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33 Cards in this Set

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  • Back
List four tremor types.
Parkinsonian
Familial-essential
Hyperadrenergic
Cerebellar
Parkinsonian Tremor
- Setting
- Frequency
- Location
- Other signs
Rest > Postural >> Intention

Slow > Fast ( < 6/sec )

Distal > Proximal

Bradykinesia, Rigidity
Familial-essential tremor
- Setting
- Frequency
- Location
- Other
Intentional = Postural >> Resting

Fast > Slow ( > 6/sec )

Proximal > Distal

FH, EtOH, and may improve
Caused by stress
Hyperadrenergic tremors
- Settings
- Frequency
- Location
- Other
Intentional = Postural >> resting

Fast > Slow ( > 6/sec )

Proximal > Distal

Stress/anxiety, adrenergic drugs, drug-withdrawal states, Hypoglycemia, Hyperthyroidism
Cerebellar
- Setting
- Frequency
- Location
- Other
Intentional >> Postural

Slow, but
Greater in Amplitude as it nears target

Proximal > Distal

Ataxia, nystagmus
Who is da MAN?
Young! Young! Young! Young! Young!
Define akinesia
The absence of voluntary movement or slow initiation of movement.
Define bradykinesia
Reduction in amplitude and velocity of voluntary movement
Define rigidity.
Increased tone through ROM
Describe the physiological mechanism behind hyperkinesia.
Excitation of thalamocortical activity

from greater activity in direct pathway
Describe the physiological mechanism behind hypokinesia.
Inhibition of the thalamocoritcal activity

from greater activity in indirect pathway.
Define Hemiballismus.
Involuntary, violent movement of CONTRALATERAL limbs (proximal)
A lesion of the subthalamic nucleus would lead to what movement disorder?
Hemiballismus
Define Chorea
Rapid, coarse, random, semipurposeful nonrhythmic movements of extremities, face and trunk.
Define Athetosis
Slower, coarse irregular and nonrhythmic writhing or wavering movements.

Snake like
Define akathitic movements
Restless movements with inner feeling of restlessness
Classic Triad of Parkinson's.
Tremor at rest
Rigidity
Akinesia/Bradykinesia
Postural/gait disorder
Early signs of Parkinson's when there is no tremor. x6
Fatigue, malaise
Weakness
Mild incoordination
Difficulty writing
Muscle pain
Depression
What is the hallmark pathological feature of Parkinson's? x2
Loss of substantia nigra pars compacta

Loss of Lewy bodies
What does F-DOPA PET imaging show us?
The rate of decarboxylation of F-DOPA to F-dopamine

and

its storage in dopamine nerve terminals
In PD, what effects can be worsened by dopaminergic treatment? x4
Dementia
Sleep
Delusions
Hallucinations
List the mutations associated with Parkinson's. x3
1. Alpha Synuclein

2. Parkin

3. Ubiquitin hydrolase
Describe the mechanism associated with the genetic mutation etiology of PD.
Alpha Synuclein is typically ubiquinated, but the mutation doesn't allow it to occur.

Thus accumulation.
What are the drugs used to increase dopamine transmission?
1. Levadopa

2. Dopamine receptor agonist

3. MAO B and COMT inhibitors
(block dopamine breakdown)
What are some "tip offs" that your Parkinson's patient really has Parkinson's Plus. x4
Poor response to levodopa
Ophthalmoplegia
Early orthostatic hypotension
Tremor is less common
What is the classic triad of HD?

When is it usually onset?
Dementia
Involuntary movements
Psychiatric disturbance

onset in 4th to 5th decade
What is the most common HD involuntary movement?
Choreoathetosis
Wilson's disease is a metabolic disorder of what?
Copper
What is the inheritance of Wilson's disease?
AR
What is the inheritance of HD?
AD
What are the clinical manifestations of Wilson's disease? x4
Dementia
Involuntary movement
Personality changes

Cirrhosis of liver
Kayser-Fleischer rings
Treatment of Wilson's disease. x2
Penicillamine

Low copper diet
What is the most common dystonia and what are the symptoms x2?
Spasmodic Torticollis

Wry neck
Cervical dystonia