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26 Cards in this Set
- Front
- Back
What is the TRAP signs for parkinsonism?
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-Tremor at rest
-Rigidity -Akinesia (or bradykinesia) -Postural instability |
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T or F:
Parkinsonism affects proximal muscles early and spreads to face and extremities? |
TRUE
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_______________ is a jerky, ratchetlike resistance to passive movement as muscles alternately tense and relax.
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COGWHEEL
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____________ is a slowed or difficulty maintaining movement?
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-Bradykinesia
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What is the inability to initiate movement?
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-Akinesia
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__________________ is one of the most common signs present at initial diagnosis
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Resting tremors
"pill-rolling" |
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Which type of falls are very common with parkinsonism and why?
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-Forward Falls
-Rapid, festinating gait in combination with a stooped posture leads to forward falls. |
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What are a few other common motor signs with parkinsonism?
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-Masked face
-Micrographia -Slowing of ADLs -Stooped, shuffling gait -Decreased arm swing when walking -Hypophonia -Swallowing and chewing difficulty |
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Parkinsonism from strokes, toxins, trauma (boxing), infections (encephalitis, HIV), metabolic abnormalities (hypo- or hyper- thyroidism or parathyroidism, liver failure), drug-induced is known as?
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Secondary parkinsonism
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What is the most common parkinson-plus syndrome?
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-Progressive Supranuclear Palsy
Symptoms include: postural instability leading to falls within first year of disease onset; supranuclear ophthalmoplegia: vertical gaze paresis, especially in the downward direction. |
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What is the key sign you see with Progressive Supranuclear Palsy?
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-VERTICAL GAZE PALSY
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Which part of the brain is the Substantia Nigra Pars Compacta located?
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-MIDBRAIN
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Symptoms of Parkinson begin with Lewy Bodies reach/affect _______?
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Midbrain, specifically the substantia nigra pars compacta
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NORMAL ACTIVITY
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-Normally the D1 and D2 are balanced as shown, and we are able to both initiate wanted movements (D1) and inhibit unwanted movements (D2)
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PARKINSON ACTIVITY
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1a) Direct path gets less excitation:
1b) Inderect gets less inhibition 2) Causing increase unwanted movements (cant inhibit) 3) Causing increase difficulty with wanted movements (due to less excitation) 4) |
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The causes direct excitation:
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D1
-This allows us to choose and perform motion |
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This causes direct inhibition:
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D2
-This allows us to inhibit unwanted movements |
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How is a clinical diagnosis of Parkinson disease made?
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-Must have 2 of 4 cardinal signs (TRAP)
-Tremor -rigidity -akinisea -postural instability |
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A definitive diagnosis of Parkinson disease can be made how?
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-Autopsy
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The following are associated with getting Parkinson disease:
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-Olfactory deficits
-Obesity -Constipation -Slow reaction time |
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What are three symptoms that will give a worse prognosis for PD?
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-Older age at onset (> 57 years)
-Rigidity/hypokinesia as a presenting symptom -PIGD |
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What is PIGD?
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Postural Instability
Gait Disturbances |
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T or F:
Deep brain stimulation is another option for treating parkinson disease? |
TRUE
-Indicated when person has symptoms not adequately controlled with medications. -Person still has to have a good response to levodopa. |
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What drug will a younger patient commonly begin with?
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-May start with Dopamine agonist then advance when needed to a levadopa/sinemet
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T or F:
Deep brain stimulation has great effects on Gait and balance in Parkinson disease? |
FALSE
-Non-motor symptoms (gait and balance) of PD not affected by DBS |
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Describe "BIG therapy"?
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-Treatment effective in treating speech and voice disorders of patients with PD
-Very large exaggerated movements and speech to break motor patterns and reteach "norms" |