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Neuromus 3 > parkinsons > Flashcards

parkinsons Flashcards

1
Q

how common is parkinsons

A

the secound most common neurodegenerative disorder of the CNS

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2
Q

is age an important factor in parkinsons

A

yes

the vaerage age of on set is 50-60

rare in those < 40

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3
Q

is park more prevalent in men or women

A

men

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4
Q

what is the cause of park

A

Mostly idiopathic/unknown (78%)

Some may be linked to genetic mutation (10%)

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5
Q

what is Secondary Parkinsonism

A

a group of disorders that have features similar to those of Parkinson disease but have a different etiology.

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6
Q

what are some examples of Secondary Parkinsonism

A

Infection

Drugs - Toxins

Tumors
Vascular
Metabolic disorders

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7
Q

what does the basal ganglia consist of

A

caudate

putamen

globus pallidus

sub thalamic nucleus

substania nigra

(CPGss)

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8
Q

what are the functions of the basal ganglia

A

goal directed behavior

self regulation

regulate emotions

regulate eye movements

Regulates skeletal muscle contraction

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9
Q

how specifically does the BG regulates skeletal muscle contraction

A

Regulates muscle force,

multi-joint movements,

sequencing of movements,

involved in motor planning

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10
Q

the motor coretex feeds into what two parts of the BG

A

putamen and sub thalamic nucleus

the excite these pathway s

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11
Q

all paths in the BG lead to the

A

motor part of the thalamus

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12
Q

Pathophysiology of Park

A

loss of the neuros in the substaia nigra that produce dopamine

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13
Q

how much cell loss do we need to show the signs of park

A

up to 80%

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14
Q

what does the loss of dope (ext/ihb) do to the BG pathway

A

causes less disinhibition of “Go” pathway and excess inhibition of “No-Go” pathway

this leads to brady and hypokinesia

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15
Q

clinical manifestation of park - motor

A

tremor

ridgity

impaired postural control

bradykinesia

(cardinal signs of Park)

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16
Q

what kind of tremors do we see with park

A

resting, pill rolling tremor

rhythmic

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17
Q

where do we normally see tremors in park

A

hands and feet

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18
Q

when do park tremors increase

A

with stress, fatigue, strain

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19
Q

does the tremor seen with park changes

A

yes it can chnage as the disease progresses

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20
Q

parkinsons and rigidity - type

A

Velocity independent resistance to stretch

cogwheel or lead-pipe rigidity

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21
Q

where is parkinsons and rigidity felt

A

a and a

may feel ‘stiffness’ or ‘heaviness

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22
Q

parkinsons and rigidity and gait

A

may have less arm swing

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23
Q

what is Bradykinesia

A

Slowness of movement

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24
Q

what causes brady

A

insufficient muscle force during initiation of movement

Weakness, tremor, and rigidity can be contributing factors

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25
Q

what is Bradyphrenia

A

slowness of thought

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26
Q

what is Akinesia

A

poverty of movement

inability to voluntarily move one’s muscles and limbs

“freezing” FOG

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27
Q

what is the cause of akinesia

A

Influenced by rigidity, stage of disease, attention, depression

Difficulty or inability to initiate movement

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28
Q

what is Hypomimia

A

masked facial expressions

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29
Q

what is Hypokinesia

A

the underscaling of movements

decrease in the range or amplitude of movements

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30
Q

Micrographia

A

small handwriting

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31
Q

what is Postural Instability

A

Abnormal postural responses
due to Reduced limits of stability

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32
Q

what does decreased postural control lead to difficulties with

A

reactive and anticipatory postural control

Responses are often too slow or too small

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33
Q

motor learning and park

A

Reduced ability to retain and transfer motor skills

best to use block practice

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34
Q

what gait disturbances do we see with park

A

Freezing of gait

Slowness of pace and rhythm

decreased arm swing

decreased postural control

Retropulsion or anteropulsion - Stooped posture

35
Q

do those with park have sensory dysfunctions

A

Parasthesias/pain

Difficulty with integration of proprioceptive inputs

Olfactory dysfunction

Visual perceptual dysfunction

36
Q

what is cog wheel rigidity

A

jerky resistance to the passive movement , this is because the muscle are relaxed and contracting

