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integrated > week 5 > Flashcards

week 5 Flashcards

1
Q

symptom of parkinson’s , it is a jerky feeling in your arm or leg that healthcare provider can sense when moving or rotating your affected limb or joint

A

cogwheel motion

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2
Q

relax muscle, then flex and extend limb. physician are looking if muscle is stiff and infelxible when try to move it. Passive movement and if its rigid, then muscle do jerkiness as you do passive movement

A

test cogwheel motion

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3
Q

stooped posture, masked face, back rigidity, flexed elbows and wrists, tremors in the legs, forward tilt of trunk, reduced arm swing, hand tremor, slightly flexed knees, shuffling, short stepped gait

A

parkinsons disease symptoms

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4
Q

what are the four primary motor symptoms of parkinsons

A

resting tremor, rigidity, bradykinesia (slow movement), postural instability (balance problems)

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5
Q

is a rating tool used to gauge the severity and progression of parkinsons disease in patients, consists of 6 segments, gold standard by neurologists for monitoring response to medications used to decrease the signs and symptoms of parkinsons

A

unified parkinsons disease rating scale clinical rating system (UPDRS)

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6
Q

features segments require independent completion by people with disease and sections to be completed by clinician
-part 1: nonmotor experience of daily living
-part 2: motor experience of daily living
-part 3: motor examination
-part 4: motor complications

A

movement disorder society sponsored revision of the unified parkinsons disease rating scale (MDS-UPDRS)

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7
Q

leading causes of parkinsons disease?

A

age, drug use in the young, more advanced tools to detect, genetic, environment (pesticides)

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8
Q

what are components of the basal ganglia

A

substantia nigra, subthalamic nucleus, caudate, putaman, striatum, globus pallidus

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9
Q

damage (glutamate)= hemiballismus

A

subthalamic nucleus

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10
Q

damage (glutamate)= huntingtons

A

striatum

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11
Q

damage (GABA)= tourettes and supranuclear palsy

A

globus pallidus

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12
Q

which neurotransmitter is released from the neurons of the striatum that innervate the globus pallidus and the pars reticularis of substantia nigra?

A

GABA

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13
Q

which neurotransmitter is released from the neurons of the globus pallidus that project to thalamus and subthalamic nuclei?

A

GABA

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14
Q

which neurotransmitter is released from the neurons of the subthalamic nucleus that project to the internal globus pallidus?

A

glutamate

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15
Q

_____receptors are GPCRS
-the role of dopamine: regulate movement

A

dopamine

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16
Q

direct and indirect pathways operate in the _____

A

basal ganglia

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17
Q

boosts movement

A

direct pathway

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18
Q

inhibits movement

A

indirect pathway

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19
Q

parkinson disease is a defect in the _____ resulting in an increased signal from the indirect pathway

A

direct pathway

20
Q

parkinsons gradual onset, usually begins with?

A

mild tremor of hands or feet while at rest

21
Q

intention tremors are characteristics of _____

A

cerebellar disease

22
Q

-tremors mostly seen during action
-family history reported in more than 50% of patients
-tremor usually affects both sides of the body initially (symmetrical)
-alcohol improves tremor

A

essential tremor symptom

23
Q

-tremors seen at rest
-family history not as prominent
-tremor usually starts on one side of the body and progresses to the other side, usually remains asymmetrical
-tremor is not impacted by consumption of alcohol

A

parkinsons symptoms

24
Q

as disease progresses, what happens?

