of speech sounds
-Aphasia is inability to comprehend, integrate, and express language.

Question 19

Stroke-Related Cognitive and Other Deficits

Answer 19

-Hemineglect or Hemi-inattention is inability to attend and react to stimuli from the contralateral side (Descuida un lado de su cuerpo)
-Cognitive deficits
-Sensory Deficits
-Visual Disturbances

Question 20

Acute Ischemic Stroke Treatment Target

Answer 20

Regain blood circulation targeting Clot disruption

Question 21

Hemorrhagic Stroke Treatment Target

Answer 21

-Since bleeding increases intracranial pressure, treatment is to manage that intracranial pressure.
-Arresting Hemorrhage
-CT scan is necessary to confirm

Question 22

How to recognize and act with a Stroke? (FAST)

Answer 22

-Face Drooping
-Arm Weakness
-Speech Difficulty
-Time to call 911

Question 23

What is a Normal Cognitive Aging?

Answer 23

A slow, progressive decline over someone’s life span but does not affect functional abilities.

Question 24

Neurocognitive Disorders (NCD)

Answer 24

Decline in mental functional severe enough to interfere with a person’s ability to perform daily activities and is not a normal part of the aging process.
-Alzheimer’s Disease
-Parkinson’s Disease
-Lewy Body Disease
-Pick Disease
-Vascular Dementia

Question 25

Reversible forms of NCD should be ruled out (DEMENTIA)

Answer 25

-Drugs
-Emotional
-Metabolic
-Eyes and ears
-Normal-Pressure Hydrocephalus
-Tumor or other space-occupying lesions
-Infection
-Anemia

Question 26

Alzheimer’s Disease

Answer 26

Characterized by cortical atrophy and loss of neurons, particularly in the parietal and temporal lobes
-Nuerotransmission disruption, oxidative stress, neuroinflammation, and other factors.

Question 27

AD Pathology

Answer 27

-Neurofibrillary Tangles
-Amyloid (neuritic) Plaques
-Dense aggregates of AB that are
mutated proteins.
-Decreased cholinergic transmission in the brain
-Disrupted signaling in the cholinergic and glutamatergic systems at the cortex.

Question 28

AD Clinical presentation

Answer 28

-Loss of Short-term memory
-Difficulty with language
-Changes in behavior

Question 29

AD Diagnosis

Answer 29

-Autopsy is the only way to truly know the presence of AD
-Clock Drawing Test

Question 30

Vascular Dementia

Answer 30

Caused by brain injury resulting from ischemic or hemorrhagic damage.

Question 31

Frontotemporal Dementia (Pick Disease)

Answer 31

Atrophy of frontal and anterior temporal lobes