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Neuro 2 - Exam 2 > Parkinsons - 1 > Flashcards

Parkinsons - 1 Flashcards

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1
Q

second most common neurogenerative disorder

A

parkinson’s

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2
Q

what is parkinsons

A

disorder of the basal ganglia fxn

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3
Q

cardinal signs of parkinsons

A

tremor

rigidity

akinesia (bradykinesia)

postural instability

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4
Q

parkinson’s is not only a

A

movement disorder

has non-motor symptoms

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5
Q

non-motor symptoms

A

cognitive dysfxn

dementia

depression

pain

fatigue

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6
Q

progressions of parkinson are

A

highly variable

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7
Q

highly variable

A

some have PD for 20-30 yrs w/ only mild limitations

others become severely disabled w/in 5-10 yrs

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8
Q

who are more affected by PD

A

men more commonly than women

3:2 ration

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9
Q

ethnic groups that’re affected

A

all groups

lower prevalence among black and asian individuals

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10
Q

mean age of onset

A

early to mid 60s

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11
Q

what has there been a recent surge of

A

young onset PD occurring in 5-10% of class

generally diagnosed b/w 21 and 40

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12
Q

what is there a loss of

A

dopamine producing cells in the substantia nigra of the midbrain

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13
Q

where is the site of action of the NT loss

A

in the basal ganglia

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14
Q

how is dopamine normally transmitted

A

by way of nigrostriatal neurons from the brainstem to the BG

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15
Q

what is dopamine needed for

A

normal activation patterns of the BG and thalamus

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16
Q

what does inadequate dopamine lead to

A

substantial consequences for initiation and speed of movement

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17
Q

progressive loss of nigrostriatal neurons is accompanied by

A

increase in glial cells in the substantial nigra

loss of neuromelanin

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18
Q

what do surviving neurons have

A

presence of lewy bodies

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19
Q

where are ley bodies identified

A

cortex

amygdala

locus ceruleus

valgal nucleus

peripheral autonomic nervous system

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20
Q

what do lewy bodies in the non-motor areas account for

A

non-motor symptoms associated w/ PD

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21
Q

sxs of PD origin

A

neurochemical

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22
Q

what loses its ability to produce dopamine

A

substantia nigra

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23
Q

how much may dopamine be depleted

A

up to 80% before sxs seen

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24
Q

what can compensate for loss of dopamine

A

remaining dopaminergic cells

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25
loss of dopaminergic system
disinhibition of the cholinergic system
26
what does excessive cholinergic activity lead to
tremor rigidity
27
loss of dopamine leads to
akinesia bradykinesia
28
movement disorders
neurological conditions that affect speed, fluency, quality and ease of movement
29
most common movement disorders
parkinsonism HD
30
other examples of movement disorders (1)
ataxia dystonia myoclonus restless leg syndrome
31
other examples of movement disorders (2)
tics tourette's syndrome tremor wilson's dz
32
parkinsonism
group of disorders producing abnormalities in the BG
33
PD
idiopathic parkinsonism unknown etiology
34
secondary parkinsonism
d/t identifiable causes
35
atypical parkinsonism
parkinson-plus syndromes d/y neurogenerative disorders
36
secondary parkinsonism causes (1)
drug induced toxin induced metabolic
37
secondary parkinsonism causes (2)
structural lesions hydrocephalus infections
38
structural lesions --> secondary parkinsonism causes (2)
vascular parkinsonism
39
onset and progression course --> atypical parkinsonism
abrupt onset rapidly progressive
40
atypical parkinsonism is
early onset of or rapidly progressing dementia
41
impairments --> atypical parkinsonism
more symmetrical axial early gait/balance impairments
42
signs --> atypical parkinsonism
upward/downward gaze palsy UMN & Cb signs urinary incontinence
43
UMN & Cb signs --> atypical parkinsonism
dysmetria and ataxia
44
postural --> atypical parkinsonism
early symptomatic postural hypotension early postural instability
45
unresponsive to --> atypical parkinsonism
L - Dopa
46
atypical parkinsonism includes
progressive supranuclear palsy cortical basal ganglia degeneration multiple system atrophy
47
progressive supranuclear palsy (PSP)
upright posture frequent falls pseudobulbar emotionality furrowed brow/stare
48
supranuclear palsy --> progressive supranuclear palsy (PSP)
difficulty looking up/down
49
cortical basal ganglia degeneration (CBGD)
unilateral course tremor limb apraxia, dystonia
50
multiple system atrophy (MSA)
shy drager syndrome
51
shy drager syndrome -->multiple system atrophy (MSA)
autonomic deficiency orthostasis impotence
52
incidence --> atypical parkinsonism
60-120/100,000
53
occurs in --> atypical parkinsonism
1% of the population over 55 yo
54
increases to --> atypical parkinsonism
2.6% by 85 yo
55
how many cases develop before the age of 40 --> atypical parkinsonism
10% young onset PD often familial
56
cases that may be undiagnosed --> atypical parkinsonism
40% at any given time
57
etiology --> idiopathic PD
remains unknown
58
RFs --> idiopathic PD
environmental toxin exposure family history and genetic predisposition head trauma
59
environmental toxin exposure -->RFs --> idiopathic PD
pesticides or herbicides
60
family history & genetic predisposition -->RFs --> idiopathic PD
(+) family history parkin gene
61
parkin gene
leads to early onset PD begins ~ age 40
62
head trauma -->RFs --> idiopathic PD
3z8x higher risk for PD
63
factors that reduce risk --> idiopathic PD
cigarette smoking caffeine consumption
64
parts of the BG
caudate putamen globus pallidus subthalmamic nucleus substantia nigra
65
dz progression is
unilateral to bilateral appendicular to axial
66
as dz progresses, there is an increase in (1)
akinetic rigidity postural, balance and gait disturbances motor initiation difficulty
67
motor initiation difficulty
freezing
68
as dz progresses, there is an increase in (2)
speech, swallowing, drooling problems non-motor symptoms medications S/E, complications
69
reduction in --> dz progression
medication efficacy

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