Neuromuscular Disorders Flashcards
(32 cards)
Dyskinesias
Involuntary, non-repetitive but occasionally stereotyped movements affecting distal, proximal, and axial musculature
Most common in basal ganglia disorders
Hemiballismus
involuntary flinging motions of the extremities
often violent and wide amplitudes of motion
can occur distal or proximal on one side of the body
Dystonia
sustained abnormal postures and disruptions of ongoing movement due to alteration of muscle tone
Cardinal Signs of Parkinsons
T= tremor
R= rigidity
A= akinesia
P= postural instability
Stage 1 of Parkinsons
unilateral tremor, akinesia, minimal or no functional impairment
Stage 2 of Parkinsons
bilateral tremor, rigidity, or akinesia, with or without axial signs, independent with ADL, no balance impairment
Stage 3 of Parkinsons
worsening of symptoms, impaired righting reflexes, difficulties with ADL performance, can lead independent life
Stage 4 of Parkinsons
requires help with ADL, unable to live alone, able to walk and stand unaided
Stage 5 Parkinsons
unable to stand, walk, or perform ADL, max assist required
Medications for Parkinsons and Side effects
Levodopa compensates for the loss of dopamine
As the disease progresses drug works less evenly and predictably
on-off effect of long-term use may cause symptoms to appear and disappear suddenly
Spina bifida occulta
Bony malformation with separation of vertebral arches of one or more vertebrae
may not be discovered until late childhood
occasionally slight instability and neuromuscular impairments but no huge symptoms
Occult spinal dysraphism
red birthmark, patch of hair, dermal sinus, tumor
may result in spinal cord being split or being tethered
neurological damage and developmental abnormalities as child grows
Spina bifida with meningocele
Protrusion of sac through spine, containing CSF and meninges, does not include SC
usually does not present with symptoms impacting function on SC
Slight instability and some bowel and bladder issues may occur
Spina bifida with myelomeningocele
protrusion of sac through spine containing CSF and meninges as well as SC or nerve roots
results in sensory and motor deficits occurring below the level of the lesion
may result in LE paralysis and DVT
Lesions of S2-S4 result in bowel and bladder problems
Tethered cord syndrome
visible signs include: hairy patch of skin, hemangioma, dimple of lower spine
difficulties with bowel/bladder control, gait, scoliosis
Symptoms may be exacerbated by growth spurts or when pregnant
Signs of shunt malfunction
CRITICAL EMERGENCY
soft spot on forehead (infants)
severe headache, vomitting, irritability
change in UE function
impaired vision
onset of seizure disorder or increased activity
Average age diagnosis of muscular dystrophy
5 years unless known family history or early detection
Duchennes muscular dystrophy
most common form
detected between 3-5
enlargement of calf muscles and at times forearm and thighs
weakness of proximal joints
ambulates with trendelenburg gait , uses hands to crawl up thighs to get to standing
weakness occurs in all voluntary muscles
behavioral and learning difficults
rarely survive past early 20s
Beckers muscular dystrophy
slower to progress and less severe than Duchenne
loss of motor function of hips, thighs, pelvic area and shoulders
survival can be into late adulthood
Specific Symptoms of muscular dystrophy and atrophy
low muscle tone and weakness
difficulties with oral motor feeding
deformities of extremities and spine
difficulties breathing
Symptoms of ALS
muscle weakness and atrophy beginning dismally and asymmetrical
cramps and fasiculations
signs usually begin in hands
LMN signs (hyperactive reflexes, hypertonia)
how is ALS symptoms documented?
revised ALS Functional Rating Scale
speech, salvation, swallowing, handwriting, cutting food, dressing, turning in bed etc.
Lower scores indicate greater symptoms
ALS treatment
medications
treating secondary complications
Erbs Palsy
paralysis of upper brachial plexus
5th and 6th cervical nerves
Arm cannot be raised, elbow flexion is weakened
positioning and ROM exercises are necessary to decrease contractures