37
Q

what is lead pipe

A

is a sustained resistance throughout the attempted movement

38
Q

what is Hypokinetic dysarthria

A

present in some with park

decreased volume, monotone, decreased articulation, uncontrolled rate

39
Q

early MCI is a predictor for what

A

associated with increased risk of dementia in later stages

40
Q

how do we diagnoses park

A

there is not one single test

may be made on history and examination

Continued observation of motor & non-motor symptoms

Parkinson-plus syndromes must be ruled out

41
Q

do we use imagine to help diagnoses park

A

some what

used to rule out other central disorders

42
Q

Hoehn and Yahr Classification - stage 1

A

unilateral involvement only

min to no functional impairments

43
Q

Hoehn and Yahr Classification - stage 2

A

bilat or midline involvement

no impairment to balance

44
Q

Hoehn and Yahr Classification - stage 3

A

impaired right reflexes

unsteadiness

pt can live independently - disability is mild to mod

45
Q

Hoehn and Yahr Classification - stage 4

A

sym are severe

standing and walking are only possible with assistance

46
Q

Hoehn and Yahr Classification - stage 5

A

confined to bed or WC

47
Q

what is a righting reflex

A

corrects the orientation of the body when it is taken out of its normal upright position

48
Q

how long is the preclinical period

A

5 - 25 years

49
Q

how long to park pt last

A

10-20 years

50
Q

slower progression signs

A

younger age

tremor as the predominant feature

51
Q

rapid progression signs

A

postural instability

gait disturbances

52
Q

when do pt response to dope meds

A

beginning stages of disease

they will need an increase as the disease progresses

53
Q

increased dose of meds leads to what after effect

A

Dyskinesias

54
Q

what is the gold standard drug for PD

A

Carbidopa/Levodopa

55
Q

what does Carbidopa/Levodopa help to control

A

bradykinesia and rigidity

56
Q

what is the function of Carbidopa/Levodopa

A

compensate for dopamine deficiency

57
Q

Deep brain stimulation (DBS)
treatment

A

Involves surgically implanted, battery-operated device that delivers electrical stimulation to areas of the brain to block abnormal signals in the BG circuitry to decrease PD symptoms

58
Q

what does Deep brain stimulation (DBS) treatment help with

A

tremor and other motor symptoms

59
Q

High protein diet can do what

A

block effectiveness of levodopa

60
Q

what kind of diet should the pt adhere to

A

high calorie, low protein diet

61
Q

what is Bradyphrenia

A

slow thinking - be patient with these pt

62
Q

what to do with CN

A

screen

vision and eye movements
olf
swallowing
speech

63
Q

would we screen sensory or include it in our neuro pt exam

A

screen

Ask about paresthesia and/or pain
Light touch screen
Proprioceptive information

64
Q

screen motor

A

no fully assess

65
Q

screen coordination

A

yes

66
Q

screen balance

A

no

67
Q

outcome measure for balance

A

Berg Balance Scale
FGA
ABC

68
Q

screen function

A

no

69
Q

what do we prioritize

A

motor

balance

functional

70
Q

Restorative PT approach

A

Improving upon functional impairment/activity limitations

71
Q

Preventative & Maintenance PT approach

A

moderate to high intensity exercise in earlystages can slow the progression of the disease

Minimize secondary impairments/complications

72
Q

Compensatory PT approach

A

Focus on modification of the task/environment and getting patient the necessary equipment needed

73
Q

Flexibility exercises
for park

A

evidence is weak

74
Q

Aerobic exercise
Resistance training
Balance training
for park

A

all are reccomended

75
Q

nonprogressive exercise intervention vs progressive resistance training program

A

A progressive resistance training program was shown to be more effective than a nonprogressive exercise intervention

76
Q

common balance activities

A

Common interventions emphasize multidirectional stepping,motor agility,anticipatory postural control,and reactive balance

77
Q

what type of training should PTs use for improve postural control, balance outcomes, and spatiotemporal gait impairments

A

balance over resistance training

78
Q

is gait training good

A

yes

79
Q

external cueing good or bad

A

good

80
Q

community-based exercise good or bad

A

good

tai chi, ai chi, power yoga, hatha yoga, Pilates,group training,dance, noncontact boxing,Nordic walking,qigong, and meditation

81
Q

what is LSVT (Lee Silverman Voice Treatment) BIG Treatment

A

Focus on intensive exercise of large movement amplitudes

82
Q

what is Parkinson Wellness Recovery (PWR!)

A

Free core set of exercises to target a skill known to deteriorate in people with PD

83
Q

Later Disease Stagesand PT

A

therapy shifts from restorative interventions to preventative and compensatory interventions

84
Q
A

Neuromus 3 (7 decks)

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