pathology of nervous system

Question 1

dementia

Answer 1

aquired decline in intellectual function and memory; loss of social independence ; impairments in memory and cognitive function
affects 5-20% of ppl 65+ yrs

Question 2

three types of dementia

Answer 2

alzheimer Disease: widespread atrophy of cortex and deposition of amyloid plaques and tangles in neurons
lewy body: intracellular accumulation of lewy bodies in neurons in cortex
frontotemporal dementia: depoisition of proteins in the front and temporal lobes; early personality and behavior changes in aphasia

Question 3

Alzheimer disease characteristics

Answer 3

slow progressive disorder of CNS that begins with impairments of learning and recent memory. progresses to anomia, aphasia and acalculia-> loss of employability. progresses to spatial disorientation and apraxia. frontal lobe gait disorder

Question 4

pathogenesis of AD

Answer 4

extracellular aggregates of amyloid plaques
intracellular neurofibrillary tangles
pathogenesis amplifies via comorbidities such as HIV, PD, and hypothyroidism

Question 5

3 major symptoms of normal aging and pathological neurodegeneration

Answer 5

memory function
brain atrophy- decreased cortical volume
accumulation of amyloid protein

Question 6

dementia causes

Answer 6

alzheimer’s disease accounts for 50% of cases, multiple cerebral infarcts: second most common cause of dementia, dementia with lewy body: specific set of cognitive function, problem solving and reasoning, alcoholism

Question 7

Parkinson’s disease

Answer 7

progressive neurologic cognition affects movement. clinically: rigidity, bradykinesia, tremor and postural instability

Question 8

Parkinson Symptoms

Answer 8

tremor: begins with hands or fingers “pill rolling”
bradykinesia: slow movement, short steps, function and simple tasks become challenging
rigidity: stiff ms, contracted for extended periods of time, limited ROM
postural instability: forward flexed, stooped posture
balance declines
automatic movements: decreased ability to perform
speech: changes in pace and intensity, monotone
writing: challenging, small text

Question 9

Parkinson disease pathology

Answer 9

changes to the brain: gradual loss of cells that produce dopamine
decreased dopamine= more rigidity and tremors

Question 10

myasthenia gravis disease

Answer 10

autoimmune neurologic disorder- most common primary disorder of neuromuscular transmission
fluctuating weakness and rapid fatigue of skeletal muscle
muscles with small motor units are most affected
sever cases have diaphragm and intercostal muscles affected

Question 11

myasthenia gravis risk factors

Answer 11

30% have a maternal relative with an autoimmune disease (genetic predisposition to autoimmune dis)
young women 20-30 years
men over 50

Question 12

presynaptic vs post synaptic pathogenesis of MG

Answer 12

presynaptic: number of vesicles are normal.
postsynaptic: muscle and endplate shoes sparse, shallow, and abnormally wide or absent cleft; ACh receptors reduced.

Question 13

MG electrophysiology

Answer 13

postsynaptic membrane decreased response to acetylcholine= lack of contractibility

Question 14

myasthenia gravis PT management

Answer 14

exercise intensity, duration strategy to improve symptoms and function
snowflake disease
medically managed MG before exercise prescription
if symptoms are exacerbated, no exercise
exercise to improve baseline function

Question 14

myasthenia gravis signs/symptoms

Answer 14

visual- extraocular muscle; drooping eyelids or double vision
muscle- fatigue and weakness may vary rapidly in intensity over hours, days and weeks (muscles involved in facial, swallowing, neck and limbs)
thymus abnormalities
flare ups

Question 15

exercise stable for MG patients

Answer 15

energy conservation; dollar per day rules
medication at peak dose
large proximal muscle
short duration; HR no greater then 30bpm from baseline with mild to moderate intensity
types: upper body ergometer, stationary bike or eliptical- large ms groups, postural exercises,