Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Neuro Rehab > Parkinson's > Flashcards

Parkinson's Flashcards

(96 cards)

Start Studying
1
Q

explain the incidence of parkinsons

A

2nd most common
men 1.2-5x more likely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

average age of onset of PD

A

50-60 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is parkinsonism

A

umbrella term used to describe bradykinetic syndromes that disturb the dopamine systems of basal ganglia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what exactly causes PD

A

don’t exactly know
genetic and environmental causes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what environmental factors can cause parkinsons

A

chemicals
- occupational exposure / pesticides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what produces dopamine

A

substantia nigra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the most common form of PD

A

idiopathic PD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the subtypes of idiopathic PD

A

postural instability gait disorder
tremor dominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what can cause idiopathic PD

A

unknown things
gene mutation
substantia nigra degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what can cause secondary PD

A

drug induced
hydrocephalus
infections
toxins
trauma
tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what toxins are listed specific to secondary PD

A

CO
pesticides
manganese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the forms of atypical parkinsons that cognitive dysfunction is seen in

A

alzheimers
fronto-temporal dementia
lewy body disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what can be observed in an individual with cerebellar ataxia compared to PD

A

atax - wider base of support (drunk walking)

PD - small BOS and less mvmt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the main difference between idiopathic PD and atypical PD

A

bradykinetic mvmts are due to other neurodegenerative disease in atypical

– will have s/s that are not associated with idio PD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

lack of dopamine production affects the

A

motor and non motor loops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is dopamine responsible for

A

producing smooth purposeful movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

where does dopamine bind

A

caudate and putamen of striatum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

when PD is diagnosed, explain the status of cells in the basal ganglia as well as dopamine receptors

A

50-60% cell death
70-80% loss of dopamine receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

relation between symptoms and diagnosis of PD

A

symptoms typically precede diagnosis by 5-6 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what non-motor loops can be damaged by PD

A

visual and emotional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the mean duration of PD and how does that affect life expectancy?

A

10-20 years

– people diagnosed typically live close to normal expectancy due to later age of diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what typically causes mortality in those with PD

A

CVD disease
pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how is the rate of progression in idiopathic PD described

A

variability
– PIGD is seen to have faster progression as well as neurobehavioral disturbances/dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how is PD classified

