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Neuro Pathology Flashcards

(54 cards)

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1
Q

Alzheimer’s Disease Brain involvement

A
  • Cerebral Cortex and Subcortical areas
  • Deterioration of neurons involved with ach transmission -Formation of amyeloid plaques and neurofibrillary tangles => further deterioration
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2
Q

AD Etiology

A
  • No exact known cause
  • Risk increases with inc age
  • Higher incidence in women
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3
Q

AD Treatment

A

-Meds to inhibit acetylcholinesterase, alleviate cognitive symptoms and behavioral changes

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4
Q

Common meds for AD

A
  • Tacrine (cognex): cholinergic agent
  • Donepezil (aricept): cholinergic agent
  • Rivastigmine (exelon)
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5
Q

PT management with AD

A
  • Focus on maximizing pt’s remaining function

- Family/caregiver education

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6
Q

Progression of AD (3)

A

1) Initial: change in higher cortical functions (learning new things, memory/concentration)
2) Progression: loss of orientation, rigidity, bradykinesia, shuffling gait, impaired ability to perform self-care
3) End-stage: severe intellectual/physical destruction, incontinence, functional dependence, inability to speed

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7
Q

Amyotrophic Lateral Sclerosis (ALS) Presentation

A
  • Presents with both upper (d/t demyelination of corticospinal and corticobulbar tracts) and LMN (d/t anterior horn cell loss in the SC and motor cranial nerve nuclei in lower brainstem) impairments
  • Rapid degeneration => dennervation of muscle fibers, muscle atrophy, weakness
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8
Q

Amyotrophic Lateral Sclerosis (ALS) Etiology

A
  • unknown exact cause
  • higher incidence in men
  • commonly begins at 40-70 years of age
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9
Q

Amyotrophic Lateral Sclerosis (ALS) signs and symptoms (UMN vs LMN s/sx)

A
  • UMN: incoordination, spasticity, clonus, positive Babinksi
  • LMN: Asymmetric* muscle weakness, fasiculations, cramping, atrophy within the hands.
  • Will exhibit fatigue, oral motor impairment, motor paralysis, and eventual respiratory paralysis
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10
Q

Common meds for Amyotrophic Lateral Sclerosis (ALS) (1)

A

-Riluzole (Rilutek)

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11
Q

PT intervention for ALS

A
  • Focus on quality of life

- Family/caregiver treatment

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12
Q

Bell’s Palsy Presentation

A
  • assymetrical facial involvement
  • Eyelid and mouth drooping
  • Drooling
  • Dry eye
  • Inability to close eye d/t weakness
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13
Q

What nerve is affected with Bell’s Palsy?

A

-Facial Nerve

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14
Q

Bell’s Palsy Etiology

A
  • Herpes simplex/zoster virus thought to be a cause
  • Inflammation within auditory canal injures nerve and => demyelination of the nerve (axonal degeneration if apoxia occurs)
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15
Q

Common (types) of meds for Bell’s Palsy (2)

A
  • Anti-viral meds

- Corticosteroids

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16
Q

PT for Bell’s Palsy

A
  • Less severe cases resolve within 2 weeks with no intervention
  • Stimulation of facial nerve
  • Facial massage/exercise
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17
Q

Carpal Tunnel Syndrome (CTS) signs/symptoms

A
  • Motor and sensory disturbances in median nerve distribution d/t Median Nerve entrapment
  • Paresthesias may radiate into the UE, shoulder, and neck
  • Night pain
  • hand weakness
  • muscle atrophy
  • decreased grip strength/clumsiness
  • decreased wrist mobility
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18
Q

CTS treatement

A
  • splinting
  • ergonomic changes
  • local corticosteroid injections
  • PT
  • Carpel Tunnel release (severe cases)
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19
Q

Types of Cerebellar Disorders (4)

A

1) Congenital Malformations
2) Hereditary ataxias
3) Spinocerebellar ataxias
4) Acquired ataxias

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20
Q

Congenital Malformation

A
  • Type of Cerebellar disorder
  • Manifest early in life, non-progressive
  • Ataxia usually present
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21
Q

Spinocerebellar Ataxia

A
  • Type of Cerebellar Disorder
  • main autosomal dominant ataxia
  • affect multiple areas of the CNS and PNS
  • neuropathy, pyramidal signs, ataxia, and restless leg syndrome
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22
Q

Acquired Ataxias

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A
  • Type of Cerebellar Disorder
  • Nondenerative systemic disorder, toxin exposure, or idiopathic in nature
  • i.e. alcoholism, hypothyroidism, and vitE deficiency
23
Q

