Parkinson's Flashcards
Parkinson’s Definition
A progressive, degenerative, disorder of basal ganglia function
Characterized by
- Tremor
- Rigidity
- Bradykinesia
What are Basal Ganglia?
Function with cerebellum to make smooth coordinated movement
The substantia nigra in the basal ganglia has cells that produce DOPAMINE
Parkinsonism
PRIMARY
- Idiopathic= Parkinson’s Disease
- Genetic or sporadic
Secondary (acquired) -Infection -Intoxication -Trauma -Drug induced (any drug that deals in dopamine)
Parkinson’s Risk Factors
- Age (peak in 70s)
- Gender (male>Women) 3:2
- Genetics (both dom + recessive)
Other emerging risk factors
- Anxiety/depression
- Head trauma
- Hysterectomy
- Coffee consumption (protective)
Dopamine
Inhibitory and Excitatory Neurotransmitter
-in Parkinson’s its the inhibitory effects that are lacking
Function: Message transmission
- Controls movement and balance
- Helps muscles work smoothly, controllably, and without unwanted movement
Acetylcholine (ACH)
Excitatory Neurotransmitter
- Works in conjunction with dopamine system
- Balance in CRUCIAL
- works best with in balance with dopamine
- Stimulated muscle movements + can stimulate uncoordinated movements
Both Forms of Parkinson’s Disease Pathogenesis
- An imbalance problem
- Too much ACh in relation to dopamine
- Results in loss of coordinated movement
- Development of clinical manifestations
Primary Parkinson’s Pathogenesis
- Destruction of substantia nigra in basal ganglia
- Dopamine levels DECREASE
- Imbalance between ACh and Dopamine
- Relative excess of ACh
- Loss of controlled movements and balance
Clinical Manifestations
- Bradykinesia (slowness of movement)
- Cogwheel rigidity (stiff muscles)
- Resting tremor (pill rolling tremor)
- Shuffling gate
- Mask-like expression
- Postural instability
Progression
Gradual Onset (slow) and progression
May only involve 1 side of the body at first
Classic triad
- Tremor
- Rigidity
- Bradykinesia
Tremor
- Often first sign
- Handwriting effected
- More prominent at rest
- Aggravated by stress or concentration
- Pill roll
Parkinson’s VS Essential Tremor
Essential Tremor
- Results from faulty neurological impulses
- Tremors occur with motor function
- No other manifestation of Parkinson’s
Parkinson’s Tremor
- Results from Dopamine loss
- Tremor occur with rest and improve with movement
- Presents with other manifestations of Parkinson’s disease
Rigidity
Resistance to passive movement
Cogwheel rigidity: movements jerky and slow
Why does this happen?
- sustained muscle contraction
- too much ACh compared to dopamine
Associated Complaints
-Muscle soreness, Aches, Pain
Bradykinesia
Loss of automatic movements
- no blinking
- no swinging of arms
- no swallowing of saliva
- no self-expression with hands + face (flat expression)
- Overall lack of spontaneous movement
Postural Instabilities and Gain disturbances
They got these too
