Parkinson's Disease Flashcards
What is the part of the brain most associated with movement, what modulates voluntary motor control
The primary motor cortex, Basal ganglia
What are the steps to voluntary movement
1) Motor cortex sends excitatory signals (Ach or glutamate) to the basal ganglia 2) Once stimulated dopamine is released via the nigrostriatal pathway back to the striaitum 3) After entering the striatum the signal will either move INDIRECTLY OR DIRECTLY to return to the cortex 4) Signal rebounds after hiting the cortex to go down the spinal cord to the lower motor neuron to the muscles for movement
How does glutamate effect both the direct and indirect pathway
Direct pathway: Stimulates movement Indirect pathway: Inhibits movement
How does dopamine stimulate the direct and indirect pathway as long as the particular receptor
Direct pathway: Dopamine STIMULATES DA1 receptors to produce movement Indirect pathway: Dopamine INHIBITS DA2 receptors to produce movement
What is the hallmark pathophysiology of Parkinson’s
Destruction of the substantia nigra causing less Dopamine to be stored and used
- Direct pathway is less able to function (no movement is initiated)
- Indirect pathway is functioning to much ( large amount of inhibition of movement)
What is the most common side effect of Parkinson’s, other side effects
Bradykinesia, tremor, rigidity
T/F: Due to a decrease in dopamine there is an increase acetycholine causing tremors
True
What is a resting tremor, what can worsen it
Feeling of internal tremulousness in limbs on one side that is observable, will usually disapper when no longer at rest
Emotion excitement, anxiety, stress
What is the pull test
Pull the patient’s shoulders from behind, patients with Parkinson’s are likely to fall due to the amount of focus needed to stay upright
What are some craniofacial symptoms
- Masked facial expression
- Slow soft speaking
- Repetion of works
- Difficulty swallowing (Dysphagia)
- little eye blinking
What are some visual symptoms of parkinson’s
- Blurred vision
- Impaired contrast sensitivity
- Impaired upward gaze
- Difficult eyelid opening after closing
What are the NONMOTOR symptoms of Parkinson’s
- Cognitivite dyfunction and dementia
- Hallucinations
- Fatigue
- GI dysfunction
- Redness of the skin (Seborrhhea)
- Excessive drooling
- Depression, anxiety, apathy, sleep disorders, pain
What are the subtypes of Parkinson’s
Tremor Dominant, Postural Instability and Gait Difficulty (PIGD), Bradykinesia Dominant
What are the risk factors for Parkinson’s
- Family History
- Genetics
- Pesticides
- Depression?
