Parkinson's - Part 1 Flashcards
What is the primary pathophysiology of Parkinson’s Disease?
Degeneration of dopaminergic neurons in substantia nigra, leading to reduced dopamine production.
- Direct pathway: initiation of movement
- Indirect pathway: suppression of unwanted movement
What are the Cardinal Features of Parkinson’s Disease?
- Cardinal Features:
- Tremor
- Rigidity
- Bradykinesia
- Postural Instability (later stages)
- Non motor symptoms (May precede motor symptoms):
- loss of smell
- sonstipation
- sleep disorders
- mood disorders
- orthostatic hypotension
- cognitive problems
What percentage of Parkinson’s Disease cases are idiopathic or genetic?
Parkinson’s Disease:
- 78% of cases are idiopathic or genetic (PARK1).
What is early-onset Parkinson’s Disease?
- average age of onset 50-60 years
- < 40 years: early onset PD (4-10%)
What is…
- cogwheel rigidity?
- lead-pipe rigidity?
Cogwheel rigidity: Jerky movements with a catch and release sensation throughout the range of motion.
Lead-Pipe Rigidity: Sustained resistance to passive movement in all directions, with no jerky motions.
What is bradykinesia?
Bradykinesia:
- Slowness of movement, often influenced by rigidity, causing increased time on tasks and difficulties in daily activities.
What is micrographia?
Micrographia: A symptom of bradykinesia where handwriting starts normal but becomes progressively smaller.
What is…
- resting tremor?
- action tremor?
Resting Tremor: Involuntary shaking occurring at rest, usually suppressed by voluntary movement.
Action Tremor: A tremor that continues with movement, more common in advanced stages of Parkinson’s.
What is postural instability?
- Difficulty maintaining center of mass over base of support, leading to balance issues and fall risk.
- Contributing factors: Rigidity, loss of range of motion, decreased muscle torque, and medications.
What are some secondary motor symptoms in Parkinson’s Disease?
- reduced muscle strength
- motor planning deficits
- gait abnormalities
What are common gait abnormalities in Parkinson’s Disease?
- slowness
- festinating gait (shuffling)
- decreased arm swing
- freezing of gait
What is…
- Festination = ?
- Two kinds = ?
Festination: A type of gait abnormality where the patient takes quick, short steps, often leaning forward.
- anteropulsive (a forward festinating gait)
- retropulsive (a backward festinating gait)
What is freezing of gait (FOG)?
A sudden inability to initiate movement, often triggered by obstacles or tight spaces.
What is dysphagia?
Difficulty swallowing, experienced by 95% of Parkinson’s patients, due to muscle rigidity and reduced mobility.
Non-Motor Symptom
What is sialorrhea?
Excessive drooling caused by decreased spontaneous swallowing and increased saliva production.
Non-Motor Symptom
What are the cognitive dysfunctions associated with Parkinson’s Disease?
Deficits in
- attention
- planning
- processing
ranging from mild cognitive impairment to dementia.
What are some autonomic dysfunctions in Parkinson’s Disease?
- Hyperhidrosis (excessive sweating)
- Seborrhea (increased oil secretion)
- Abnormal slow pupillary response to light
- GI (constipation, impaired gastric emptying, urinary incontinence)
- Respiratory(airway obstruction, decreased chest expansion, lower FVC andhigher RV)
- Cardiovascular: blunted CV response to exercise (lower HR and BP during exercise)
What cardiovascular issues are common in Parkinson’s Disease?
Blunted cardiovascular response to exercise, with lower heart rate and blood pressure during activity.
What is the Hoehn-Yahr Classification Scale?
A scale used to chart the progression of Parkinson’s Disease from mild to severe.
