Quiz #3 SCI / parkinsons/MS

Question 1

MS with ataxia- focus on

Answer 1

Stability

Question 2

PD with rigidity- focus on

Answer 2

Mobility

Question 3

Where is the substantia nigra located?

Answer 3

: Basal Ganglia

Question 4

What are the primary responsibilities of the basal ganglia?

Answer 4

Regulation of posture and movement

Question 5

What causes the primary symptoms in parkinsons disease?

Answer 5

A decrease in dopamine stored in the substantia nigra

Question 6

Lesions in the basal ganglia cause

Answer 6

change in the character of movement, rather than produce weakness or paralysis.

Question 7

Secondary Parkinsonism occurs as a result

Answer 7

other conditions (encephalitis, alcoholism, exposure to toxins etc)

Question 8

inability to initiate movement

Answer 8

Akinesia

Question 9

”: constant resistance to passive limb movement in any direction regardless of speed

Answer 9

Lead-pipe rigidity

Question 10

causes a catch & release; result of combining lead-pipe rigidity and tremor

Answer 10

Cogwheel”:

Question 11

often the first sign of PD

Answer 11

Tremor

Question 12

Gait of a person with PD

Answer 12

shuffling, punctuated by short steps and progressive increase in speed. FESTINATING GAIT

Question 13

Fatigue contributes to…in PD

Answer 13

postural instability b/c of the difficulty the person with PD experiences while trying to sustain an activity.

Question 14

Hoehn & Yahr Classification

Stage 0

Answer 14

No signs of disease

Question 15

Hoehn & Yahr Classification

Stage 1

Answer 15

Unilateral disease

Question 16

Hoehn & Yahr Classification

Stage 1.5

Answer 16

Unilateral plus axial involvement

Question 17

Hoehn & Yahr Classification

Stage 2

Answer 17

Bilateral disease w/o impairments of balance

Question 18

Hoehn & Yahr Classification

Stage 2.5

Answer 18

Mild bilateral disease w recovery on pull test

Question 19

Hoehn & Yahr Classification

Stage 3

Answer 19

Mild to moderate bilateral disease with recovery on pull test

Question 20

Hoehn & Yahr Classification

Stage 4

Answer 20

severe disability; still able to walk or stand unassisted

Question 21

Hoehn & Yahr Classification

Stage 5

Answer 21

w/c bound or bedridden unless aided

Question 22

is the major mainstay in the Rx of PD.

Answer 22

Levodopa (L-dopa)
Works best to decrease rigidity and make movement easier
Works for only 5-7 years before effectiveness decreases

Question 23

often used as the first medications after DX of PD to slow the progression

Answer 23

Selegiline or rasagiline (Azilect)

Question 24

Primary PT goal of PD

Answer 24

to maximize function in the face of progressing pathology

Question 25

Secondary PT goal of PD

Answer 25

prevent secondary complications

Deconditioning, musculoskeletal changes related to stiffness, loss of extension, and rotation

Question 26

Use of AD depends on the patient, should encourage trunk

Answer 26

ROTATION

Question 27

A chronic, debilitating disease that results from demyelination of the CNS

Answer 27

MS

Question 28

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

Answer 28

MS Diagnosis

Question 29

Clinical Features MS Sensory Systems

Answer 29

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

Question 30

An oscillating movement of an eye at rest

Answer 30

Nystagmus

Question 31

Gait characterized by MS

Answer 31

poor balance and lurching; possibly ataxia or general incoordination

Question 32

MS disease Course

Answer 32

unpredictable because its presentation is highly variable
Majority of cases are RRMS relapsing-remitting type
Periods of exacerbations and remission

Question 33

Primary Goals of PT for MS

Answer 33

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

Question 34

Muscle weakness is a cardinal sign secondary to atrophy and weakness from the loss of LMN and destruction of corticospinal tract
of what disease

Answer 34

Amyotrophic lateral sclerosis- ALS

Question 35

a terminal progressive disease involving both UMN and LMN.

Answer 35

ALS

Question 36

Early signs ALS?

Answer 36

include muscle cramps, weakness, atrophy, and fatigue.

-Distal before proximal

Question 37

ALS-PT Intervention early stage

Answer 37

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

Question 38

Most frequent cause of acute generalized weakness

Answer 38

gbs

Question 39

What Motor neuron level is GBS

Answer 39

classic lower motor neuron (LMN) disorder
Nerve roots (radiculopathy) and peripheral nerves (polyneuropathy) are affected resulting in flaccid paralysis.

Question 40

What can happen after you have polio

Answer 40

New muscle weakness, fatigue and loss of function after having polio

Question 41

How many spinal nerves

Answer 41

31 pairs

Question 42

Where does C8 exit

Answer 42

between c7 and T1

Question 43

What cranial nerves are more susceptible to injury. Why more injuried?

Answer 43

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