Hereditary Ataxias

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A
  • autosomal dominant
  • Autosomal recessive = Fredrich’s ataxa (gait unsteadiness, upper extremity ataxia, dysarthria, paresis, declined mental function).
24
Q

Cerebellar Disorders s/sx

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A
  • depends on affected areas

- ataxia

25
Diabetic Neuropathy Nerve Damage
-Microvascular diases combined with effects on nerves from hyperglycemia => nerve ischemia
26
Diabetic Neuropathy s/sx
- Symmetrical pattern of weakness and sensory distrubances ("stocking-glove" distribution) - May involve sensory, motor, or autonomic systems
27
Diabetic Neuropathy Treatment
- Monitor blood glucose levels | - PT for pain management, foot care, overall fitness
28
Epilepsy
- Chronic condition where temporary brain dysfunction => seizure - Unprovoked and unpredictable
29
Epilepsy etiology
-many cases idiopathic
30
Conditions leading to increased risk of Epilepsy (7)
- genetics - head injury - dementia - CVA - Cerebral Palsy - Down Syndrome - Autism
31
Epilespy Treatment
- Antiepileptic meds (major side effects) | - Possible surgical intervention
32
Guillain-Barre Syndrome (GBS) aka Acute Polyneuropathy
- temporary inflammation and demyelination of peripheral nerves due to attack from GBS autoantibodies - Peak in frequency in young adults and between 5th-8th decades
33
Etiology of GBS
-hypothesized autoimmune response to a previous respiratory infection, influenza, immunization, or surgery
34
GBS s/sx
- motor weakness in distal-proximal progression - sensory impairment - potential respiratory paralysis (life-threatening) - absence of DTRs - Inability to speak/swallow
35
Time to peak level of disability with GBS
2 to 4 weeks after onset
36
PT treatment with GBS
- pulmonary PT - strenghening - mobility raining - w/c and orthotic prescription - AD training
37
Huntington's Disease (HD) aka Huntington's Chorea brain involvement
- Degeneration/atrophy of the basal ganglia and cerebral cortex - Deficient neurotrasmitters => unable to modulate movement
38
HD etiology
- Autosomal dominant trait linked to chromosome 4 | - average age 35-55 years
39
HD s/sx: inital stage
- involuntary choreic movements - mild personality changes - grimacing/tongue protrusion - ataxia with choreathetoid movements
40
HD s/sx: late stage
- mental deterioration - decrease in IQ - depression - dysphagia - incontinence - immobility/rigidity
41
PT for HD
-maximize endurance, strength, balance, postural control, and functional mobility
42
Mutliple Sclerosis (MS) brain involvement
- patches of demyelination in brain and SC - subsequent plaque formation - evental failure of impulse transmission
43
MS etiology
- unknown, but theorized is an autoimmune repsone from a slow-acting virus combined with genetic and environmental factors - highest incidence 20-35 years old
44
MS s/sx
- Periods of relapse and remission - initially visual problems - parethesias - clumsiness/weakness - ataxia - balance dysfunction - fatigue
45
PT for MS
- regulate activity level - energy conservation techniques - normalize tone - balance/gait training - core stabilization - adaptive/assistive device training
46
Myasthenia Gravis
- autoimmune diease | - antibodies block/destroy ach receptors in synapse and prevent muscle contraction => weakness
47
Myasthenia Gravis etiology
- autoimmne disease associated with an enlarged thymus - association with other autoimmune disorders - range from mild-severe involvement
48
Myasthenia Gravis s/sx
- remissions and exacerbations - extreme fatiguability - muscle weakness (occular muscles typically affected first) - dysphagia, dysarthrira, and cranial nerve weakness
49
PT for Myasthenia Gravis
- pulmonary intervention - energy conservation techniques - isometric strengthening exercises
50
Parkinson's Disease
- degenerative disorder d/t decrease in dopamine production within basal ganglia - 50-79 year olds are majority diagnosed - PT focuses on strength, endurance, and functional mobility
51
Post-Polio Syndrome
-Occurs when compensated reinnervation from Polio fails and results in ongoing muscle denervation
52
PPS s/sx
- Slow and progressive weakness - fatigue - muscle atrophy - pain - trouble swallowing
53
PPS treatment
- no deds to alter progression | - lifestyle modification and symptomatic intervention
54
PT for PPS
- encourage supervised exercise - functional independence - adaptive equipment - education

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