Week 10 Flashcards
What are the parts of the basal ganglia?
caudate nucleus putamen globus pallidus claustrum amygdaloid nucleus
What is the striatum?
the caudate nucleus and the putamen
What is the lenticular nucleus?
putamen and the globus pallidus
Where is noradrenaline produced?
the pons
Where is noradrenaline stored?
brainstem
What does a decreased amount of noradrenaline associate with?
tremors
Where is dopamine produced?
substantia nigra
What does a decreased amount of dopamine associated with?
hypokinesia/Parkinson’s
mask-like affect
What does an increased amount of dopamine associated with?
hyperactivity/dyskinesia
Where is ACh secreted?
Basal forebrain
Brainstem
Myoneural junctions
Where is ACh released?
Throughout the brain
- The primary neurotransmitter of PNS
- The important neurotransmitter of the CNS
What does ACh facilitate?
Neural firing
Changes in cognition occur in about ____ of patients with hypokinetic dysarthria?
Half (1/2)
What is the function of the indirect system?
Posture and tone
Facilitation of all movement and freedom of movement
Changing posture and locomotion
Flexion of limbs
Coordinates conflict of flexion and extension
What are the effects of the chest/respiration in hypokinetic dysarthria?
Inflexible Rapid shallow cycles/paused between cycles Wastage of air before speaking Decreased VC Reduced loudness Short breath groups Fading at end of sentences Speaking on residual air
What are the effects of the larynx/phonation in hypokinetic dysarthria?
No pathology/ VF bowing Rigidity Decreased strength Laryngeal tremor Breathiness Roughness Low pitch Monopitch/monoloud Reduced stress
What are the effects of the velopharynx/resonance in hypokinetic dysarthria?
no changes
What are the effects of the lips/tongue/jaw and articulation in hypokinetic dysarthria?
Variable rate Accerlate at end of phrases Decreased ROM Resting tremors Imprecise movements Reduced force High tone Palilalia Omissions of sounds
What are the effects of AMR/SMR and MPT in hypokinetic dysarthria?
Fast, slow or both, imprecise consonants
Short, breathy and rough
What does the early stage of hypokinetic dysarthria (and other progressive diseases) look like?
Identification and differential diagnosis Maintanance and prevention SLP treatment (educational, counceling, behavioral)
What does the middle stage of hypokinetic dysarthria (and other progressive diseases) look like?
SLP treatment (counseling and behavioral)
What does the late state of hypokinetic dysarthria (and other progressive diseases) look like?
SLP Treatment (AAC, maintenance, counseling/resources)
Paucity of speech
Social isolation
What is a treatment for hypokinetic dysarthria that has a negative effect on speech and swallowing symptoms?
Deep brain stimulation
- improves general motor function
What is degenerating in the cause of hypokinetic dysarthria?
Substantia nigra, subthalamic nucleus, basal ganglia
What percentage of dopamine loss does it typically take to see changes in the movement?
50-70%
What are etiologies of Idiopathic Parkinson’s
Idiopathic Genetic Stroke Trauma Infection Side effect of neuroleptic drugs Toxicity CO and CO2 poisoning Oxidation
What are global changes of Idio PD?
Increased tone -assymetry with flexion -reduced strength and ROM Rest tremor Palilalia Masked facies
What are the types of multiple system atrophies (MSA)?
Shy-Drager - undetermined etiology Olivopontocerebellar Degeneration (OPCA)- no known cause
What is the etiology of progressive supranuclear palsy (PSP)?
Idiopathic
Deterioration of brain cells
What are two main differences between Idiopathic PD and Parkinson Plus syndromes?
Parkinson’s plus
- progress quicker
- do not respond well to medication
What are the distinguishing characteristics of Shy-Drager?
Orthostatic hypotension - drop in BP when standing
Laryngeal stridor
What are the distinguishing characteristics of OPCA?
Dementia
Palatal myoclonus
Disrupted prosody
What are the distinguishing characteristics of PCP?
Pseudobulbar affect with irritability and depression
Cognitive changes
Doll’s eyes
Hypernasality
Doll’s eyes focus where?
The horizon
