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Flashcards in Neuromuscular Disease Deck (29)
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1

Neuromuscular Diseases (NMD

Primary muscle disease decreases the ability of a normal neural impulse to generate effective muscle contraction

2

Peripheral nerve disorders that cause respiratory muscle dysfunction may be caused by

🔹Inflammatory process
🔹Vascular disorders
🔹Metabolic disorders

3

NMD- Cardiopulmonary consequences may include

🔹Ventilatory insufficiency
🔹Central sleep apnea
🔹Aspiration PNA
🔹Atelectasis leading to hypoxemia
🔹Cor Pulmonale

4

Pathophysiology of NMD
❗Diaphragmatic paralysis most often diagnosed by PFT

🔹⬇ Decreased VC, FEV1, TLC
🔹Normal or ⬆ increased RV and diffusing capacity
🔹Positional changes suggest diaphragmatic weakness
▶seated to supine ->20% decline in FVE1 and VC
⬇ Decrease MIP and Mep

5

Pathophysiology of NMD
❗ Chief complaint

🔹Exertional dyspnea
🔹Fatigue
🔹 Orthopnea

6

Respiratory muscle weakness leads to

🔹Fatigue and respiratory failure, May meed MV
🔹Monitor MIP, VC and ABG's
🔹ABG's: ⬇ PaO2 ⬇ PaCO2, deterioration leads to ⬆PaCO2
🔹 Monitor all respiratory function / nocturnal oximetry

7

Pt with significant muscle weakness are at risk for

🔹 Mucous Plugging
🔹 PNA
🔹 Pulmonary edema

8

Muscle weakness leads to

🔹Respiratory insufficiency
🔹 Retained secretions

9

Other names for (GBS) Guillain-Barre Syndrome

🔹Landry-Guillain-Barre-Strhol syndrome
🔹Acute idiopathic polyneuritis
🔹Postinfectious polyneuritis
🔹Landry's paralysis
🔹Acute post-infectious polyneuropathy
🔹Acute Polyradiculitis
🔹Polyradiculoneurooathy

10

GBS is a

Autoimmune disorder of the peripheral nervous system
🔹 In which flaccid paralysis of skeletal muscles and loss of reflexes develop in a previously healthy individual.

11

Severe cases of GBS may result in

Ventilatory failure from diaphragmatic paralysis

12

Nerves with GBS demonstrate

🔹Demyelination
🔹Inflammation and edema (microscopically)

13

If GBS is not managed properly ventilatory failure form paralysis may result from

🔹Alveolar consolidation
🔹Atelectasis

14

GBS affects

Male and female equally

15

Grater incidence of GBS in people

🔹Over the age of 50
🔹50-60% more common in whites

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GBS etiology

🔹Idiopathic
🔹Believed to be an immune disorder that causes inflammation and deterioration of the pt's peripheral nervous system.
🔹Elevated antibodies (IgM) are found in serum blood test

17

GBS causative agent

🔹Campylobacterjejuni
🔹Cytomegalovirus

18

Other infections that have been implicated to GBS

🔹Mononucleosis
🔹Measles and Mumps
🔹Mycoplasm Pneumoniae
🔹Chlamydia psittaci

19

GBS diagnosis is based in

🔹Clinical history
🔹Abnormal (EMG) Electromyography
🔹 ⬆ Elevated protein levels on cerebral fluid

20

GBS Non-cardiopulmonary clinical manifistations

🔹Paresthesia or dysesthesias (tingling sensation and numbness in extremities).
🔹Pain in BACK, BUTTOCKS, and LEGS
🔹Progressive ascending paralysis
🔹Loss of deep tendon reflexes
🔹Difficulty swallowing

21

GBS recovery % of functional recovery

🔹Functional spontaneous recovery in about 90% of cases

22

GBS cardiopulmonary clinical manifestations

🔹Diminished breath sounds
🔹Crackles and Rhonchi
🔹 ⬇ Decreased flows ⬇Decreased Volumes
🔹Restrictive disorders
🔹CXR show ⬆ increased opacity

23

GBS Heart rhythms

🔹Tach and Bradycardia

24

GBS BP

🔹Hypotension

25

GBS are in danger of due to immobilization

🔹Thromboembolism

26

In GBS what has shown to decrease morbidity rates? And been proven to reduce antibody titers?

🔹Plasmapheresis

27

Immunoglobulin infusion

🔹Can block damaged antibodies

28

Corticosteroids are contraindicated in GBS because?

🔹They may prolong pt's recovery time

29

What can RT's do for GBS?

🔹O2
🔹CPT
🔹Hyperinflation
🔹MV