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Neuro II > PD > Flashcards

PD Flashcards

1
Q

The basal ganglia are involved in

a. volitional control
b. automatic control
d. both
e. neither

A

both volitional and automatic

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2
Q

The cortical basal ganglia loop is responsible for

a. automatic control
b. volitional control
c. planning strategies
d. motor strategies

A

volitional control

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3
Q

Which process is the strongest volitional control?

A

paremetal system

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4
Q

What are the main structures of the basal ganglia?

A

caudate
putamen
globus palidus

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5
Q

The BG is part of the _ _ system

A

extra paramydal system

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6
Q

(afferent/efferent) input to caudate and putamen from areas of cerebral cortex and thalamus

A

afferent

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7
Q

the output from the substantia nigra is governed by

A

dopamine

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8
Q

The globus pallidus sends info to the _ then to the _

A

thalamus

motor cortex

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9
Q

What are the functions of the BG?

A

skeletal motor circuit
oculomotor circuit
prefrontal circuit
limbic circuit

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10
Q

The circuits are in the regulation of

A

movement and cognitive behavior

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11
Q

What are functions of the BG?

A

adapt behavior as task requirements change
organize sensory input
motivation to move

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12
Q

This circuit prepares for and executes movement, selective activation, initiation of complex movements organized here

a. oculomotor circuit
b. limbic circuit
c. prefrontal circuit
d. skeletal motor circuit

A

skeletal motor circuit

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13
Q

This circuit is responsible for saccadic eye movement, and quick movements from one point to another

a. oculomotor circuit
b. limbic circuit
c. prefrontal circuit
d. skeletal motor circuit

A

oculomotor circuit

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14
Q

This circuit is respobile for organizing behaviors, governing and executive function, dampens on certain behaviors

a. oculomotor circuit
b. limbic circuit
c. prefrontal circuit
d. skeletal motor circuit

A

prefrontal circuit

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15
Q

This circuit is responsible for motivated behavior, procedural learning, verbal cognitive stage of learning

a. oculomotor circuit
b. limbic circuit
c. prefrontal circuit
d. skeletal motor circuit

A

limbic circuit

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16
Q

what disorders involve the action system

A

involuntary movements, difficulty initiating movements, akinesia, bradykinesia, postural instability

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17
Q

movements are (internally/externally) generated

A

internally

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18
Q

What is the average age of onset in PD?

A

50-60 years

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19
Q

Incidence (increases/decreases) with age

A

increases

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20
Q

what is the youngest onset of PD?

A

<21 years

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21
Q

2/3 of patients with PD present initially with

a. tremor
b. postural instability
c. rigidity
d. bradykinesia

A

tremor

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22
Q

1/3 of patients with PD present initially with

a. tremor
b. postural instability
c. rigidity
d. bradykinesia

A

postural instability

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23
Q 
Postinfectious 
toxic and drugs
tumors
normal pressure hydrocephalus 
vascular 
metabolic 
these re
A

secondary parkinsonism

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24
Q

The direct loop represents _ movement

A

volutitional

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25
Q

Which loop is related to hypokinesia?

a. indirect loop
b. direct loop

A

direct loop

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26
Q

The indirect loop role is _

A

inhibition

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27
Q

The indirect loop has a role in _ movement

A

automatic

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28
Q

What is the most affected with the indirect loop?

A

regulation of trunk and limb muscles for posture and balance

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29
Q

The _ _ communicates with striatum

A

substania nigra

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30
Q

What is the role of the substania nigra?

A

produce dopamine inhibitory to neurons in indirect pathway

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31
Q

Dopamine has an (inhibitory/excitatory) effect on the indirect pathway

A

inhibitory

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32
Q

Dopamine has an (inhibitory/excitatory) effect on the direct pathway

A

excitatory

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33
Q

Production of dopamine is the largest problem due to

A

lost of receptors

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34
Q

(underactive/overactive) indirect pathway gives rise to akinesia and rigidity

A

overactive

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35
Q

an overactive indirect pathway leads to

a. akinesia and spasticity
b. rigidity and bradykinesia
c. akinesia and hypokinesia
d. akinesia and rigidity

A

akinesia

rigidity

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36
Q

an underactive direct pathway leads to

a. akinesia
b. rigidity
c. spasticity
d. bradykinesia

A

bradykinesia

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37
Q

an overactive direct pathway leads to

A

dyskinesia
dystonia
athetosis

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38
Q

What is caused by a release of inhibition in basal ganglia?

