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Neurologic PT > Parkinson's Disease > Flashcards

Parkinson's Disease Flashcards

1
Q

The diagnosis of PD is entirely based on ______ and ______.

A

History

Physical Examination

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2
Q

List 4 signs and symptoms associated with PD.

A
  1. Resting tremor
  2. Bradykinesia/Akinesia
  3. Rigidity
  4. Festinating gait handwriting or speech
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3
Q

PD is caused by the degeneration of the ________.

A

Substantia nigra

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4
Q

A diagnosis of PD is further confirmed by a patient’s positive response to ________.

A

Dopamanergics

Patient experiences a decrease in symptoms when placed on drugs, such as L Dopa, further confirming the diagnosis of PD.

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5
Q

What are 2 differential diagnoses that are characterized by a poor response to Levodopa?

A
  1. Multiple Systems Atrophy

2. Progressive Supranuclear Palsy

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6
Q

Multiple systems atrophy results in ________ abnormalities such as ______ and _______.

A

ANS abnormalities
Hypotension
Tachycardia

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7
Q

Multiple Systems Atrophy is caused by the accumulation of the protein ______ in the ______ cells.

A

Accumulation of the protein ALPHA SYNUCLEIN in the GLIAL cells

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8
Q

List 4 symptoms of progressive supranuclear palsy.

A
  1. Rigidity
  2. Bradykinesia
  3. Oculomotor impairments
  4. Depression
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9
Q

Progressive supranuclear Palsy is caused by _____ protein accumulation in the ______.

A

Tau protein accumulation

Brain stem

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10
Q

_______ and ________ are 2 common types of tremors seen in patients with PD.

A

Resting tremor (affecting hands and feet)

Pill rolling tremor (affecting the fingers)

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11
Q

What is bradykinesia? (2)

A
  1. Slowness of movement

2. Reduction in movement amplitude

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12
Q

What is rigidity? What type of rigidity is commonly seen in patients with PD?

A
  1. Increase in muscle tone that causes resistance to passive movement
  2. Cog wheeling type
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13
Q

Describe the postural instability often seen in patients with PD.

A

Stooped forward posture with decreased postural control

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14
Q

List 7 CONTINUOUS gait disorders seen in patients with PD.

A
  1. Reduce speed
  2. Reduce stride length
  3. Decrease arm swing
  4. Decrease single support
  5. Increase double support
  6. Increase cadence
  7. Gait shuffling
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15
Q

List 2 EPISODIC gait disorders common in patients with PD.

A
  1. Freezing of gait: gait is halted and the patient complains that his/her feet are glued to the ground.
  2. Festinating gait: short, jerky steps, COM in front of BOS
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16
Q

What is the most common neuropsychiatric disorder affecting patients with PD?

A

Cognitive decline

17
Q

List 5 neuropsychiatric disorders commonly affecting patients with PD.

A
  1. Cognitive decline (84%)
  2. Dementia (48%)
  3. Daytime sleepiness (79%)
  4. Depression (50%)
  5. Hallucinations (21%)
18
Q

81% of patients with PD report experiencing _____.

A

FALLS

19
Q

List 4 additional signs and symptoms associated with PD.

A
  1. Tented hands
  2. Micrographia
  3. Masked face
  4. Paucity of speech
20
Q

______ agents are used to medically manage PD. What are the effects of the agents in the first few years vs after several years of use?

A

Dopaminergic agents

First several years = sxs improved with limited side effects

After several years = on and off state; dyskinesias

21
Q

Describe one surgical treatment used to treat PD.

A

Deep brain stimulation

Implantation of electrodes inside the sub-thalamus connected to pacemakers implanted under the skin

22
Q

List 2 types of destructive surgeries used to treat PD.

A

Palliodotomy: Thermocoagulation at the globus pallidus

Thalamotomy

23
Q

List 2 rating scales used for the evaluation of motor impairments and disability in patients with PD.

A
  1. Hoehn and Yahr Staging

2. Unified Parkinson’s Disease Rating Scale (UPDRS)

24
Q

List the 7 stages that make up the Hoehn and Yahr Scale.

A
  1. Unilateral involvement only
    1.5 Unilateral and axial involvement
    2 Bilateral involvement without impairment of balance
    2.5 Mild Bilateral Disease with recovery on pull test
    3 Mild to moderate bilateral disease; some posture instability; physical independent
    4 Severe disability; still able to walk or stand unassisted
    5 W/C bound or bedridden unless aided
25
Q

List 6 general PT interventions used to manage PD.

A
  1. PROM/AROM (axial mobility)
  2. Posture/Alignment
  3. Strength
  4. Larger scale movement
  5. Relaxation
  6. Breathing Exercise/Airway Clearance
26
Q

List 5 PT interventions used to treat postural instability and falls in patients with PD.

A
  1. Balance reactions
  2. Increase limits of stability
  3. Activate vestibular responses (galvanic vestibular stimulation)
  4. Dual tasking (walking + cognitive)
  5. Strength Training
27
Q

List 4 PT interventions used to improve gait in patients with Parkinson’s Disease.

A
  1. Treadmill
  2. Obstacle Course
  3. Changing directions/turns
  4. Dual task

Neurologic PT (11 decks)

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