Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NMR II > Final: Parkinson's Impairments > Flashcards

Final: Parkinson's Impairments Flashcards

1
Q

What are the 4 cardinal motor symptoms associated with Parkinson’s?

A
  1. Tremor
  2. Rigidity
  3. Bradykinesia
  4. Postural instability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a tremor?

A

Involuntary oscillations resulting from contraction of opposing muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 3 characteristics of early stage tremor?

A
  1. Distal hand or foot
  2. One side of the body
  3. Resting tremor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 4 characteristics of late stage tremor?

A
  1. Increased severity
  2. Bilateral
  3. Action tremor
  4. Interferes with ADLs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is rigidity?

A

Increased resistance to passive motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Is rigidity velocity dependent?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is cogwheel rigidity?

A

Jerky, ratchet-like resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is lead pipe rigidity?

A

Sustained rigidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does rigidity progress over the course of the disease?

A

Proximal to distal and unilateral to bilateral. Increased severity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are secondary complications associated with rigidity?

A

Contracture, postural deformity, fatigue, increased energy expenditure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is braykinesia?

A

Insufficient recruitment of muscle force and under scale internally generated movements. Slowness of movement resulting in both increased reaction and movement time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is hypokinesia?

A

Decreased movement, smaller amplitude, less movement, micrographia, decreased arm swing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is akinesia?

A

Absence of movement, freezing, no arm swing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are balance impairments associated with Parkinson’s?

A

Decreased limits of stability, slow anticipatory adjustments, poor reactive balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are posture impairments associated with Parkinson’s?

A

Decreased activation of antigravity muscles, flexed posture, COM located towards the forward limits of stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What % of Parkinson’s pt’s have had a single fall in the past year?

A

70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What % of Parkinson’s pt’s have had multiple falls in the past year?

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are gait deviations associated with Parkinson’s?

A

Slow pace, increased variability and symmetry, poor postural control, decreased step size, reduced arm swing, reduced anticipatory postural alignment, turn en bloc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is festination?

A

Unintentionally rapid short steps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is freezing of gait?

A

Trembling or absent movement with the transient inability to take a step that is triggered by confrontation with competing stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What types of pain are common with Parkinson’s?

A

Musculoskeletal, dystonic, neuropathic, radicular, central, akathisia, hypersensitivity more common in off state of medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Is there primary sensory loss associated with Parkinson’s?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What sensory impairments are associated with Parkinson’s?

A

Pain, perception of kinesthesia and proprioception, visual perceptual deficits, oculomotor changes, olfactory dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a hallmark early clinical sign of Parkinson’s?

A

Decreased or loss of smell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Why does dysphagia develop?

A

A result of rigidity and reduced movement

26
Q

What does dysphagia affect?

A

Tongue control, chewing, bolus formation, swallowing, peristalsis

27
Q

What complications are associated with dysphagia?

A

Choking, aspiration pneumonia, poor nutrition, weight loss, sialorrhea

28
Q

What is hypokinetic dysarthria?

A

Decreased speech volume, monotone, imprecise articulation, uncontrolled rate of speech, hoarse

29
Q

What two speech impairments are associated with Parkinson’s?

A

Hypokinetic dysarthria and mutism

30
Q

What are contributing factors to speech disorders?

A

Motor symptoms including rigidity, hypokinesia, bradykinesia, tremor that impact muscles that control respiration, phonation, resonation, and articulation

31
Q

What cognition impairments are associated with Parkinson’s?

A

Bradyphrenia, MCI, dementia, symptoms of levodopa toxicity

32
Q

What is bradyphrenia?

A

Slowness of thought - is an early symptom

33
Q

What is MCI?

A

Mild cognitive impairment - processing speed, set-shifting, attention, verbal fluency, planning, abstract reasoning, visuospatial, verbal, visual memory

34
Q

What symptoms are indicative of levodopa toxicity?

