Chapter 36 Flashcards Preview

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Flashcards in Chapter 36 Deck (29)
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1
Q

What is hypotonia?

A

State of low muscle tone

  • soft muscles on palpation
  • diminished resistance and reflexes
2
Q

What is hypertonia?

A

State of increased muscle tone

- hyper excitability causing rigidity and spasticity

3
Q

What is clonus?

A

Involuntary rhythmic muscle contractions and relaxations

4
Q

What is plegia?

A

stroke or paralysis

5
Q

What is paralysis?

A

loss of movement

6
Q

What is paresis?

A

weakness

7
Q

What is mono?

A

One limb

8
Q

What is Hemi?

A

Both limbs on one side

9
Q

What is di- or para?

A

Both upper/ or both lower limbs

10
Q

What is quadi- or tetra?

A

All 4 limbs

11
Q

What is UMN (upper motor neuron) damage?

A

weakness or loss of voluntary motion

  • spinal reflexes are intact but cannot be controlled by the brain
  • increased muscle tone, hyperreflexia, spasticity
12
Q

What is LMN (lower motor neurone) damage?

A

neurone directly supplying muscles are affected

  • irritated neurons you get spontaneous muscle contractions (fasciculations= contracting and relaxing)
  • Death of neurons leading to spinal reflex lost, flaccid paralysis, denervation atrophy of muscles
13
Q

What is a cause of muscle disorders?

A

Muscle atrophy

14
Q

What 2 things can muscle atrophy be broken down into?

A

disuse: not using muscle (decrease diameter/loss of protein filaments)
Denervation: deprived nerve supply

15
Q

What is muscular dystrophy?

A

Contractile proteins don’t properly attach to cytoskeleton of muscle cells
- muscles can’t contract properly

16
Q

Explain muscular dystrophy. What is the cause?

A

Genetic disorder (progressive degeneration and necrosis of skeletal muscle fibers and tissue

  • Fat and connective tissue replace it ( incr. muscle size= weakness)
  • Cause: mutation in the dystrophingene
17
Q

What are the 2 types of muscular dystrophy?

A
  1. Duchene
    - common and severe (females are asymptomatic or milder symptoms)
  2. Becker
    - slower and less severe
    - later in childhood
18
Q

What is the presentation of MD?

A
  • boys asymptomatic at birth
  • 2-3 abnormal posture, falls, contractors, scoliosis= wheelchair by teens
  • hip/ shoulders are affected first
  • calf muscle hypertrophy (broken down and replaced with fat/ tissue)
  • incontinence
  • weak cough= infection, cardiomyopathy
  • GROWERS SIGN- can’t stand- use hands to push them selves up/ using knees)
19
Q

What is the diagnosis for MD?

A
  • family hx
  • observation of movement
  • elevated creatine kinase (leaks out of damaged muscles)
  • muscle biopsy (shows fat/scar formation)
  • Echo/ ECG (shows cardiac involvement)
20
Q

What is the treatment of MD? (note: no known cure)

A
  • maintain ambulation
  • prevent deformities (stretching/ splinting)
  • prevent respiratory infections
  • death in young adults
21
Q

What is acetylcholinesterase? What are 3 ways disorders of neuromuscular junctions can occur?

A
  • enzyme that inactivates transmitters
    1. decreased acetylcholine release
    2. decreased acetylcholine effects on muscles d/t decreased receptors
    3. decreased acetylcholinesterase activity (buildup at junction = interference with impulses)
22
Q

What is myasthenia gravis?

A

Decreased motor response d/t loss of acetylcholine receptors

  • Auto immune disorder
  • Antibodies destroy receptors at neuromuscular junction
  • receptor sites are blocked d/t antibodies
23
Q

What are the risk factors of myasthenia gravis?

A
  • early adulthood for women, 50 for men
  • placental transfer of acetylcholine anti-bodies (spontaneous resolution)
  • Thymus tumor or hyperplasia in 75 % of cases (T cells not working properly to prevent infection)
24
Q

What is the manifestations of MG? (explain them in the 3 stages)

A

Initial: progressive throughout day, muscle weakness, ptosis/drooping, diplopia/ double vision, fatigue
Progression: resp. muscle weakness, diff. speaking, chewing, swallowing, weak limb
Myasthenia crisis: muscle weakness becomes severe and compromises ventilation d/t stress, infection, emotional upset, pregnancy, alcohol, surgery, cold

25
Q

Diagnosis of MG?

A
  • Hx, physical exam
  • Anti-cholinesterase test
  • electro-phsyiological studies to assess stage (assess muscle response to motor nerves)
26
Q

What is the treatment of MG?

A
  • corticosteriods (immunosuppressant)
  • thymectomy (if tumor)
  • plasmapheresis (removes antibodies)
  • IGg IV
27
Q

What are peripheral nerves?

A

Nerves that are located outside the CNS.

28
Q

Explain carpal tunnel syndrome and its causes.

A

Mononeuropathy, compression of neural nerve passing through carpal bones and ligaments
- inflammation of tendons, synovial swelling, tumor, RA, hyper/hypothyroidism, DM , repetitive flexion and extension movements, pinching and griping motions

29
Q

What are the manifestations of carpal tunnel?

A

pain, parenthesis (tingling), numbness of thumb, 1 2 3 and 4 digit, wrist and hand pain, worst at night, atrophy of abductor polices muscle, weakness of precision grip