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Flashcards in Module 12 Deck (24)
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1

What is the definition of Parkinson's Disease?

A chronic and slowly progressive CNS disease involving the basal ganglia (striatum, globus pallidus, subthalamic nucleus, substantia nigra) with cardinal symptoms of rigidity, tremor, postural instability, and bradykinesia.

2

Why do Parkinson's patients think they are making bigger movements then they really are?

Lack of Dopamine

3

What is the range of age of onset for PD?

50-60 years

4

What is the gender influence of PD?

There is none

5

What is the prevalence of PD?

1,500,000

6

What is the incidence of PD?

60,000

7

What is the mortality rate of PD?

PD is not considered fatal

8

What percent of Parkinson's patients have Primary Parkinsonism?

78%

9

What is involved in secondary Parkinsonism?

Post-infectious Parkinsonism
Toxic Parkinsonism (manganese- coal miner)
Metabolic Parkinsonism (hypothyroidism)

10

What is involved in Parkinson-Plus Syndromes?

multiple system atrophy (MSA), progressive suranuclear palsy (PSP), Alzheimer's disease, Huntington's disease, Wilson's disease, Creutzfeldt-Jakob disease (CJD)

11

What is Hoehn and Yahr Classification of Disability?

1- minimal or absent; unilateral if present.
2- minimal bilateral or midlines involvement. Balance not impaired
3- impaired righting reflexes. Unsteadiness when rising from chair. some activities are restricted, but patient can live independently and continue some forms of employment
4- all symptoms present and severe. Standing and walking possible only with assistance.
5- confined to bed or wheelchair.

12

What is the diagnostic criteria for PD?

objective evidence of > 2 of the 4 cardinal signs
exclusion of Parkinson-plus syndromes

13

What is the difference between a normal brain and a Parkinson's brain?

In a normal brain the excitatory hormones= the inhibitory hormones. In a Parkinson's brain there is more excitatory hormones, but then the body over compensates by shutting more of them down and causing the person to only make small movements.

14

What drugs are used for PD patients?

Early PD stage: Deprenyl- relaz tremor
Middle PD stage: Sinemet (Levadopa)- Dopamine replacement
Late PD stage: Bromocriptine

15

What can happen when not on the drugs?

On-off Phenomenon- can't move when they go off the drug
End-of-Dose Deterioration- will deteriorate

16

What are some surgical procedures associated with PD?

Pallidotomy- Destructive lesion in Sensorimotor portion of the globus pallidus
Thalamotomy- ventral intermediate nucleus
Deep Brain Stimulation- Block nerve signals

17

What is neuroprotection?

<20% dopamine loss

18

What is Neurorestoration?

21-60% dopamine loss

19

What is compensation in PD?

>60% Dopamine loss

20

What can help treat PD?

Forced-use paradigms (intensive exercise protocols) can protect or rejuvenate viable DA neurons during pre-clinical or early PD stages. Stopping exercise or adding stress cancels the brain and behavioral benefits gained. Exercise can improve mobility, balance, gait, and endurance.

21

What does exercise do for PD?

stimulate proliferation of new neurons
alter metabolic and immune responses
increase blood suplly
protect against natural neurodegeneration
develop an external cue to help with freezing episodes
helps mobility, balance, gait, and endurance

22

What are the cardinal symptoms of PD?

Rigidity (cogwheel or leadpipe)
bradykinesia (hesitation, freezing)
Tremor (resting and postural)
postural instability

23

What are some other symptoms of PD?

sensory changes
hypokinetic dysarthria
dysphonia/mutism
dysphagia
sialorrhea
dementia
bradyphrenia
seborrhea
akathisia
festinating gait
micrographia
masked face
fatigue
orthostatic hypotension

24

What scales are used to rate PD?

unified Parkinson's disease rating scale (UPDRS)
Parkinson's disease Questionnaire (PDQ-39)