A

Hallucinations, delusions, psychosis

35
Q

What three sleep disorders are associated with Parkinson’s?

A

REM sleep behavior disorder, excessive daytime somnolence, insomnia

36
Q

When does REM sleep behavior disorder occur?

A

Occurs prior to motor symptoms in 60% of individuals

37
Q

What % of people with Parkinson’s experience depression?

A

40%

38
Q

What % of people with Parkinson’s experience anxiety?

A

31%

39
Q

What % of people with Parkinson’s experience apathy?

A

40%

40
Q

What are neurobiological causes of decreased mental health in pt’s with Parkinson’s?

A

Alterations in the levels of dopamine, serotonin, norepinephrine. Apathy will improve initially with dopamine therapy

41
Q

What is hypomimia?

A

Reduced facial expression that may be mistaken for depression or apathy

42
Q

What are symptoms of autonomic dysfunction?

A

Impaired thermoregulation, slow pupillary response to light, decreased gastric motility, incontinence, blunted HR response to exercise, orthostatic hypotension, pulmonary dysfunction

43
Q

What diagnostic test is used to medically diagnose Parkinson’s?

A

None - MRI used to rule out other causes and chemical markers can confirm dopamine deficits but are not specific to PD

44
Q

What symptoms are characteristic of Parkinsonism?

A

Bradykinesia + tremor or rigidity

45
Q

What are three keys to medically diagnosing PD?

A
  1. No symmetrical bilateral signs
  2. Rule out Parkinson-plus syndromes
  3. Clear and dramatic benefit from dopamine therapy
46
Q

What is the MOA of Levodopa/Carbidopa?

A

Dopamine replacement. Carbidopa prevents levodopa from conversion to dopamine before it crosses the BBB

47
Q

What is the MOA of a dopamine agonist?

A

Stimulate dopamine receptors in the basal ganglia

48
Q

What is the MOA of COMT Inhibitors?

A

Blocks breakdown of dopamine to prolong effects and reduce “wearing off”

49
Q

What is the MOA of MAO-B Inhibitors?

A

Blocks breakdown of dopamine to prolong effects and reduce “wearing off”

50
Q

What is the MOA of Anticholinergics?

A

Reduces excessive acetylcholine influence. May reduce tremor and dystonia

51
Q

What is the MOA of amantadine?

A

Antiviral. Blocks the effects of glutamate. May reduce dyskinesia

52
Q

What is the MOA of norepinephrine precursors?

A

Increased norepinephrine levels. May reduce orthostatic hypotension

53
Q

What is the MOA of Cholinesterase Inhibitors?

A

Inhibits acetylcholine breakdown. May improve memory function and gait instability

54
Q

What is the MOA of atypical antipsychotics?

A

Blocks some effects of serotonin. Used to treat hallucination and psychosis side effects

55
Q

What are common side effects of pharmacological management?

A

Wearing off, dyskinesia, dystonia, low BP, dizziness, nausea, dry mouth, insomnia, constipation

56
Q

What is deep brain stimulation?

A

Electrodes implanted in the brain with a subclavicular impulse generator and controlled by an external controller

57
Q

What are the two locations for electrode placement with a deep brain stimulator?

A

Subthalamic nucleus and globus pallidus internus

58
Q

What is the effect of placing an electrode in the subthalamic nucleus?

A

Improve motor symptoms and tremor, reduce medication

59
Q

What is the effect of placing an electrode in the globus pallidus internus?

A

Improve motor symptoms and tremor, suppression of dyskinesia

60
Q

How effective is a deep brain stimulator?

A

Only an effective treatment for 10-20% of individuals who are considered good candidates

61
Q

If a pt’s symptoms are poorly controlled with levodopa, will they have success with deep brain stimulation?

A

Symptoms will unlikely improve and may worsen

62
Q

What is the effect of nutrition on Parkinson’s?

A

High protein diet can block levodopa absorption. Should reduce calories from protein by 15%

NMR II (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions