Parkinsons Disease Flashcards
(71 cards)
1
Q
what does the basal ganglia role in movement and posture?
A
movement scale movement initiation movement preparation identifying one's own body position relative to the environment longer loop postural reflexes perceptual and cognitive
2
Q
what are 4 common BG disorders?
A
Parkinson’s disease
Huntington’s disease
Wilson’s disease
Dystonia
3
Q
what are the typical signs and symptoms of PD?
A
changes in muscle tone decreased movement coordination decreased motor control decreased postural stability presence of extraneous movement
4
Q
True or False
Parkinson’s Disease is the 3rd most common BG disorder?
A
False
it is the most common
5
Q
PD usually affects people _____
A
over 50 yrs
6
Q
True or False
PD is more prevalent in women
A
False
MEN=WOMEN
7
Q
1 in _____ who are 85 years old have PD
A
1 in 3
8
Q
S/S of PD are?
A
rigidity ( leadpipe; cogwheel) bradkinesia micrography masked face postural abnormalities lack of equilibrium reactions resting tremor decreased trunk rotation
9
Q
what kind of postural abnormality is seen in PD?
A
flexed posture
10
Q
_______ of patients with PD fall with a ____% chance of 1 fall per week
A
2/3
10%
11
Q
PD non-motor symptoms (cognitive) include:
A
anxiety and depression bradyphrenia and mild cognitive impairment (MCI) decreased attention easily distracted decreased executive functioning decrease ability of dual tasking decreased organizational ability
12
Q
PD non-motor symptoms (other) include:
A
sleep disturbances bladder urgency and frequency orthostatic hypotension hyposmia pain/paraesthesia
13
Q
what is hyposmia?
A
low energy, hypoglycemia due to not eating, “I can’t taste anything.”
14
Q
secondary problems and complications of PD include?
A
muscle atrophy respiration compromise nutritional changes osteoporosis contracture and deformity decubiti
15
Q
examples of respiratory compromise that affect PD include?
A
Decreased vital capacity
Decreased Chest expansion
Posture
Rigidity
UE posturing
Increased energy consumption
16
Q
what kind of nutritional changes will a person with PD have?
A
Problems with eating, chewing, swallowing
keeping a good appetite
17
Q
Modified Hoehn and Yahr Scale: stage 0 means?
A
no signs of disease
18
Q
Modified Hoehn and Yahr Scale: stage 1 means?
A
unilateral disease
19
Q
Modified Hoehn and Yahr Scale: stage 1.5 means?
A
unilateral disease w/ axial involvement
20
Q
Modified Hoehn and Yahr Scale: stage 2 means?
A
bilateral disease w/o postural instability
21
Q
Modified Hoehn and Yahr Scale: stage 2.5 means?
A
early signs of postural instability
22
Q
Modified Hoehn and Yahr Scale: stage 3 means?
A
bilateral disease with postural instability, physically independent
23
Q
Modified Hoehn and Yahr Scale: stage 4 means?
A
severe disability but still able to strand or walk unassisted
24
Q
Modified Hoehn and Yahr Scale: stage 5 means?
A
confinement to WC or bed
25
how do you test for early signs of postural instability ( 2.5 )
see if patient has recovery on 'pull test'
26
what are the PD treatments?
```
Pharmacological/Medical Management
Surgery
Nutrition
Exercise!
Physical Management of Symptoms
```
27
deep brain stimulation involves a stimulator impacted into the _______ ______
subthalamic nucleus
28
True or False
| Deep brain stimulation is a slower movements and gait deviations respond well
False
| faster movements
29
what is the disadvantage of deep brain stimulation?
low morbidity but significant psychiatric complication concerns (depression/mania)
30
Deep brain stimulation works on PD symptom relief in _______ after the implantation
minutes
31
Deep brain stimulation works on dystonia symptom relief in _______ after the implantation
days to weeks
32
_____ _____ ______ can black the effectiveness of dopamine replacement and it recommended that no more than _____% come from this?
high protein diet
| 15
33
how can you manage your protein so it doesn't affect your motor fluctuations during the day?
intake in the evening
34
True or False
| Longevity and physical activity are related for individuals with PD
True
35
True or false
| There is no link identified between lack of exercise and development of PD
False, there is a link
36
______ exercise is found to reduce PD dysfunction
aerobic exercise
37
what are additional benefits of aerobic exercise for PD pts?
Additional important pulmonary benefits
| Improved QOL with decreased depression, improved mood and initiative
38
what does UPDRS stand for?
