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adult neuro test 3 > Parkinsons Disease > Flashcards

Parkinsons Disease Flashcards

1
Q

what does the basal ganglia role in movement and posture?

A 
movement scale
movement initiation
movement preparation
identifying one's own body position relative to the environment
longer loop postural reflexes
perceptual and cognitive
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2
Q

what are 4 common BG disorders?

A

Parkinson’s disease
Huntington’s disease
Wilson’s disease
Dystonia

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3
Q

what are the typical signs and symptoms of PD?

A 
changes in muscle tone
decreased movement coordination
decreased motor control
decreased postural stability
presence of extraneous movement
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4
Q

True or False

Parkinson’s Disease is the 3rd most common BG disorder?

A

False

it is the most common

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5
Q

PD usually affects people _____

A

over 50 yrs

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6
Q

True or False

PD is more prevalent in women

A

False

MEN=WOMEN

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7
Q

1 in _____ who are 85 years old have PD

A

1 in 3

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8
Q

S/S of PD are?

A 
rigidity ( leadpipe; cogwheel)
bradkinesia
micrography
masked face
postural abnormalities
lack of equilibrium reactions
resting tremor
decreased trunk rotation
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9
Q

what kind of postural abnormality is seen in PD?

A

flexed posture

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10
Q

_______ of patients with PD fall with a ____% chance of 1 fall per week

A

2/3

10%

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11
Q

PD non-motor symptoms (cognitive) include:

A 
anxiety and depression
bradyphrenia and mild cognitive impairment (MCI)
decreased attention
easily distracted
decreased executive functioning
decrease ability of dual tasking
decreased organizational ability
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12
Q

PD non-motor symptoms (other) include:

A 
sleep disturbances
bladder urgency and frequency 
orthostatic hypotension
hyposmia
pain/paraesthesia
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13
Q

what is hyposmia?

A

low energy, hypoglycemia due to not eating, “I can’t taste anything.”

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14
Q

secondary problems and complications of PD include?

A 
muscle atrophy
respiration compromise
nutritional changes
osteoporosis 
contracture and deformity
decubiti
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15
Q

examples of respiratory compromise that affect PD include?

A 
Decreased vital capacity
     Decreased Chest expansion
     Posture
     Rigidity
     UE posturing
Increased energy consumption
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16
Q

what kind of nutritional changes will a person with PD have?

A

Problems with eating, chewing, swallowing

keeping a good appetite

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17
Q

Modified Hoehn and Yahr Scale: stage 0 means?

A

no signs of disease

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18
Q

Modified Hoehn and Yahr Scale: stage 1 means?

A

unilateral disease

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19
Q

Modified Hoehn and Yahr Scale: stage 1.5 means?

A

unilateral disease w/ axial involvement

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20
Q

Modified Hoehn and Yahr Scale: stage 2 means?

A

bilateral disease w/o postural instability

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21
Q

Modified Hoehn and Yahr Scale: stage 2.5 means?

A

early signs of postural instability

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22
Q

Modified Hoehn and Yahr Scale: stage 3 means?

A

bilateral disease with postural instability, physically independent

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23
Q

Modified Hoehn and Yahr Scale: stage 4 means?

A

severe disability but still able to strand or walk unassisted

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24
Q

Modified Hoehn and Yahr Scale: stage 5 means?

A

confinement to WC or bed

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25
Q

how do you test for early signs of postural instability ( 2.5 )

A

see if patient has recovery on ‘pull test’

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26
Q

what are the PD treatments?

A 
Pharmacological/Medical Management
Surgery 
Nutrition
Exercise! 
Physical Management of Symptoms
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27
Q

deep brain stimulation involves a stimulator impacted into the _______ ______

A

subthalamic nucleus

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28
Q

True or False

Deep brain stimulation is a slower movements and gait deviations respond well

A

False

faster movements

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29
Q

what is the disadvantage of deep brain stimulation?

A

low morbidity but significant psychiatric complication concerns (depression/mania)

30
Q

Deep brain stimulation works on PD symptom relief in _______ after the implantation

A

minutes

31
Q

Deep brain stimulation works on dystonia symptom relief in _______ after the implantation

A

days to weeks

32
Q

_____ _____ ______ can black the effectiveness of dopamine replacement and it recommended that no more than _____% come from this?

A

high protein diet

15

33
Q

how can you manage your protein so it doesn’t affect your motor fluctuations during the day?

A

intake in the evening

34
Q

True or False

Longevity and physical activity are related for individuals with PD

A

True

35
Q

True or false

There is no link identified between lack of exercise and development of PD

A

False, there is a link

36
Q

______ exercise is found to reduce PD dysfunction

A

aerobic exercise

37
Q

what are additional benefits of aerobic exercise for PD pts?

A

Additional important pulmonary benefits

Improved QOL with decreased depression, improved mood and initiative

38
Q

what does UPDRS stand for?

