parkisons Flashcards
characteristics that describe parkisons
Slowly progressive neurodegenerative disorder
Second most common neurological disorder after AD
Now documented as a motor and non-motor disease
Over 1.5 million people in United States have PD
Over 4 million world-wide
PD no longer restricted to a specific age population
Young Onset PD (21-50) becoming more common
Two types: Tremulous and Akinetic Rigidity
who is most likely to develop parkisons???
Affects men and women equally
African Americans and Asians less likely than Whites to develop PD
Currently no cure
Not contagious
describe the physiology of PD
Slowly progressive neurodegenerative disorder
Occurs when neurons in the midbrain called the substantia nigra die or become impaired
These neuron produces Dopamine.
Chemical messenger responsible for transmitting signals allowing for smooth, coordinated functions of the body’s muscles and movement
Clinical signs of 4 character signs of PD
Tremor: at rest, “pill-rolling”- between thumb and forefinger: Suppressed by purposeful movement
Bradykinesa (slowness of movement)- small steps, shuffling gait, “freezing”:
Rigidity of the limbs and trunk: Uniform resistance to passive movement “Catches” in resistance during PROM (cogwheel rigidity)
Postural instability: causes patient to develop forward or backward lean and to fall easily. Stooped posture, with head bowed and shoulders drooped
5 stages of PD the Hoehn and Yarh scale
unilateral tremor, rigidity, akinesia, no functional impairment
- bilateral tremor, rigidity or akinesia, independent with ADL, no balance impairment
- worsening of symptoms, impaired righting reflexes, onset of disability in ADL performance, can lead independent life
- requires assistance with some or all ADLs, unable to live alone, able to walk/stand unaided
- confined to a w/c or bed, max assistance needed.
Some secondary symptoms of PD
micrographia (small handwriting), reduced arm swing, Slight foot drag
Freezing: stuck in place when attempting to initiate movement
Intermittently freeze as if the feet were stuck to the floor. Freezing occurs especially when approaching doorways or if forced to hurry. It is common to have difficulties with balan
Hypominia – decreased facial expression due to rigidity of facial muscles
Dysarthria: low voice volume or muffled speech
nxiety, depression
Decrease in automatic reflexes: blinking and swallowing.
Blinking and spontaneous eye movements are less frequent, giving rise to a staring expression. This can be misinterpreted as lack of interest or depression.
Sleep disturbances
What causes loss of dopamine in the Basal Ganglia
Dopamine, a neurotransmitter transmits dopamine to Basal Ganglia (BG) where it is needed for motor control
Loss of dopamine in the SN reduces output sent to BG causing a deficiency of dopamine in the BG
Dopamine shortage causes PD motor symptoms
The SN is a small, crescent-shaped structure in the mid-brain that loses its pigmentation as nigral nerve cells die with the progression of PD
Description of lewey body dementia
Frederick Lewy – first to identify microscopic proteins in the dead nigral cells (1912) –post mortem
Make up the dark pigmented substance of SN
Lose pigmentation and diminish as nerve cells continue to die in SN
Round, encapsulated colorless cells found in the SN in idiopathic PD (post mortem)
Mainly found in the cortex and sub-cortical regions in Lewy Body Dementia (LBD)
what does damages in the basal ganglia cause???
Initiation of movement Postural control Arm swinging while walking Emotional motor expression Muscle tone(at rest)
Depletion of dopamine in basal ganglia causes PD
some things to do with Parkinson patients.
Tactile stimulation: brushing Joint compression Deep pressure Prone, supine, quadruped exercises Sitting exercise Standing exercise for posture/ balance Gait and ambulation/ assisted gait and ambulation Transitional movements Dancing and Tai chi Stress reductions
What are some ways to increase communication abilities with Parkinson patients.
Communication: writing – think “big strokes” when writing. Use lined paper and various size, wt and shape of pens. Adapted devices
Speaking: singing, read aloud
Use short sentences, eliminate background noise
ways to prevent falls!!!!
Never carry objects in both hands while walking
If you experience lightheadedness when changing position, do so slowly
Stop walking if feeling dizzy
Install handrails along the hallways/ stairways
Remove throw rugs, clutter from indoor/outdoors
Avoid stepladders or stools to reach high objects