A

hoehn - yahr classification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what does the hoehn yahr classification tell us
estimation of stage and severity via motor signs and elements of functional status
26
Hoehn-Yahr 1
minimal / absent disability unilateral disability
27
Hoehn-Yahr 2
minimal bilateral/midline involvement balance in tact
28
Hoehn-Yahr 3
impaired righting reflexes unsteadiness turning/standing from seated can live independently / continue forms of employment
29
Hoehn-Yahr 4
all symptoms present and severe standing / walking only possible with assistance
30
Hoehn-Yahr 5
confined to bed/WC
31
what would intervention look like in Hoehn-Yahr 1
education with a possible maintenance exercise program
32
what could intervention look like in Hoehn-Yahr 2
may need DME exercise plan
33
at what stage of the Hoehn-Yahr classifications does PT become absolutely necessary
3 and on
34
what is the gold standard of measuring PD progression
unified parkinson's disease rating scale
35
how long does the UPDRS take to be administer? what can it be used for / what does it include
30 min provide evidence of impairments outside of PT scope Hoehn-Yahr stages
36
what are the motor signs associated with PD
weakness apraxia bradykinesia akinesia rigidity postural instability gait abnormalities
37
explain weakness seen in PD? is it motor neuron weakness?
not UMN weakness, instead weakness due to disuse and rigidity of muscle
38
what's apraxia in PD due to
difficulty with automatic and voluntary movements directed through the pyramidal system
39
why is postural instability very important to address
those with PD are 2x more likely to fall
40
what gait abnormalities are seen in PD
festination trouble initiating/terminating no arm swing no trunk rotation shortened step length
41
what outcome measures can be used to assess PD patients
MCTSIB Stand and Reach
42
what is a typical presentation of akinesia in those with PD
mask-like facial expression
43
what is the definition of rigidity
equal resistance in agonists / antagonists
44
what is the symptom reported of rigidity
heaviness and stiffness in limb
45
explain rigidity in relation to progression of PD
starts proximally in shoulders and neck and moves distally as progression occurs
46
how is LOS affected by PD
reduced, more so forward than backward directions
47
how do those with PD respond to perturbations
not well -- will not use postural control strategies due to abnormal coactivation of musculature / poor sensorimotor integration
48
how does dual tasking affect postural control in those with PD
worsens
49
why may a patient with PD experience dysphagia or dysarthria
rigidity in musculature leading to reduced ROM - can cause speech disorders
50
what are non motor clinical signs of PD
depression anxiety apathy _________ dysfunction cognitive autonomic olfactory visual / visuospatial perception vestibular auditory
51
what is sialorrhea
excessive drooling
52
what can lead to dementia in those with PD
depression
53
what autonomic dysfunction can be seen in those with PD
hypotension bowel/bladder blurry vision dyspnea orthostatic hypotension
54
how is visual and visuospatial perception dysfunction observed in those with PD
impaired postural control abnormal vestibulospinal reflexes impaired sensory integration
55
what is the pharmacological agent that is used to treat PD
levadopa/carbidopa (sinemet)
56
what is levodopa/carbidopa
gold standard for dopamine replacement
57
what is something to keep in mind when working with those on levadopa/carbidopa
needs to be on a fixed schedule & on and off times when the drug is active -- want to do PT with patient when they are "on"
58
how long after dosage does "on time" begin on levodopa/carbidopa
20-60 min
59
side effects of levodopa/carbidopa
hypotension nausea dry mouth dizziness fluctuations dyskinesia during "off times"
60
what do dopamine agonists do
stimulate dopamine receptors in basal ganglia
61
what is deep brain stimulation
multi-electrode leads implanted into thalamus
62
where is deep brain stimulation implanted
subthalamic nucleus globus palladis internus
63
what is deep brain stimulation effective for? what are the side effects
advanced PD depression, paresthesia, paresis, loss of balance, dystonia
64
what are the cardinal signs of PD? what qualifies a diagnosis
rigidity resting tremor bradykinesia postural instability 3 or more
65
how would an exam look in those with PD
cognitive screen msk screen cardiopulm screen movement analysis postural control assessment
66
what can be used to assess cognition
MMSE MOCA geriatric depression scale
67
what posture is seen typically in those with PD? how could that affect MSK screen?
flexed / stooped - kyphotic limit shoulder, spine and hip ROM
68
what is common pain wise in those with PD? why?
low back and neck pain postural abnormalities
69
what could indicate PD via cardiopulmonary screen
orthostatic hypotension
70
what outcome measures can be used to test cardiopulmonary system
2/6 MWT
71
what is looked at during movement analysis
if movements are bradykinetic if the tremor affects ADLs gait abnormalities UE function
72
what is used to test UE function
9 hold peg test
73
what is the most recommended postural control assessment in PD populations
miniBEST test
74
downward gaze palsy during neuro exam would indicate
progressive supranuclear palsy
75
what symptoms may mimic PD but are instead atypical parkinsonism
freezing of gait and/or frequent falls early in the disease
76
what would a patient present with that would cause one to think normal pressure hydrocephalus vs parkinson
urinary incontinence freezing of gait cognitive impairment (wet wobbly wacky)
77
what H&Y stage of PD is freezing of gait typically seen
3 into the late stages
78
what typically causes normal hydrocephalus
older adults that have brain tissue atrophy and CSF is allowed to build up in the ventricles over time
79
explain the difference between the current model of PD rehab and potential model
rehabilitation typically occurs once disability or acute events occur -- can be too late in the progression to really slow it down, more reactive than proactive
80
when physical therapy is applied early in progression, what is each interval of care assessed by
progression of disease and its effect on mobility, ADLs and quality of life
81
what H-Y classification is associated with early PD rehab? what is focused on intervention wise
1 restorative and preventative intervention strategies
82
what H-Y classification is associated with middle PD rehab? what is focused on intervention wise
2-4 restorative and preventative intervention (may be some compensatory)
83
what H-Y classification is associated with late PD rehab? what is focused on intervention wise
5 preventative and compensatory
84
what is under the physical capacity umbrella in PD rehab
exercise tolerance flexibility strength (power)
85
what manual activities are focused on in PD rehab
UE reach dexterity
86
what transfers are focused on during PD rehab
sit to/from stand in/out bed turning over
86
additional areas to be focused on during PD rehab
pain management respiratory function education
87
CPG guidelines suggest
aerobic exercise resistance training balance training external cueing community based exercise gait training task specific training
88
what is the recommended level of aerobic exercise
moderate to high 60-75% max HR
89
what is important to monitor during aerobic exercise?
vitals, RPE, exertional intolerance
90
what can long term L-dopa administration produce
arrhythmias orthostatic hypotension
91
does the mode of resistance training make a significant difference in those with PD
no - machines may be safer than free weights / may be easier to do body weight or bands
92
recommended dosage of resistance training in PD patients
2 days per week
93
what is recommended during gait training - dosage - cueing - progressions
high repetition block practice external cues (visual and auditory) varying directions/obstacle courses
94
how is freezing gait solve
reset clock weight shifts
95
what is the focus on during gait training, in relation to automatic and intentional tasks
move from automatic tasks (cant do due to extrapyramidal system damage) and toward intentional tasks

Neuro Rehab (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions