Parkinson's Disease (Exam 2) Flashcards
Parkinson’s Disease: Definition
A progressive, degenerative disorder of basal ganglia function
Progressive (worsening of symptoms)
Parkinson’s Disease Characterized by
-Rest tremor
-Rigidity
-Bradykinesia (slow movement)
What does basal ganglia do?
Function with cerebellum to make smooth coordinated movements
Concerning parkinson’s disease and basal ganglia. what are we concerned with?
The substantia nigra in the basal ganglia
These cells produce dopamine
Primary Parkinsonism
Idiopathic = parkinson’s disease
Genetic or Sporadic
Unknown cause (no defining events)
Secondary Parkinsonism
Acquired by:
-infection
-intoxication
-trauma
Secondary Parkinsoinism can be reversible once medication and things are stopped
Parkinson’s Disease: Risk factor
Age = Start after 50 and peak in 70s
Gender = Men
Genetics = Both dominant and recessive trait
Environmental exposures (pesticides) (farm) (ag work)
Depression (alter dopamine)
Head trauma (boxer)
Hysterectomy (decrease estrogen)
What is protective of parkinson’s disease?
Coffee Consumption
Dopamine is what type of neurotransmitter
Inhibitory Neurotransmitter
What is the function of dopamine
Controls movement and balance by INHIBITING unnecessary movements
Helps muscles work smoothly, controllably, and without unwanted movement
Acetylcholine is what type of neurotransmitter
Excitatory Neurotransmitter
Acetylcholine function
Increase muscle movements
Works in conjunction with dopamine system
Balance is CRUCIAL because it
WORKS BEST when in balance with dopamine
Parkinsons Disease: Pathogenesis Neurotransmitters
An imbalance problem
Too much ACH in relation to dopamine
Results in loss of coordinated Movement
Development of clinical manifestations
Extra muscle movements and decrease coordination
Primary Parkinson’s: Pathogenesis
Destruction of substantia nigra in basal ganglia (where dopamine is produced)
Dopamine levels decrease
Imbalance between dopamine and ACH
Relative excess of ACH
Loss of controlled movement and balance
Parkinson’s: Clinical manifestations
Bradykinesia (slowness of movement)
Cogwheel Rigidity (Stiff Muscles)
Resting Tremor (Pill Rolling Tremor)
Shuffling Gait
Mask Like expression (flat affect)
Postural instability (loss of balance)
Parkinsons: Clinical Manifestations Timeline
Gradual onset and progression
May only involve 1 side of the body at the first
Classic triad of parkinson’s
Rest tremor (pill rolling)
Rigidity (cogwheel)
Bradykinesia (slow movement)
Parkinson’s: Pill Roll Tremor
Often the first sign and occurs with rest
Handwriting effected
More prominent at rest
Aggravated by stress or concentration
Parkinson’s Tremor vs Essential Tremor
Essential
-results from faulty neurological impulses
-tremors occur with motor function (motion) (with movement)
-no other manifestations of parkinson disease
-WORSE WITH MOVEMENT
Parkinson’s
-results from dopamine deficiency
-tremors occur with rest and improve with movement
-presents with other manifestations of parkinson’s disease
-BETTER WITH MOVEMENT
Parkinsons: Rigidity
Resistance to passive movement
COGWHEEL RIGIDITY (jerky and slow)
Hold out arms and have someone try to move the arm = resistance
Why does rigidity happen?
Sustained muscle contraction
Too much ACH in comparison to dopamine
ACH is causing the muscle to contract continuously
Rigidity: Associated Complaints
Muscle soreness
Aches
Pain
Parkinson’s: Bradykinesia
Loss of automatic movements
-no blinking
-no swinging of arms
-no swallowing of saliva
-no self expression with hands and face (FLAT affect)
Overall lack of spontaneous movement
Slowness of movement
MAJOR CAUSE of DISABILITY
Parkinson’s Disease: Complications
-Dementia (40%)
-Sleep Disturbances
-Fatigue
-Depression / Anxiety
Decreased Mobility
-malnutrition
-aspiration
-PNA
-UTI
-Skin breakdown
Drug Related complications