A

tremor

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39
Q

What are the cardinal motor symptoms?

A 
TRAP 
tremor 
rigidity 
akinesia 
postural instability
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40
Q

This symptom is shown initially in about 70% of PD patients

a. rigidity
b. akinesia
c. postural instability
d. tremor

A

tremor

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41
Q

Tremor is

a. resting
b. intentional
c. during movement
d. constant

A

resting

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42
Q

A resting tremor (increases/decreases) with movement

A

decreases

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43
Q

Tremor (appears/disappears) during sleep

A

disappears

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44
Q

Tremors can be aggravated by

A

stress and fatigue

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45
Q

The later the stage the (better/worse) the tremor is

A

worse

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46
Q

What is the cause of tremor

A

overactive indirect pathway

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47
Q

Rigidity is felt

a. at fast velocity
b. at the end of the range
c. slow and fast velocity and most of the range
d. at slow velocity at mid range

A

slow and fast velocity and most of the range

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48
Q

This is defined as difficult to move, feels completely stiff

a. cog wheel
b. rigidity
c. lead pipe
d. low tone

A

lead pipe

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49
Q

This is when there is jerking throughout the range

a. cog wheel
b. rigidity
c. lead pipe
d. low tone

A

cog wheel

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50
Q

Rigidity makes it difficult to

A

motor plan

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51
Q

Movement preperation deficits are

A

start hesitation

freezing

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52
Q

this difficulty with motor planning is a difficulty with initiating or changing direction

a. akinesia
b. hesitation
c. freezing
d. rigidity

A

freezing

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53
Q

difficulty perfoming ,,_ movements

A

complex
stimultaneous
sequential

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54
Q

This is defined as a slowness of movement

a. hypokinesia
b. akinesia
c. hypomimia
d. bradykinesia

A

bradykinesia

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55
Q

This is defined as reduced amplitude and slowness

a. hypokinesia
b. akinesia
c. hypomimia
d. bradykinesia

A

hypokinesia

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56
Q

This is defined as a poverty of movement

a. hypokinesia
b. akinesia
c. hypomimia
d. bradykinesia

A

akinesia

57
Q

What is hypomimia?

A

masked face

58
Q

this is defined as masked face where there is a loss of expression, lifeless in the face

a. hypokinesia
b. akinesia
c. hypomimia
d. bradykinesia

A

hypomimia

59
Q

What type of posture do patients with PD show?

A

kyphosis

60
Q

What types of contracture can patients have?

A

hip and knee flexion

61
Q

What is the biggest problem with patients who have PD?

a. tremor
b. rigidity
c. falls
d. small movement

A

falls

62
Q

(increased/decreased) body sway

A

increased

63
Q

Base of support is

a. wide
b. narrow
c. normal

A

narrow

64
Q

Patients show difficulty in dynamic _ initiated movements

A

self

65
Q

How do they react to a perturbation?

A

decreased reaction

66
Q

patients show difficulty in _ postural control

A

feedforward anticipatory

67
Q

What cardinal sign is the last to develop?

A

postural instability

68
Q

Clinical diagnosis is based on the presence of

A

2 of first 3 cardinal signs

69
Q

What are the torque production deficits seen?

A

decreased at all speeds
disuse weakness as disease progresses
extensors weakness more noticeable
increased weakness in off periods

70
Q

What is the main byproduct of rigidity?

A

fatigue

71
Q

What type of gait is seen?