A

Unified Parkinson’s Disease Rating Scale (UPDRS)

39
Q

what is the Unified Parkinson’s Disease Rating Scale (UPDRS)

A

Comprehensive adult neuro examination

40
Q

PT Evaluation of Medication Effectiveness includes?

A

“all day evaluation”
Choose 3-5 impairments or functional limitations that are issues for the patient
5-7 minute examinations on the hour and perhaps on the half-hour as well
Consult with MD to discuss “best” and “worst” times
Recommendations made for medication titration

41
Q

describe typical gait for a person with PD

A 
decreased velocity
decreased stride length
decreased foot clearance
flat footed progression
decreased arm swing
42
Q

what is festination?

A

Festination: attempt to catch up BOS with COG

43
Q

what is retropulsion?

A

disorder of locomotion associated especially with Parkinson’s disease that is marked by a tendency to walk backwards

44
Q

what triggers Freezing in Gait?

A 
sudden direction changes, turning, or pivoting
doorways or thresholds
approaching furniture/obstacles
turning around to sit
change in floor pattern
confined spaces
crowds
stress, anxiety, hurrying
45
Q

what triggers retropulsion?

A

backing up to sit down
reaching overhead
stepping away from sink, counter
opening door
carrying items close to the body in both hands
being approached closely/ suddenly jostled

46
Q

PD rehabilitation includes?

A 
Aerobic (forced)
Flexibility (to maintain ROM)
Strengthening
Rhythmic exercise
Mambo
Tai chi
Functional activity
Pushing complexity
Gait and balance
Decrease fall risk  
Changing task & environmental contexts
47
Q

what is the leading cause of death in person with PD?

A

Pneumonia

48
Q

how can respiratory management be addressed with pts with PD?

A

early aggressive aerobic exercise

maintain regular moderate exercise as disease progresses

49
Q

an example of an exercise that is Forced, Not Voluntary, and Improves Motor Function in PD Patients
 is?

A

Tandem Cycling

50
Q

goals for early phase PD ( 1-2.5)

A

Prevent inactivity
Prevent fear of falling
Improve physical capacity

51
Q

goals of mid phase PD ( 2-4)

A 
same as early phase plus maintain or improve:
Transfers
Body posture
Reaching and grasping
Balance
Gait
52
Q

goals for late phase ( 5 ) include?

A

same mid phase plus:
Maintain vital functions
Prevent pressure sores
Prevent contractures

53
Q

what are two examples of Parkinson Plus Syndromes:

A

Progressive supranuclear palsy (PSP)

Multiple system atrophy (MSA)

54
Q

what is Progressive supranuclear palsy (PSP)

A

Similar to PD
More cognitive impairment
Progression more rapid
Does not respond to L-dopa

55
Q

what is Multiple system atrophy (MSA)?

A

Cortical, BG and cerebellar
Frontal lobe and autonomic dysfunction
Does not respond to L-dopa

56
Q

what is a classic order resulting in hyperactivity of the basal ganglia?

A

Huntington’s Disease

57
Q

True or False

Huntington is an autosomal recessive trait

A

False

autosomal dominant trait

58
Q

S/S of Huntington Disease include?

A 
Abnormalities in postural reactions
Decreased trunk rotation
Abnormal tone
Extraneous movements
They exhibit too much movement
59
Q

Wilson’s disease AKA?

A

hepatolenticular degeneration

60
Q

what causes wilson’s disease?

A

caused by abnormal copper metabolism that lead to toxic copper levels and degeneration of liver and BG

61
Q

True or False

if wilson’s disease is recognized and properly treated, then the pt functions w/o restrictions

A

true

62
Q

what is Tardive Dyskinesia?

A

Drug-induced disorder

Dyskinesia = inability to perform voluntary movement
Series of rhythmical extraneous movements
Associated with extension of spine/trunk

63
Q

what is dystonia?

A

Movement disorder characterized by sustained muscle contraction in the extreme end range of a movement, frequently with a rotational component.

64
Q

dystonia can be _____ or ______

A

generalized or focal

65
Q

generalized dystonia is usually ________ and it most prevalent in those with ____ ____ _____

A

inherited

European Jewish Descent

66
Q

focal dystonia is usually related to _________ movement produce under high cognitive ______ and ______

A

repetitive

constraints and attention

67
Q

what is the most common focal dystonia?

A

spasmodic torticollis

68
Q

other example of focal dystonia include:

A

vocal folds, tongue, facial muscles, hand, toes

69
Q

how is dystonia managed?

A

Botox

Rehab

70
Q

True or False?
In all cases, excessive co-activation of agonists and antagonists occurs that interferes with timing, execution, and loss of independent joint movements

A

true

71
Q

true or false

With dystonia, there is generally abnormal tone or abnormal reflexes

A

There is generally NO abnormal tone or abnormal reflexes

adult neuro test 3 (7 decks)

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