Neuromuscular: Etiology Flashcards

Question

Resting Tremors

Answer 1

At rest May disappear with movement May increase with mental stress Pill-rolling tremor in Parkinson's

Answer 2

During voluntary contraction to maintain posture Rapid tremor in hyperthyroidism, fatigue, or anxiety Benign essential tremor

Answer 3

With activity Increase as the target approaches Lesion of cerebellum or its efferent pathways MS

Answer 4

Sudden, brief, repetitive coordinated movements Irregular intervals Simple vs complex Myoclonic jerks to jumping movements that may include vocalization and repitition of other sounds Tourette's syndrome

Answer 5

Hyperkinesia with brief, irregular rapid contractions (not as rapid as myoclonic jerks) (Sudden, random, involuntary movements) Damage of caudate nucleus "Fidgeting" Ballism: choreic jerks of large amplitude - flailing of limbs - damage of subthalamic nucleus Huntington's

Answer 6

Sustained contractions frequently causing twisting, abnormal postures and repetitive movements Accentuated in volitional movement With progression can produce overflow Genetic, acquired, environmental, medications Related to athetosis but larger axial muscle involvement rather than appendicular muscles Agonist and antagonist sustained contractions One muscle group repeatedly persisting Overflow causes voluntary to create involuntary movements Torsion spasms continual, patterned, and twisting Others Parkinson's CP Encephalitis

Answer 7

Slow, twisting, and writhing movements with large amplitude Face, tongue, trunk, extremities If brief, merges with chorea (choreoathetosis) If sustained, merges with dystonia and often associated with spasticity (Involuntary movements with posture instability) (Peripheral movements occur without central stability) CP secondary to basal ganglia pathology

Answer 8

Inability to initiate movement | Parkinson's

Answer 9

Generalized weakness | Cerebellar pathology

Answer 10

Inability to perform coordinated movements

Answer 11

Slow movement

Answer 12

Resistance in ROM of hypertonic joint | Resistance greatest at initiation and lessens with movement

Answer 13

Involuntary alternating spasmodic contraction Caused by quick stretch reflex Indicative of UMN lesion

Answer 14

Phasic rigidity | Parkinson's

Answer 15

Inability to perform rapidly alternating movements

Answer 16

Inability to control ROM and force of muscle activity

Answer 17

Muscle twitch from random discharge of LMN and it's muscle fibers Suggests LMN disease but can be benign

Answer 18

Involuntary violent movement of large body part

Answer 19

Rigidity with uniform and constant resistance to ROM | Lesion of basal ganglia

Answer 20

Severe hypertonicity | Sustained muscle contraction does not allow for movement at that joint

Answer 21

Neurons involved with Ach transmission deteriorate In cerebral cortex and subcortical areas Amyloid plaques and neurofibrillary tangles cause further damage Treatment: (-) acetylcholinesterase, alleviate cognitive symptoms, control behavioral changes.

Answer 22

Chronic degeneration creates UMN and LMN impairments Loss of anterior horn cells and motor cranial nerve nuclei in lower brainstem Demyelination of corticospinal/bulbar tracts cause UMN symptoms Rapid degeration causes denervation of muscle fibers, atrophy and weakness

Answer 23

Genetic, virus, metabolic, toxic (PB, AL) Men 40-70

Answer 24

``` Fatigue, oral motor impairment, motor paralysis, eventual respiratory paralysis LMN Signs: Asymmetric weakness Distal to proximal weakness Fasciculations Cramping Hands atrophy UMN Symptoms: Incoordination Spasticity Clonus (+) Babinski ```

Answer 25

Temporary unilateral facial paralysis | Trauma with demyelination and/or atonal degeneration of facial nerve.

Answer 26

15-45 Viral infection - Herpes simplex/herpes zoster virus Inflammation and pressure injure nerve Inflammation in auditory canal demyelinates nerve If ischemia, also atonal degeneration

Answer 27

``` Asymmetrical facial appearance "Drooping" of eyelid and mouth Drooling Eye dryness Inability to close eyelid from weakness ```

Answer 28

``` Mild = Resolve in 2 weeks Severe = Anti-viral and high-dose corticosteroid meds. PT = Stimulate facial nerve, facial massage or exercise if PT indicated ```

Answer 29

Normal tunnel tissue pressure = 3-7 mmHg CTS pressure can be > 30 mmHg with wrist at rest Increased pressure = ischemia within nerve Ischemia = sensory and motor disturbances

Answer 30

``` Repetitive use RA Pregnancy DM Cumulative trauma disorders Tumor Hypothyroidism Wrist sprain or fx ```

Answer 31

``` Sensory/paresthesias along median nerve Radiate into UE, shoulder, and neck Night pain Hand weakness Atrophy Decreased grip strength Decreased wrist mobility Clumsiness ```

Answer 32

Congenital malformations: non-progressive, ataxia Hereditary Ataxias: Autosomal recessive or dominant Friedreich's Ataxia autosomal recessive, impaired mitochondria function, ataxia, dysarthria, paresis, mental function, slight tremors, abnormal reflexes, vibration, and position sense Spinocerebellar Ataxias: Autosomal dominant, CNS and PNS, neuropathy, pyramidal signs, ataxia, restless leg syndrome Acquired Ataxias: Neurodegenerative systemic disorders, toxin, idiopathic

Answer 33

Nerve ischemia from microvascular disease and direct effects of hyperglycemia on neurons Most common forms symmetric polyneuropathy and autonomic neuropathy. Also cranial, mono, and radiculopathies

Answer 34

