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Neuro 2 - Exam 2 > Parkinsons - 1 > Flashcards

Parkinsons - 1 Flashcards

1
Q

second most common neurogenerative disorder

A

parkinson’s

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2
Q

what is parkinsons

A

disorder of the basal ganglia fxn

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3
Q

cardinal signs of parkinsons

A

tremor

rigidity

akinesia (bradykinesia)

postural instability

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4
Q

parkinson’s is not only a

A

movement disorder

has non-motor symptoms

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5
Q

non-motor symptoms

A

cognitive dysfxn

dementia

depression

pain

fatigue

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6
Q

progressions of parkinson are

A

highly variable

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7
Q

highly variable

A

some have PD for 20-30 yrs w/ only mild limitations

others become severely disabled w/in 5-10 yrs

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8
Q

who are more affected by PD

A

men more commonly than women

3:2 ration

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9
Q

ethnic groups that’re affected

A

all groups

lower prevalence among black and asian individuals

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10
Q

mean age of onset

A

early to mid 60s

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11
Q

what has there been a recent surge of

A

young onset PD occurring in 5-10% of class

generally diagnosed b/w 21 and 40

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12
Q

what is there a loss of

A

dopamine producing cells in the substantia nigra of the midbrain

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13
Q

where is the site of action of the NT loss

A

in the basal ganglia

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14
Q

how is dopamine normally transmitted

A

by way of nigrostriatal neurons from the brainstem to the BG

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15
Q

what is dopamine needed for

A

normal activation patterns of the BG and thalamus

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16
Q

what does inadequate dopamine lead to

A

substantial consequences for initiation and speed of movement

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17
Q

progressive loss of nigrostriatal neurons is accompanied by

A

increase in glial cells in the substantial nigra

loss of neuromelanin

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18
Q

what do surviving neurons have

A

presence of lewy bodies

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19
Q

where are ley bodies identified

A

cortex

amygdala

locus ceruleus

valgal nucleus

peripheral autonomic nervous system

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20
Q

what do lewy bodies in the non-motor areas account for

A

non-motor symptoms associated w/ PD

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21
Q

sxs of PD origin

A

neurochemical

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22
Q

what loses its ability to produce dopamine

A

substantia nigra

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23
Q

how much may dopamine be depleted

A

up to 80% before sxs seen

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24
Q

what can compensate for loss of dopamine

A

remaining dopaminergic cells

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25
Q

loss of dopaminergic system

A

disinhibition of the cholinergic system

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26
Q

what does excessive cholinergic activity lead to

A

tremor

rigidity

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27
Q

loss of dopamine leads to

A

akinesia

bradykinesia

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28
Q

movement disorders

A

neurological conditions that affect speed, fluency, quality and ease of movement

29
Q

most common movement disorders

A

parkinsonism

HD

30
Q

other examples of movement disorders (1)

A

ataxia

dystonia

myoclonus

restless leg syndrome

31
Q

other examples of movement disorders (2)

A

tics

tourette’s syndrome

tremor

wilson’s dz

32
Q

parkinsonism

A

group of disorders producing abnormalities in the BG

33
Q

PD

A

idiopathic parkinsonism

unknown etiology

34
Q

secondary parkinsonism

A

d/t identifiable causes

35
Q

atypical parkinsonism

A

parkinson-plus syndromes

d/y neurogenerative disorders

36
Q

secondary parkinsonism causes (1)

A

drug induced

toxin induced

metabolic

37
Q

secondary parkinsonism causes (2)

A

structural lesions

hydrocephalus

infections

38
Q

structural lesions –> secondary parkinsonism causes (2)

A

vascular parkinsonism

39
Q

onset and progression course –> atypical parkinsonism

A

abrupt onset

rapidly progressive

40
Q

atypical parkinsonism is

A

early onset of or rapidly progressing dementia

41
Q

impairments –> atypical parkinsonism

A

more symmetrical

axial

early gait/balance impairments

42
Q

signs –> atypical parkinsonism

A

upward/downward gaze palsy

UMN & Cb signs

urinary incontinence

43
Q

UMN & Cb signs –> atypical parkinsonism

A

dysmetria and ataxia

44
Q

postural –> atypical parkinsonism

A

early symptomatic postural hypotension

early postural instability

45
Q

unresponsive to –> atypical parkinsonism

46
Q

atypical parkinsonism includes

A

progressive supranuclear palsy

cortical basal ganglia degeneration

multiple system atrophy

47
Q

progressive supranuclear palsy (PSP)

A

upright posture

frequent falls

pseudobulbar emotionality

furrowed brow/stare

48
Q

supranuclear palsy –> progressive supranuclear palsy (PSP)

A

difficulty looking up/down

49
Q

cortical basal ganglia degeneration (CBGD)

A

unilateral course tremor

limb apraxia, dystonia

50
Q

multiple system atrophy (MSA)

A

shy drager syndrome

51
Q

shy drager syndrome –>multiple system atrophy (MSA)

A

autonomic deficiency

orthostasis

impotence

52
Q

incidence –> atypical parkinsonism

A

60-120/100,000

53
Q

occurs in –> atypical parkinsonism

A

1% of the population over 55 yo

54
Q

increases to –> atypical parkinsonism

A

2.6% by 85 yo

55
Q

how many cases develop before the age of 40 –> atypical parkinsonism

A

10%

young onset PD

often familial

56
Q

cases that may be undiagnosed –> atypical parkinsonism

A

40%

at any given time

57
Q

etiology –> idiopathic PD

A

remains unknown

58
Q

RFs –> idiopathic PD

A

environmental toxin exposure

family history and genetic predisposition

head trauma

59
Q

environmental toxin exposure –>RFs –> idiopathic PD

A

pesticides or herbicides

60
Q

family history & genetic predisposition –>RFs –> idiopathic PD

A

(+) family history

parkin gene

61
Q

parkin gene

A

leads to early onset PD

begins ~ age 40

62
Q

head trauma –>RFs –> idiopathic PD

A

3z8x higher risk for PD

63
Q

factors that reduce risk –> idiopathic PD

A

cigarette smoking

caffeine consumption

64
Q

parts of the BG

A

caudate

putamen

globus pallidus

subthalmamic nucleus

substantia nigra

65
Q

dz progression is

A

unilateral to bilateral

appendicular to axial

66
Q

as dz progresses, there is an increase in (1)

A

akinetic rigidity

postural, balance and gait disturbances

motor initiation difficulty

67
Q

motor initiation difficulty

68
Q

as dz progresses, there is an increase in (2)

A

speech, swallowing, drooling problems

non-motor symptoms

medications S/E, complications

69
Q

reduction in –> dz progression

A

medication efficacy

Neuro 2 - Exam 2 (16 decks)

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