Parkinson's Flashcards
Parkinson’s is a chronic progressive disease characterized by ________________.
rigidity
bradykinesia
tremor
postural instability (later stages)
What are the types of PD?
Idiopathic
Secondary
What is the most common form of PD?
Idiopathic
What are potential risk factors of PD?
genetic marker
family history
What part of the basal ganglia is damaged in PD?
pars compacta
What does damage to the basal ganglia cause?
slow movement
decreased ability to adapt to changes in environment
decreased coordination
What is the hallmark of PD?
cogwheel rigidity
Degeneration of substantia nigra leads to deficiency in ____________ production.
dopamine
What are early signs/symptoms of PD?
movement disorder of hand
slowness of movement
shuffling gait
What is the primary motor loop?
loss of dopamine in SN
decreased inhibition of striatum
less output to internal GP and more output to external GP
internal GP provides more inhibition to thalamus, brain stem, spinal cord
External GP provides less inhibition of subthalamic nuclei
increased output of subthalamic nuclei
increased excitation of internal GP
furthered inhibition of internal GP
What is the secondary loop?
frontal lobe gives direct input to subthalamic nuclei
facilitation of internal GP
output is inhibitory to thalamus, brainstem and spinal cord
double inhibition
How do PD pts usually die?
respiratory dysfunction
becomes pulmonary restrictive disease
Why is a mask like appearance an early sign of PD?
face takes up lots of space on homunculus and requires more dopamine
What is the early tremor typically seen with PD?
Pill rolling
Motor planning deficits result in ______________.
bradykinesia/akinesia
difficulty with dual task control
Postural/gait characteristics of PD
stooped posture
poor balance
shuffling gait
difficulty starting AND stopping movement
How is PD diagnosed?
clear response to Levadopa
pt must present with at least two of four cardinal features
What is the Hoehn-Yahr Scale?
Stage I - minimal to no symptoms (unilateral if present)
Stage II - minimal B or midline sx, balance not impaired
Stage III - Stage II with impaired balance
Stage IV - All sx present and severe needs assistance to ambulate
Stage V - Wheelchair bound or bedridden
What are medical treatment options for PD?
pharmacology
deep brain stimulation
surgery
tissue transplant
Why is levadopa often help until pt is 70?
people build tolerance so longer you go without meds, the longer you get to use it in later stages
What is sinemet?
contains both levadopa and carbidopa
When would deep brain stimulation be indicated?
in later stages– pharmacologic resistant motor deficits
If a patient presents with a tremor first (opposed to pill rolling) a _____________ course is expected.
slower
