Quiz #3 SCI / parkinsons/MS Flashcards
MS with ataxia- focus on
Stability
PD with rigidity- focus on
Mobility
Where is the substantia nigra located?
: Basal Ganglia
What are the primary responsibilities of the basal ganglia?
Regulation of posture and movement
What causes the primary symptoms in parkinsons disease?
A decrease in dopamine stored in the substantia nigra
Lesions in the basal ganglia cause
change in the character of movement, rather than produce weakness or paralysis.
Secondary Parkinsonism occurs as a result
other conditions (encephalitis, alcoholism, exposure to toxins etc)
inability to initiate movement
Akinesia
”: constant resistance to passive limb movement in any direction regardless of speed
Lead-pipe rigidity
causes a catch & release; result of combining lead-pipe rigidity and tremor
Cogwheel”:
often the first sign of PD
Tremor
Gait of a person with PD
shuffling, punctuated by short steps and progressive increase in speed. FESTINATING GAIT
Fatigue contributes to…in PD
postural instability b/c of the difficulty the person with PD experiences while trying to sustain an activity.
Hoehn & Yahr Classification
Stage 0
No signs of disease
Hoehn & Yahr Classification
Stage 1
Unilateral disease
Hoehn & Yahr Classification
Stage 1.5
Unilateral plus axial involvement
Hoehn & Yahr Classification
Stage 2
Bilateral disease w/o impairments of balance
Hoehn & Yahr Classification
Stage 2.5
Mild bilateral disease w recovery on pull test
Hoehn & Yahr Classification
Stage 3
Mild to moderate bilateral disease with recovery on pull test
Hoehn & Yahr Classification
Stage 4
severe disability; still able to walk or stand unassisted
Hoehn & Yahr Classification
Stage 5
w/c bound or bedridden unless aided
is the major mainstay in the Rx of PD.
Levodopa (L-dopa)
Works best to decrease rigidity and make movement easier
Works for only 5-7 years before effectiveness decreases
often used as the first medications after DX of PD to slow the progression
Selegiline or rasagiline (Azilect)
Primary PT goal of PD
to maximize function in the face of progressing pathology
Secondary PT goal of PD
prevent secondary complications
Deconditioning, musculoskeletal changes related to stiffness, loss of extension, and rotation
Use of AD depends on the patient, should encourage trunk
ROTATION
A chronic, debilitating disease that results from demyelination of the CNS
MS
is based on clinical evidence of multiple lesions in the CNS white matter, distinct time intervals, and occurrence in individuals between the ages of 10 and 50 years of age
MS Diagnosis
Clinical Features MS Sensory Systems
is based on clinical evidence of multiple lesions in the CNS white matter, distinct time intervals, and occurrence in individuals between the ages of 10 and 50 years of age
An oscillating movement of an eye at rest
Nystagmus
Gait characterized by MS
poor balance and lurching; possibly ataxia or general incoordination
MS disease Course
unpredictable because its presentation is highly variable
Majority of cases are RRMS relapsing-remitting type
Periods of exacerbations and remission
Primary Goals of PT for MS
Minimize progression
Maintain an optimum level of functional indep.
Prevent or decrease secondary complications
Maintain respiratory function
Conserve energy and manage fatigue
Educate the patient and family
Muscle weakness is a cardinal sign secondary to atrophy and weakness from the loss of LMN and destruction of corticospinal tract
of what disease
Amyotrophic lateral sclerosis- ALS
a terminal progressive disease involving both UMN and LMN.
ALS
Early signs ALS?
include muscle cramps, weakness, atrophy, and fatigue.
-Distal before proximal
ALS-PT Intervention early stage
Preventative exercise programs to forestall activity limitations.
Guidelines:
Avoid heavy eccentric
Moderate resistance can increase strength
Overuse not an issue if strength is over 3/5
Continue with mobility as disease progresses
Most frequent cause of acute generalized weakness
gbs
What Motor neuron level is GBS
classic lower motor neuron (LMN) disorder Nerve roots (radiculopathy) and peripheral nerves (polyneuropathy) are affected resulting in flaccid paralysis.
What can happen after you have polio
New muscle weakness, fatigue and loss of function after having polio
How many spinal nerves
31 pairs
Where does C8 exit
between c7 and T1
What cranial nerves are more susceptible to injury. Why more injuried?
C1, C2, C5-7, T12-L1
More rotation= less stability
Also enlarged in these areas b/c large number of cell bodies are located there