Unified Parkinson’s Disease Rating Scale (UPDRS)
39
what is the Unified Parkinson’s Disease Rating Scale (UPDRS)
Comprehensive adult neuro examination
40
PT Evaluation of Medication Effectiveness includes?
“all day evaluation”
Choose 3-5 impairments or functional limitations that are issues for the patient
5-7 minute examinations on the hour and perhaps on the half-hour as well
Consult with MD to discuss “best” and “worst” times
Recommendations made for medication titration
41
describe typical gait for a person with PD
```
decreased velocity
decreased stride length
decreased foot clearance
flat footed progression
decreased arm swing
```
42
what is festination?
Festination: attempt to catch up BOS with COG
43
what is retropulsion?
disorder of locomotion associated especially with Parkinson's disease that is marked by a tendency to walk backwards
44
what triggers Freezing in Gait?
```
sudden direction changes, turning, or pivoting
doorways or thresholds
approaching furniture/obstacles
turning around to sit
change in floor pattern
confined spaces
crowds
stress, anxiety, hurrying
```
45
what triggers retropulsion?
backing up to sit down
reaching overhead
stepping away from sink, counter
opening door
carrying items close to the body in both hands
being approached closely/ suddenly jostled
46
PD rehabilitation includes?
```
Aerobic (forced)
Flexibility (to maintain ROM)
Strengthening
Rhythmic exercise
Mambo
Tai chi
Functional activity
Pushing complexity
Gait and balance
Decrease fall risk
Changing task & environmental contexts
```
47
what is the leading cause of death in person with PD?
Pneumonia
48
how can respiratory management be addressed with pts with PD?
early aggressive aerobic exercise
| maintain regular moderate exercise as disease progresses
49
an example of an exercise that is Forced, Not Voluntary, and Improves Motor Function in PD Patients
is?
Tandem Cycling
50
goals for early phase PD ( 1-2.5)
Prevent inactivity
Prevent fear of falling
Improve physical capacity
51
goals of mid phase PD ( 2-4)
```
same as early phase plus maintain or improve:
Transfers
Body posture
Reaching and grasping
Balance
Gait
```
52
goals for late phase ( 5 ) include?
same mid phase plus:
Maintain vital functions
Prevent pressure sores
Prevent contractures
53
what are two examples of Parkinson Plus Syndromes:
Progressive supranuclear palsy (PSP)
| Multiple system atrophy (MSA)
54
what is Progressive supranuclear palsy (PSP)
Similar to PD
More cognitive impairment
Progression more rapid
Does not respond to L-dopa
55
what is Multiple system atrophy (MSA)?
Cortical, BG and cerebellar
Frontal lobe and autonomic dysfunction
Does not respond to L-dopa
56
what is a classic order resulting in hyperactivity of the basal ganglia?
Huntington's Disease
57
True or False
| Huntington is an autosomal recessive trait
False
| autosomal dominant trait
58
S/S of Huntington Disease include?
```
Abnormalities in postural reactions
Decreased trunk rotation
Abnormal tone
Extraneous movements
They exhibit too much movement
```
59
Wilson's disease AKA?
hepatolenticular degeneration
60
what causes wilson's disease?
caused by abnormal copper metabolism that lead to toxic copper levels and degeneration of liver and BG
61
True or False
| if wilson's disease is recognized and properly treated, then the pt functions w/o restrictions
true
62
what is Tardive Dyskinesia?
Drug-induced disorder
Dyskinesia = inability to perform voluntary movement
Series of rhythmical extraneous movements
Associated with extension of spine/trunk
63
what is dystonia?
Movement disorder characterized by sustained muscle contraction in the extreme end range of a movement, frequently with a rotational component.
64
dystonia can be _____ or ______
generalized or focal
65
generalized dystonia is usually ________ and it most prevalent in those with ____ ____ _____
inherited
| European Jewish Descent
66
focal dystonia is usually related to _________ movement produce under high cognitive ______ and ______
repetitive
| constraints and attention
67
what is the most common focal dystonia?
spasmodic torticollis
68
other example of focal dystonia include:
vocal folds, tongue, facial muscles, hand, toes
69
how is dystonia managed?
Botox
| Rehab
70
True or False?
In all cases, excessive co-activation of agonists and antagonists occurs that interferes with timing, execution, and loss of independent joint movements
true
71
true or false
| With dystonia, there is generally abnormal tone or abnormal reflexes
There is generally NO abnormal tone or abnormal reflexes
