Week 7 Neuromuscular Disorders Flashcards
Meds for Parkinsons
Levodopa
Levodopa/carbidopa- advanced
Pramipexole (Mirapex) - early
*Selegiline (Deprenyl) - early
Anticholinergics
Meds for MS
Methylprednisolone (Solu-medrol)
Mitoxantrone (novantrone)
Baclofen (Lioresel)
Gabapentin (Neurontin)
Complications of neuromuscular disorders
- Aspiration
- PN
- UTI
- Pressure sores
- Malnourishment
- Falls
How many sacral vertebrae
5
How many coccygeal vertebrae
4
How many cervical vertebrae
7
How many thoracic vertebrae
12
How many lumbar vertebrae
5
Above C4 problem
Can’t breathe
-lose respiratory muscle function
Above C8 problem
Tetraplegia
T1-T6 problem
Para plegia
-trunk & legs no feeling
Above T6 problem
Cardiovascular changes
-bradycardia
-hypotension
Clinical manifestations of spinal cord injury
- DVT
- GI system
- Urinary system
- Cardio system
- Respiratory system
Causes of peripheral neuropathy
- DM
- Hypothyroidism
- Vitamin deficiencies
- MS
Neuromuscular exam
- Mental status
- Cranial nerves
- Motor
- Sensory
- Cerebellar
- Reflex testing
Many children make salsa chip runs
Triggers of MS
Infection
Stress
Fatigue
Neuro exam saying
Many children make salsa chip runs
Parkinson’s classic triad
Bradykinesia- hard to initiate movement
Rigidity- Increased muscle tone- cogwheel, Jack-knife, monotone- swallow issues- face emotionless
Tremor at rest -pill rolling- prominent at rest/aggravated by stress/concentration
Early signs of Parkinson’s
Unilateral
Mild tremor
Slight limp
Arm swing
Later stages of Parkinson’s
Bilateral
Shuffle
Propulsive gait
Loss of postural reflexes
Speech pattern changes
Dopamine is responsible for
Trunk support
Voluntary motion
Posture
Complications of neuromuscular disorders
Respiratory - aspiration PN and respiratory failure b/c impaired swallow = aspiration= chest infection/PN
Nutrition - malnutrition and dehydration
Skin - pressure sores, infection, contractures
Elimination - urinary retention, incontinence , uti, constipation
Safety - falls
What is significant about T6 level?
SCI above T6 decrease SNS
Bradycardia and vasodilation occur. =BP and venous return drops
Blood pools in legs
*Shock *
What is significant of high Cervical SCI?
Above C4= respiratory loss
Phrenic nerve must function for below C4. Still affects ventilation (diaphragm muscles impaired).
Injuries at thoracic level impact this
Abdominal muscles= can’t cough (protective )
Post SCI assess these systems
- CNS - pain (spasm)
- Resp. - lung collapse (atelectasis), PN, etc
- Cardio - Brady, hypotension, DVT
- GI - hypomotility =constipation
- GI- retention, UTI, incontinence
- Skin- sores/ ulcers
- Musculoskeletal- atrophy, contractures
- Mental health - depression
Which cranial nerves are sensory
1- Olfactory
2 - Optic
8- Accoustic
Which cranial nerves are motor
4- Trochear
6- Abucens
11- Spinal
12- Hypoglossal
Which cranial nerves are both sensory and motor
3 - occulomotor
5- Trigeminal
7- facial
9- glossalpharhyngeal
10- vagus
Cranial nerve 1
Olfactory
smell
Cranial nerve 2
Optic
sight
Cranial nerve 3
Occulomotor
- eyelids
- pupils
Cranial nerve 4
Trochear
- eyes cross and look down
Cranial nerve 5
Trigeminal
- chewing muscles
- face sensory
Cranial nerve 6
Abucens
- eyes side to side
Cranial nerve 7
Facial
- face muscles
- taste
- PNS
- Saliva/tears
Cranial nerve 8
Accoustic
- hearing/balance
Cranial nerve 9
Glossalpharyngeal
- speak
- swallow
-taste
Cranial nerve 10
Vagus
- voice
- swallow
- sensory (organs)
Cranial nerve 11
Spinal
- traps
- sternocleiodmastoid muscles
Cranial nerve 12
Hypoglossal
tongue