A

tremor becomes more pronounced, bradykinesia and postural instability

25
Q

____ symptoms of parkinsons
-bradykinesia, vocal symptoms, rigidity and postural instability, tremors, walking or gait difficulties, dystonia

A

motor skill symptoms

26
Q

____symptoms of parkinsons
-mental/behavioral issues, senses of smell, sweating and melanoma, gastrointestinal issues, pain

A

nonmotor skill symptoms

27
Q

-rapid eye movement sleep disorder (RBD)
-excessive daytime sleepiness (EDS)
-postural instability and gait disorder (PIGD) patients with parkinsons stooped posture, in parkinsons decrease arm swing and shuffling gait

A

prodromal symptoms

28
Q

_____symptoms may occur 15-20 years before motor symptoms

A

prodromal

29
Q

pathophysiology of parkinsons: loss of substantia nigra, the black deposition is due to

A

melanin

30
Q

pathophysiology of parkinsons: damage to the neurons is associated with disruption of post translational trafficking of proteins. the proteins alpha synuclein binds to ___ which now can not be transported for secretion

A

ubiquitin

31
Q

pathophysiology of parkinsons: ubiquitin and alpha synuclein accumulates within the cells as ____

A

lewy bodies

32
Q

histology of parkinsons: has diminshed numbers of ____

A

pigmented neurons

33
Q

why Levodopa as treatment for parkinsons?

A

crosses BBB and metabolizes dopamine

34
Q

why is Levodopa combined with carbidopa?

A

it maintains it so it gets to the neurons and it gets metabolized before it gets to neurons (keeps it around longer)

35
Q

what is a focused ultrasound of thalamus/subthalamic nuclei?

A

administer a drug to shut down bbb, send ultrasound waves to targeted brain area, it seems to benefit to motor systems

36
Q

-progressive supranuclear palsy
-multiple system atrophy
-viral parkinsonism
-drug and toxin induced parkinsonism
-post traumatic parkinsonism
-cortical basal ganglionic degeneration
-lewy body diease
-normal pressure hydrocephallus (NPH)

A

parkinson like symptoms

37
Q

-loss voluntary eye movements, reflexive eye movements are unaffected
-postural instability causing falls (specifically a tendency to fall backward)
-bradykinesia
-muscular rigidity with progressive dyskinetic movements due to disordered tonicity of muscle
-pseudobulbar palsy: difficulty swallowing (dysphagia) and speech disturbance (dysarthria) with emotional lability
-cognitive impairment
-sleep disturbances
-agitation, irritability, disinibition
-depression (late in course)
-dementia (eventually occurs)

A

symptoms of progressive supranuclear palsy

38
Q

such as muscle rigidity and unsteady gait, these symptoms occur with other disorders so it makes the diagnosis more difficult. the physcial exam along with various autonomic tests and imaging studies, can help your doctor determine diagnosis

A

multiple system atrophy

39
Q

these medications block the dopamine receptors in nerve cells. The resulting reduction in dopamine levels causes parkinsonism. typically, when someone stops taking these medications, the symptoms of parkinson decrease over time

A

drug-induced parkinsonism

40
Q

it is hypothesized that a traumatic brain injury can damage neural tissue and induce the release of cellular breakdown products from damaged cells in the surrounding area. the cellular breakdown products can then act on neighboring healthy cells and promote intracellular alpha synuclein aggregation

A

post traumatic parkinsonism

41
Q

-cerebral cortex and basal ganglia waste away
-rigidity and impaired balance usually begins on one side and spread to the other over time

A

cortical basal ganglionic degeneration

42
Q

lewy body disease is generally diagnosed when at least 2 of the following features also occur with dementia?

A

changes in attention and alertness, visual hallucintaions, movement symptoms consistent with PD

43
Q

these changes may last for hours or days. signs of these changes include staring in space, being lethargic or drowsy and having speech problems

A

changes in attention and alertness

44
Q

hallucinations recur and are very detailed, they generally do not bother the person having them

A

visual hallucinations

45
Q

these include slow movement, shuffling gait, rigidity and falls. the person may also have tremors. but they are not as pronounced as in a person with PD with dementia

A

movement symptoms consistent with PD in lewy body disease

46
Q

the cause of excess fluid in the ventricles of the brain may be due to injury, bleeding, infection, brain tumor or surgery on the brain. however the cause is often ____

A

not known

47
Q

normal pressure hydrocephalus though rare, most often affects older adults, and its symptoms can be similar to those of ____ and ____

A

Alzheimer and Parkinson disease

integrated (2 decks)

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