``` Influencing Factors: Metabolic High blood glucose DM duration Neurovascular Impaired O2 and nutrient transport to nerves Autoimmune Inflammation in nerves Inherited traits Environmental and lifestyle (ETOH and smoking) ```

Answer 35

Sensory, motor, or autonomic systems Weakness and sensation distally in symmetrical pattern Tingling, numbness, pain especially in feet Wasting in feet or hands "Stocking glove" Orthostatic hypotension Urinary impairments

Answer 36

Chronic Temporary dysfunction of the brain Hypersynchronous electrical discharge of cortical neurons and seizure activity that is unprovoked and unpredictable Transient event symptom of interrupted brain functioning

Answer 37

``` Idiopathic Genetic Head trauma Dementia CVA CP Down's syndrome Autism ```

Answer 38

Loss of awareness/consciousness Disturbances of movement, sensation, mood, or mental function Antiepileptic meds if serious - adverse effects

Answer 39

Prodromal period rarely occurs hours or days before seizure Can include mood changes, lightheadedness, sleep disturbances, irritability, difficulty concentrating Aura is a brief, simple partial seizure minutes before a complex partial or generalized tonic-clomic seizure Can include restlessness, nervousness, anxiety, heaviness, general feeling something in body is not right After seizure place on their left side, stay 5-20 min (when fully recovered)

Answer 40

Acute polyneuropathy Temporary inflammation and demyelination of peripheral nerve myelin sheath with possible axonal degeneration Autoantibodies attack myelin sheath.

Answer 41

``` Young adult and again 40s-70s Autoimmune response to previous: Respiratory infection Viral infection Bacterial infection Influenza Epstein-Barr syndrome Cytomegalovirus Immunization Surgery ```

Answer 42

``` Disability peaks in 2-4wks Distal to proximal progression Motor weakness Sensory impairment Possible respiratory paralysis (life threatening) Absence of DTRs Possible inability to speak or swallow ```

Answer 43

Hospitalization: Cardiac monitoring, plasmapheresis, mechanical ventilation Pharmacological: Immunosuppressive and analgesic/narcotic meds PT: Pulmonary rehab, strength, mobility, wheelchair, orthotic, AD

Answer 44

Degeneration and atrophy of basal ganglia and cerebral cortex. Neurotransmitters become deficient and unable to modulate movement Autosomal dominant Chromosome four Symptoms 35-55, any age possible

Answer 45

``` Involuntary choreic movements Ataxia with choreoathetoid movements Protrusion of tongue Mod personality change Mental deterioration Depression Dysphasia Incontinence Immobility Rigidity ```

Answer 46

Patches of demyelination of myelin sheaths in brain and SC Decreases efficiency of nerve impulse, plaque develops with eventual impulse failure Slow acting virus causes autoimmune response with genetic and environmental factors 20-35, Any age possible

Answer 47

``` Exacerbations and remissions Visual problems Sensory changes Weakness Ataxia Balance Fatigue ```

Answer 48

``` Autoimmune diease with pathology of nerve impulses to muscle at NMJ Antibodies block or destroy receptors for Ach uptake, preventing muscle contraction. Associated with: Enlarged thymus DM RA Lupus Other autoimmune diseases ```

Answer 49

``` Extreme fatiguability Weakness can fluctuate in minutes or extended period Ocular muscle first 50% have ptosis and diplopia Dysphagia Dysarthria CN weakness "Crisis" - respiratory and swallowing difficulty, labored talking or chewing ```

Answer 50

Pharmacological: Anticholinesterase, plasmapheresis, immunosuppressive therapies PT: Respiratory baseline, pulmonary intervention, energy conservation, isometrics, osteoporosis for long-term corticosteroids

Answer 51

``` Episodic, short duration Autonomic symptoms Precipitating factor Pallor, sweating N/V Auditory fullness (in ears) Tinnitus ```

Answer 52

``` Benign Paroxysmal Positional Vertigo (BPPV) Meniere's Disease Infection Trauma/Tumor Metabolic Disorders (DM) Acute alcohol intoxication ```

Answer 53

``` Autonomic symptoms less severe Loss of consciousness possible Neurological symptoms: Diplopia Hemianopsia Weakness Numbness Ataxia Dysarthria ```

Answer 54

Meningitis Migraine HA Neurological complications post ear infection Trauma/Tumor Cerebellar degeneration disorders (alcoholism) MS

Answer 55

Mild and does not change in severity | Not associated with other pathology

Answer 56

Imbalance of vestibular signals to oculomotor neurons Constant shift in one direction countered by quick in opp direction Acute vestibular lesion lasting 24 hours

Answer 57

Peripheral vestibular lesion | Inhibited with visual fixation on an object

Answer 58

Central lesion of brainstem/cerebellum | Not inhibited with visual fixation on an object

Answer 59

Induced by change in head position | Semicircular canals stimulate nystagmus lasting a few seconds

Answer 60

Induced by eyes shifting from primary to alternate position Result of inability to maintain stable gaze position CNS pathology, associated with brain injury and MS

Answer 61

Unidirectional, fast segment opposite direction of lesion Visual fixation inhibits nystagmus and vertigo Significant vertigo Minutes, days, weeks but finite period of time; recurrent Ménière's disease, vascular disorders, trauma, toxicity, inner ear infection

Answer 62

``` Bi- or unidirectional No inhibition with fixation Mild vertigo May be chronic Demyelination of nerves, vascular lesion, CA/tumor ```

Neuromuscular: Etiology Flashcards

(86 cards)