Parkinson's Disease - Review Flashcards
Primary PD
Nigrostriatal cell degeneration.
Bradykinesia, tremor, rigidity (extrapyr hypertonia), dyskinesia, depression, apathy, dementia, cardioresp. (difficulty adapting to increased aerobic activity), digestive system (decreased DA -> weak contractions).
Secondary PD
Drug and toxin related, more related to dementia. Non-progressive.
Associated symptoms
Sleep disorders (due to tremors)
Cognitive disorders (memory and attention)
Dysmetria
Dysdiadochokinesia
Difficulty reasoning (aCC) and online modulation (AR - CB)
Hallucinations due to medication not being correctly dosed.
What is the lack of precision caused by?
Decreased balance
Bradykinesia
Rigidity
Planning/reasoning
Attention
Dysmetria
Online modulation deficit
Goal directed behavior
What is the cause for decreased balance?
Dysdiadochokinesia
Dysmetria
Attention
What is the cause for Pain? and what does the pain affect?
Rigidity. Affects sleep and goal directed behavior.
What is the cause for the patient being stuck (hip dissociation)?
Rigidity.
Planning/reasoning.
What do sleep disorders affect?
mental health, memory, attention, planning/reasoning, goal directed behavior.
What does Automatic Reactions affect?
Bradykinesia, rigidity, FoF, dysdiadochokinesia, dysmetria, attention, FoG.
Mesolimbic Pathway
SN-VTA-AM
Goal directed behavior
FoF
Anxiety
Mesocortical Pathway
SN-VTA-aCC-PFC
Attention, memory, reciprocal inhibition, planning/reasoning, goal directed behavior.
Nigrostriatal Pathway
SN-STN-DCN-CB, STN-THA, SN-Striatum, Striatum - GPi - GPe, STN-GPi.
Tremor (GPi)
Rigidity (STN)
Bradykinesia (STN)
FoG
Automatic reactions
What is FoG affected by?
Attention - memory
Planning/reasoning
Online modulation deficit
Dysmetria affecting B&R
Dysdiadochokinesia - B - Asymmetry
Sleep disorders (memory, planning, goal directed behavior, attention)
Automatic reactions
FoF
Smart Goals Examples
Improve pelvic mobility to increase dynamic balance.
Increase trunk rotation to decrease pain.
Increase selective/divided attention to decrease FoG/increase WM/dual tasks/improve planning/reasoning/decrease FoF/increase balance.
Red flags and special considerations
hallucinations, wrong dosage of medication.
Signs of depression
Sudden loss of facial expression
Increased rigidity in off periods (progression of disease -> adjust medication)
Increased risk of falls; either reported by the patient him/herself or by care givers
