Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
24 Cards in this Set
- Front
- Back
|
What are the 4 caridnal signs of PD?
|
Postural instability
Resting tremor Bradykinesia Rigidity |
|
|
What are some (5) non-motor signs that can result from PD?
|
Cognition can decrease, fatigue, pain, depression, motivation can decrease
|
|
|
Are men or women more likely to get PD?
|
men (2x> chance)
|
|
|
What are 2 atypical parkinsonian syndromes?
|
Progressive supranuclear palsy (PSP)- can't look down, severe postural control problems, stiff spine, don't respond to L-dopa
Multiple systems atrophy( MSA)- autonomic effects, cerebellar symptoms |
|
|
How is postural instability assessed?
|
posterior pull test
|
|
|
How is bradykinesia assessed?
|
with hands in front, open and close hands as quickly as possible
|
|
|
What are 3 main causes of pain in PD?
|
musculoskeletal
neuropathic dystonic posturing |
|
|
How is PD clinically diagnosed?
|
Has bradykinesia and one or more of the other cardinal signs
Will respond to L-dopa |
|
|
What are the 5 stages of Hoehn and Yahr?
|
1. unilateral
2. bilateral 3. bilateral with some postural instability, still functioning in community 4. Severe disability, walks independently 5. w/c dependent, bedridden unless assisted |
|
|
What is the UPDRS? what do scores under 20 signify, greater than 30-40?
|
Unified Parkinson's Disease Rating Scale
<20- difficulty, but no loss of independence 30-40- loss of independence |
|
|
What are the 2 types of Parkinson's in terms of how they firs present? What are their implications?
|
Postural instability and gait disorder (PIGD)- greater instability and gait problems, more likely to have cognitive decline, decline quicker
Tremor predominant- tremor as an initial symptom, better prognosis, slower decline |
|
|
What are the 3 main options for medical management of PD?
|
Increase dopamine production
Decrease dopamine breakdown Increase dopamine receptors |
|
|
How is dopamine production increased medically?
|
L-Dopa
|
|
|
How is dopamine prevented from being broken down medically? (2 ways)
|
MAO inhibitor (i.e. selegiline)
COMT inhibitor (i.e. entacapone) |
|
|
How is dopamine receptors increased?
|
Dopamine agonists (i.e. pergolide)
|
|
|
What is the traditional progression in which dopamine medications are given to patients with PD ?
|
Dopamine agonists --> Dopamine breakdown inhibitors --> L-dopa
|
|
|
What are the medications amantadine and artane used for respectively?
|
Amantadine- helps with positive motor symptoms due to L-dope meds
Artane- usefulr for resting tremor |
|
|
When is deep brain stimulation used in individuals with PD?
|
Later in stages when dyskinisias become highly disabling
H&Y stages 2-4 Does not solve problems with postural instability Not used in those showing signs of cognitive decline |
|
|
What does loss of automaticity refer to in individuals with PD?
|
There motor planning looses its intuitive nature.
i.e. not taking a step towards a cabinet when reaching i.e. keeping a forward head in supine up off of the table |
|
|
What is the Continuous Scale Physical Functional Performance?
|
test and measure to look at how one fatigues after multiple tasks are performed
|
|
|
What are some effective ways to bypass the basal ganglia?
|
auditory, visual and somatosensory cures
|
|
|
What is the best way to increase someone's gait speed?
|
Rhythmic auditory stimulation (RAS), increase natural cadence by 10% each time up to 112 steps/minute (normal)
|
|
|
Why is it concerning that people with PD are difficult to muscularly fatigue?
|
because the activation deficits may indicate that they are not recruiting all of their fibers --> how can you hypertrophy a muscle if you can't fatigue it?
|
|
|
Is loss of endurance a primary or secondary impairment?
|
unknown, what is known is that they have a higher VO2 (energy expenditure) at a given gait speed
|