A

festinating gait

72
Q

This type of gait is an increased step frequency with shortening of stride

A

festinating gait

73
Q

Common deviations seen with gait

A 
reduced stride length
increased variability
decreased speed
shuffling 
initial contact with foot flat or toes first 
decreased trunk rotation and arm swing 
freezing
difficulty turning, dual-task, attentional demands of complex environments
74
Q 
(increased/reduced) stride length and (increased/decreased) variability 
(decreased/increased) speed
shuffling 
initial contact with _ 
(increased/decreased) trunk rotation and arm swing 
difficulty _ 
difficulty in _ _ 
difficulty in _ _
A 
reduced 
increased
decreased 
foot flat or toes first 
decreased 
turning
dual task 
attentional demands of complex environments
75
Q

Patients have problems with (procedural/declarative) learning deficits

A

declarative

76
Q

Which type of practice is best for motor learning?

a. random practice
b. blocked practice
c. massed practice
d. constant practice

A

blocked practice

77
Q

Patients experience _ type of sensation

A

paresthesia and pain

78
Q

This is described as a sense of need to move, restlessness

A

akathisia

79
Q

Proprioception is impaired (true/false)

A

true

80
Q

The sensation is impaired in all patients with PD (true/false)

A

false

81
Q

What autonomic NS dysfunction occurs?

A

excess sweating
slow pupillary responses
GI problems

82
Q

Dementia is a (direct/indirect) effect

A

direct

83
Q 
visual disturbances with some drugs
orthostatic hypotension 
arrhythmias 
decreased circulation and edema 
deconditioning 
decreased chest expansion 
these are (primary/secondary) features
A

secondary

84
Q

What walking category are most patients?

A

least limited

85
Q

fMRI is used to

A

rule out secondary and parkinson-plus syndromes

86
Q

stages 0-1:

a. severe stage
b. bilateral signs and balance problems
c. no signs or unilateral

A

no signs or unilateral

87
Q

stages 2-3:

a. severe stage
b. bilateral signs and balance problems
c. no signs or unilateral

A

bilateral signs and balance problems

88
Q

stages 4-5:

a. severe stage
b. bilateral signs and balance problems
c. no signs or unilateral

A

severe stage

89
Q

What neuroprotective medication is taken?

A

MAO inhibitor

90
Q

MAO inhibitor purpose is to

A

improve metabolism of dopamine

91
Q

What symptomatic medications are taken?

A

levodopa
dopamine agonists
anticholinergic drugs

92
Q

The purpose of this medication is to control symptoms related to a limited about of dopamine

a. dopamine agonist
b. MAO inhibitor
c. levodopa
d. anticholinergic drugs

A

levodopa

93
Q

The purpose of this medication is to act on post synaptic receptors to decrease amount of l-dopa needed

a. dopamine agonist
b. MAO inhibitor
c. levodopa
d. anticholinergic drugs

A

dopamine agonists

94
Q

This medication is taken to help decrease l-dopa dosage needed

a. dopamine agonist
b. MAO inhibitor
c. levodopa
d. anticholinergic drugs

A

dopamine agonists

95
Q

This medication is used to control tremor and rigidity

a. dopamine agonist
b. MAO inhibitor
c. levodopa
d. anticholinergic drugs

A

anticholingergic drugs

96
Q

How should their nutrition be managed?

A

high calorie, low protein

97
Q

This surgery is a permanent fix to help tremor and akinesia

A

ablative surgery

98
Q

During this stage, the goal is a preventive exercise program

a. early middle
b. late
c. late middle
d. early

A

early

99
Q

During this stage, the physical goal is a corrective exercise program

a. early middle
b. late
c. late middle
d. early

A

early middle

100
Q

During this stage, the physical treatment is compensatory and corrective exercise

a. early middle
b. late
c. late middle
d. early

A

late middle

101
Q

During this stage, the physical treatment is compensatory exercise, dietary concerns, skin care, hygiene, pulmonary function

a. early middle
b. late
c. late middle
d. early

A

late

102
Q

This test has 4 parts and measures mentation, behavior, mood, sleep, speech, tremor, walking, motor exam, freezing, dyskinesia, and more

a. MOCA
b. unified parkinsons disease rating scale
c. Parkinsons Disease questionnaire

A

unified parkinsons disease rating scale

103
Q

This scale measures cognitive function

a. MOCA
b. unified parkinsons disease rating scale
c. Parkinsons Disease questionnaire

A

Montreal Cognitive Assessment (MOCA)

104
Q

What visual changes are seen?

