parkinson disease

Question 1

parkinson’s

Answer 1

complex motor disorder w other systemic and non motor and neuro s
progressive degen disorder of basal ganglia function characterized by rest tremor, rigidity, bradykinesia
systemic and non motor s contribute to disability
progressive so worsen -> some s faster than others

Question 2

basal ganglia disorder

Answer 2

function with cerebellum (inside cerebellum) to make smooth coordinated movements (altered with disease
substantia nigra: cells that produce dopamine (NT)

Question 3

parkinsonism: primary

Answer 3

idiopathic (parkinson’s disease) - no defining events that lead to, damage to dopamine producing cells
genetic or sporadic

Question 4

parkinsonism: secondary

Answer 4

acquired, altered dopamine production
infection, intoxication, trauma, drug induced (antiemetics, antidep, usually reversed when stopped, really any drug that interferes with dopamine transmission)

Question 5

rf

Answer 5

age: begin at 50, avg = 60, peak in 70s, can happen young
M > F
genetics: dom and rec
env exposure: pesticides, air pollution, farm/agri
dep: can form earlier, alters dopamine
head trauma: boxer
hysterectomy: decrease estrogen
coffee consumption actually protective!

Question 6

dopamine

Answer 6

inhibitory NT (and excitatory, depends on receptor type), I is lacking in parkinson’s
transmit message, control movement and balance, help muscle work smoothly, controllable, w/o unwanted movement

Question 7

acetylcholine

Answer 7

SM contraction, dilate BV, increase secretion, decrease HR
excitatory (stim muscle movement and can cause uncoordinated movements)
works with dopamine, balance is crucial! -> works best

Question 8

patho

Answer 8

imbalance problem with dopamine (I doesnt work) and acetylcholine
causes decreased coord
dopamine < ACH

Question 9

cm

Answer 9

bradykinesia: slowness of movement
cogwheel rigidity: muscle stiff
resting tremor: pill rolling tremor
shuffling gait: short step, dont lift feet when walk
mask like expression: flat affect, less expression
postural instability: increased r/o fall
loss of balance, decreased ability to prevent fall
classic triad = rest tremor, rigidity, bradykinesia

Question 10

cm onset

Answer 10

primary: d/t damage to dopamine producing cells
secondary: d/t altered dopamine production
gradual and progressive -> may only be 1 sided at first

Question 11

rest tremor

Answer 11

1st s, handwriting if dom hand
more prominent at rest -> supported against G but not engaged in activity
may decrease with movement, aggravated by stress or []
pill roll

Question 12

tremor: parkinson

Answer 12

from dopamine def, with rest and improve with movement, other cm of parkinsons

Question 13

tremor: essential

Answer 13

non park
from faulty neuro impulses, tremor with motor function, no other park cm

Question 14

rigidity

Answer 14

resistance to passive movement (non intentional movement)
cogwheel = jerky and slow
happens bc sustained muscle contraction, ACH > dop
associated complaints: sore, ache, pain
assess: hold our arms, hcp will try to move arm to flex at elbow

Question 15

bradykinesia

Answer 15

loss of automatic movements, slow, major cause of disability
dont blink, no arm swing, cant swallow saliva (drool), no self expression with hands and face (flat)
overall lack of spont movement

Question 16

complications

Answer 16

dementia (40%): lewy bodies, spread (in brain), hallucinations
sleep disturbances, fatigue, dep/anx (bc dependent)
drug related
decreased mobility: malN, asp, pna, UTI (retention), skin breakdown (decreased mobility)