Pathophys - Test Iii - Cns Pathophysiology

Front 1

the basal ganglia is

Back 1

a collection of nuclei found on both sides of the thalamus

Front 2

the basal ganglia is connected with

Back 2

the cerebral cortex, thalamus, brainstem, and cerebellum

Front 3

the basal ganglia is associated with what functions

Back 3

motor control, emotion, cognition, learning

Front 4

subdivisions of the basal ganglia include

Back 4

putnum, caudate nucleus, pallidus, subthalmic nucleus, substantia nigra

Front 5

many neuro disorders arise because of

Back 5

neurotransmitter disorders of the basal ganglia (very general statement)

Front 6

gayle thinks of the thalamus as

Back 6

a relay station to the rest of the brain

Front 7

the cerebral cortex is

Back 7

the outer grey matter of the brain - especially the motor and somato sensory cortex

Front 8

parkinson's disease is a lack of which neurotransmitter

Back 8

dopamine

Front 9

parkinson's disease is too much of which neurotransmitter

Back 9

acetylcholine

Front 10

cause of parkinson's disease

Back 10

unknown

Front 11

Parkinson's disease occurs in

Back 11

the substantia nigra

Front 12

why is the substantia nigra named thus

Back 12

dopamine is a darkly colored neurotransmitter and the substantia nigra has a large concentration of dopamine

Front 13

the substantia nigras funtion is

Back 13

to control the rate of fire in the extrapyramidal motor system which coordinates movements. dopamine plays an inhibitory role here

Front 14

types of movements controlled by the substantia nigra

Back 14

postural control, reflexes, locomotion, complex movements

Front 15

the extrapyramidal motor system is modulated by what brain parts

Back 15

substantia nigra, vestibular system, cerebellum, some parts of the sensory cortex

Front 16

dopamine depletion of Parkinson's disease causes

Back 16

uninhibited excitatory acetylcholine affects on the extrpyramidal motor system

Front 17

what is the most important risk factor for development of Parkinson's disease

Back 17

age - most people develop it between 50 and 70 years of age

Front 18

symptoms of Parkinson's disease

Back 18

TRAP
tremors
rigidity
akinesia
postural disturbances

Front 19

the classic triad of Parkinson's disease

Back 19

tremors, rigidity, akinesia

Front 20

characteristics of tremors associated with Parkinson's disease

Back 20

worsens with rest and improves with voluntary motor movement, slow hertz

Front 21

describe rigidity associated with Parkinson's disease

Back 21

appears first in the proximal skeletal muscles of the neck

Front 22

akinesia means

Back 22

difficulty initiating and maintaining motion

Front 23

earlies manifestation of akinesia with Parkinson's disease is

Back 23

loss of normal arm swing while walking or failure to rotate the head when the body rotates

Front 24

symptoms of worsening akinesia associated with Parkinson's disease

Back 24

facial immobility as a loss of blinking and slowness of emotional response
shuffling gait and gait freeze

Front 25

slowness to execute a movement is aka

Back 25

bradykinesia

Front 26

4th and 5th symptoms associated with Parkinson's disease

Back 26

postural instability (cause of OR visits) and Emotional disturbances

Front 27

types of emotional disturbances associated with Parkinson's disease

Back 27

insomnia, depression, memory loss, hallucinations and dementia

Front 28

treatment of Parkinson's disease is designed to

Back 28

increases amount of dopamine in the substantia nigra or to inhibit acetylcholine

Front 29

treatment of Parkinson's disease include

Back 29

levodopa (L-dopa) and anticholinergic drugs
MAOI, COMT inhibitors
symptom management
surgical management

Front 30

surgical management of Parkinson's disease includes

Back 30

implantation of electrical devices similar to pacemakers that can control shakes

Front 31

how do MAOIs affect Parkinson's disease

Back 31

inhibits enzyme that breaks down dopamine

Front 32

problem with just giving oral dopamine to treat Parkinson's disease

Back 32

gets broken down by peripheral system and cannot get through the BBB - so give L-DOPA instead

Front 33

examples of anticholinergics

Back 33

atropine
glycopyrrolate
symbicort??

Front 34

a problem with many of the drugs given for Parkinson's disease is

Back 34

hemodynamic issues

Front 35

half life of levodopa

Back 35

6 hours

Front 36

anesthetic management of Parkinson's disease

Back 36

1. continue parkinson's drugs up to surgery and levodopa throughout surgery
2. avoid antidopaminergics
3. anticholinergics and antihistamines are useful
4. pts on levodopa may be hypo or hypertensive
5. autonomic instability
6. potassium increase with succs

Front 37

what should you remember about patients on levodopa in surgery

Back 37

keep on levodopa schedule, abrupt withdrawl will worsen muscle rigidity and interfere with ventilation

Front 38

examples of antidopaminergic drugs

Back 38

phenergan, haldo, droperidol, reglan

Front 39

what drug can you use for pts with Parkinson's disease

Back 39

zofran

Front 40

what are good drugs to use for pts with Parkinson's disease

Back 40

benadryl is useful as premedication sedation and antiemetic effect
also use atropine

Front 41

Parkinson's disease causes autonomic instability so consider

Back 41

placing an art line

Front 42

which pts with Parkinson's disease should you avoid succs

Back 42

those who are not still mobile

Front 43

direct acting drugs

Back 43

epi and phenylephrine