A

saccadic eye movement

105
Q

What motor function is expected to be seen?

A 
rigidity
bradykinesia
tremor
dyskinesia 
postural instability
106
Q

Which test is better for postural instability in early stages?

A

miniBEST

107
Q

TUG with cognitive should not increase more than _ seconds with cognitive task

A

5

108
Q

What are you assessing for with 10MWT?

A 
speed
stride length
cadence
stability
variability
safety
109
Q

This test looks at quality of life and how they perceive their abilities?

a. MOCA
b. unified parkinsons disease rating scale
c. Parkinsons Disease questionnaire

A

parkinsons disease questionnaire

110
Q

ability to turn, gait speed, and stride length are most highly correlated with

A

severity of disease
QoL
confidence

111
Q

Which is the most common neuromuscular movement system diagnoses?

A

hypokinesia

112
Q

Dual task should be practiced in _ stages

A

earlier

113
Q

What cues should be used for initiation, freezing, and gait problems?

A

external cues

114
Q

What are external cues for PD?

A

auditory
visual
combined

115
Q

PNF rhythmic initiation, rotation, rocking, distal to proximal relaxation and yoga used as what treatment

a. strength training
b. functional training
c. rigidity and bradykinesia
d. ROM and flexibility

A

rigidity and bradykinesia

116
Q

PNF, Traditional stretching, Positioning – prolonged stretch, Trunk/joint mobs, Music – facilitates movement used for what treatment type

a. strength training
b. functional training
c. rigidity and bradykinesia
d. ROM and flexibility

A

ROM and flexilbity

117
Q

For strength training focus on _

A

extensors

118
Q

What stages is it better to do strength training

A

mild to moderate

119
Q

Avoid _ with strength training

A

isometrics

120
Q

PNF, NDT assisted to cueing, mobility and transitional movements, adaptive equipment used as what type of treatment

a. strength training
b. functional training
c. rigidity and bradykinesia
d. ROM and flexibility

A

functional training

121
Q

Dynamic balance training is

A

most engaging

high level of physical and cognitive

122
Q

What is key with gait training?

A

bigger and faster

123
Q

This type of intervention addresses flexibility, balance, gait, kinesthetic awarenss, dual tasking, agility, aerobic and function

A

Big and PWR

124
Q

Big and PWR address

a. tremor
b. rigidity
c. bradykinesia
d. hypokinesia

A

hypokinesia

125
Q

This treatment if 4 foundational movements, the building blocks of function, 5 body positions in variety of ways, used across all levels of disease severity, framework not protocol, patient centered-dosing

a. PWR
b. LSVT Big

A

PWR

126
Q

This treatment is 7 movement exercises, 2 body positions, protocol is not adaptable, requires 4x/week for 4 weeks, followed by HEP

a. PWR
b. LSVT Big

A

LSVT Big

127
Q

What stage is balance disturbed?

a. 2
b. 3
c. 4
d. 5

A

3

128
Q

At what stage do gait impairments begin?

a. early
b. early middle
c. late middle
d. late

A

early middle

129
Q

What stage are they severely disabled, dependent with ADL’s?

a. early
b. early middle
c. late middle
d. late

A

late

130
Q

Fatigue is caused by

A

rigidity

131
Q

Postural response:

A

co-activation

132
Q

Which tool is best to use to measure muscle performance?

A

5 x sit to stand

133
Q

Which outcome measures are best for postural instability?

A

miniBEST

Berg

134
Q

Which outcome measures should be used to measure gait?

A

TUG
FGA
10MWT

135
Q

Cause of tremor is

a. overactive direct pathway
b. underactive direct pathway
c. overactive indirect pathway
d. underactive indirect pathway

A

overactive indirect pathway

136
Q

Visual processing is completed in the

a. thalamus
b. cerebellum
c. brainstem
d. basal ganglia

A

brainstem

137
Q

This structure receives ascending information from the SC

a. cerebellum
b. thalamus
c. brainstem
d. motor cortex

A

thalamus

138
Q

freezing is a difficulty _ or _ direction

A

initiation

changing

Neuro II (11 decks)

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