Pathologies Flashcards
Alzheimer’s Disease
E: unknown- hypothetical = lower level of neurotransmitters, higher levels of aliuminum in brain, genetics, autoimmune diesease, abnormal processing of amyloid, virus
S/S: change in higher cortical functions (difficulty learning new things, change in memory/concentration)
progression= loss of orientation, word finding problems, depression, poor judgement, rigitidy, bradykinesia, shuffling gait, impaired ADLs
end-stage = severe intellectual/physical destruction, incontinence, functional dependence, inability to speak
Tx: no cure, medications= alleviate cognitive symptoms, control behavioral changes
PT = focus on maximixing pt’s remaining function, provide family/caregiver ed
Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s Disease)
E: unknown- theories = genetics, virus, metabolicc disturbance, lead/aluminum toxicity
higher inceidence in men, 40-70 yrs old
S/S: Early= lower motor neuron (asymmetric weakness, fasciculation, cramping, atrophy in hands), weakness spreads from distal-proximal, upper motor neuron (incoordination, spasticity, clonus, + Babinski), fatigue, oral impairment, motor paralysis, eventual respiratory paraylisis
Tx: supportive care/ symptomatic therapy, meds, physical/ occupatopnal/ speech/ respiratory/ nutritional therapy, focus on quality of life and caregiver ed
Carpal Tunnel Syndrome
E: unclear- associated= repetetive use, rheumatoid arthritis, pregnancy, diabetes, culumative trauma, tumor, hypothyroidism, wrist pain/fracture
S/S: inital sensory changes/ paresthesias along median nerve, may radiate into UE/shoulder/neck- night pain, weakness in hand, muscle atrophy, decreased grip strength, clumsiness, decreased wrist mobilty
Tx: no universally acceptec Tx, typical = conservative (splinting, egronomics, local corticosteroid, PT), severe = surgical reslease of carpal tunnel
Cerebella Disorders
E: Congenital: early manifestation, non-progressive, usually ataxia is present
- Hereditary Ataxia:* most common= Frierich’s ataxia )gene mutation causes abnorma DNA repetition, mitochondrial defect), gait unsteadiness, UE ataxia, dysarthria, paresis, declining mental function, slight tremor, impaired relfexes/ vibration/position sense
- Spinocerebellar ataxia:* main autosomal dominant ataxia- affects multiple areas in CNS/PNS, present w/ neuropathy, pyramidal signs, ataxia, restless leg syndrome
- Acquired Ataxia:* neurodegenerative systemic disorder (alcoholism, hypothyroidism), toxin exposure (CO, heavy metals, lithium), idiopathic
Tx: diagnosis dependent, systemic disorders are treatable, surgery for tumor/hydrocephalus, majority of Tx is supportive
Diabetic Neuropathy
E: Diabetes Mellitus- factors= prolongued exposure to high blood glucose, metabolic, duration of DM, neurovascular, impaired O2/nutrient transport, autoimmune, nerve inflam, etc.
S/S: symmetrical weakness/sensory disturbances, tingling, numbness/pain especially in feet, muscle wasting in hands/feet, “stocking glove” sensory impairment, orthostatic hypotension, urinary impairment
Tx: strict blood glucose monitoring for prevention, PT to address pain management, foot care and overall fitness, meds may be needed
Epilepsy
E: mostly idiopathic- associated conditions= genetics, head trauma, dementia, CVA, CP, Down Syndrome, autism
S/S: siezures (varying w/ type/ extend of siezure), loss of awareness/consciousness, distrubances of movement/sensation/mood/mental function
Tx: most require meds, no “cure”, initiating meds is serious decision due to adverse side effects, surgery ONLY if meds don’t work & high disruption of quality of life
Guillan-Barre Syndrome (aka Acute Polyneuropathy)
E: unknown- hypothesis= autoimmune response to previous respiratory infection/flu/vaccine/surgery
S/S: motor wekaness that moves distal-proximal, sensory impairement, possilble respiratory paralysis- initially = distal symmetrical motor weakness, mild distal sensory impairment, transient paresthesias. Peaks @ 2-4 weeks post onset. Can be life-threatening (inability to speak/swallow, absence of deep tendon reflexes may occur)
Tx: hospitalization for symptom management- meds= immunosuppressant/analhesic/narcotics, cardiac monitoring, plasmaphresis, mechanical ventilation may be required
Physical/ occupational/speech therapy indicated- pulomary rehab, strengthening, mobility/wheelchair training, orthotics/assistive devices
Huntington’s Disease
E: genetic- autosomal dominant, passed on before parent is diagnosed, avg age to develop symptoms= 35-55 yrs
S/S: involuntary chorea, mild alteration of personality, grimacing, tongue protrusion, ataxia + choreoathetoid movements (irregular migrating contractions + twisting and writhing), decreased IQ, depression, dysphagia, incontinece, immobility, rigidity
Tx: genetic/ psychological/ social counseling for pt & family, meds once choreiform movement impairs function, PT to maximize endurance, strength, balance, posture, and functional mobility
Multiple Sclerosis
E: unknown- genetics/ viral infections/ environment play a role, incidence highest between 20-35 yrs
S/S: vary based on disease, location, extent of dymyelination, degree of sclerois, etc- inital = visual problems, paresthesias/ sensory changes, clumsiness, weakness, ataxia, balance issues & fatigue, frequency/intensity of exacerbation may indicate speed/course of disease process
Tx: meds, medical & therapeutic interventions required- goal = lessen length of exacerbations & maximize pt health
meds + physical/occupational/speech therapies + nutrition/psychological counseling = regulation of activity level, relax/energy conservation techniques, normalizing tone, balance/gait training, core stabilization, assistive device training
Myasthenia Gravis
E: autoimmune disease process + enlarged thymus, associated w/ diabetes, rheumatoid arthritis, lupus, etc.
S/S: extreme fatigue/ skeletal muscle weakness that fluctuates w/in min-extended periods- ocular muscles affected 1st (1/2 of pts= ptosis, diplopia), dysphagia, dyarthria and cranial nerve weakness common
Tx: pt will experience remissions & exacerbations- a “crisis” is a medical emergency (pt requires ventilator), PT focus= obtaining respiratory baseline, pulmonary intervention, energy conservation, isometrics, secondary osteoporosis Tx
Parkinson’s Disease
E: unkown- genetics, CO toxicity, encephalitus, Huntington’s, Alzheimer’s, etc., incidence= 50-79 yrs, 10% diagnosed before 40
S/S: initally= resting tremor in hands/feet that increases w/ stress and disappears w/movement/ sleep
Early= balance disturbances, difficulty rolling over/rising from bed, fine motor impairment (writing, bathing, dressing)
Progression= hypokinesia, festinating gait, bradykinesia, poor posture, dysphagia, “cogwheel” or “lead pipe” rigidity, “freezing” episodes during amb/speech/blinking/arm movement, mask-like appearace/ no facial expression
Tx: dopamine replacement therapy, physical/occupational/speech therapy to maximize endurance, strength, and functional mobility, verbal cueing/ visual feedback needed
Post-Polio Syndrome
E: seen in 25-50% of persons 25 years post inital recovery
S/S: slow/progressive weakness, fatigue, muscle atrophy, pain, swallowing issues
Tx: lifestyle modification, symptomatic intervention, PT= supervised exercise, functional independence, adaptive equipment, pt ed
