Neuro Dysfunction II - A

olanjones's version from 2016-03-21 17:18

Section 1 Alzheimer's Disease

Question Answer
Early onset Alzheimer's Disease is linked to mutations on what?chromosomes 14, 19, 21
The senile plaques associated with Alzheimer's disease are a result of what?the development of neurofibrillary tangles and amyloid deposits
What is the relationship between Ach and Alzheimer’s?decreased synthesis of acetylcholine
What are the manifestations of Alzheimer’s?it may present at different ages with varying degrees of intensity and symptom sequence
What motor changes are associated with Alzheimer’s?Rigidity, flexion posturing, propulsion/retropropulsion
How does Alzheimer’s initially present?as progressive forgetfulness, most recent memories lost first
What cognitive processes does moderate Alzheimer’s impair?Global (language, problem solving, disorientation, lack of insight, inability of ADLs)
What characterizes severe Alzheimer’s?cannot respond to the environment, require full care

Section 2 Parkinson's Disease

Question Answer
What is the etiology of Parkinson’s disease?Unknown / may be linked to genetic mutations caused by virus or toxins
What neurotransmitter problems are associated with Parkinson’s?decreased levels of dopamine create imbalance with Ach (inhibitory vs excitatory)
Where does the decrease in dopamine synthesis occur?Substantia nigra in the basal ganglia
What are classical gross motor symptoms of Parkinson’s?tremors, postural abn/cogwheel rigidity, bradykinesia
What are classical fine motor symptoms of Parkinson’s?decreased blink & swallow reflex, dysarthria
What are neuro/cog symptoms of Parkinson’s?depression (50%), dementia (30%), bradyphrenia, masked faces

Section 3 Multiple Sclerosis

Question Answer
What is destroyed in MS?myelin sheaths in the CNS (causes nerve impulse interruptions)
What is theory on the etiology of MS?an abnormal immune response caused by a previous viral insult
Is MS a genetic disorder?it is not identified as such but 15% of affected persons have a relative with MS
How does demyelination occur in MS?T-cells damage myelin / maintain inflammation (causes further damage)
What part of the CNS is affected by MS lesions?white matter of the brain, spinal cord, & optic nerve (but may extend to gray matter)
What is the “universal” manifestation of MS?Overwhelming Fatigue
What optic nerve manifestations are associated with MS?diplopia, optic neuritis, visual disturbances
What are cranial nerve manifestations of MS?dysphagia, facial weakness and pain
What motor dysfunctions are associated with MS?weakness, paralysis, spasticity, gait abnormalities
What sensory dysfunctions are associated with MS?paresthesia, balance/proprioception problems, decreased temp sensation
What cognitive problems are associated with MS?decreased short term memory, attn span, concentration, mood changes

Section 4 Guillain-Barre

Question Answer
How does Guillain-Barre Syndrome present?starts in lower body and moves up (Ground to Brain)
Where does demyelination occur in Guillain-Barre?in the PNS (where repair of myelin may occur)
How does demyelination occur in Guillain-Barre?(idiopathic) evidence shows B and T-cell mediated immunological involvement
When does Guillain-Barre often occur?1-8 weeks post GI or respiratory infection, surgery, or inoculation
Why can Guillain-Barre be particularly dangerous?can involve respiratory musculature and a loss of autonomic regulation (BP/cardiac)
What is commonly the course of Guillain-Barre?Peak of disability occurs at 10-14 days, most spontaneously recover (10-20% have mild disability)

Section 5 Myasthenia Gravis / Bell's Palsy

Question Answer
How does Myasthenia Gravis present?downwards through the body (Mind to Ground)
How is acetylcholine inhibited in Myasthenia Gravis?Ach receptor antibodies (IgG) block/destroy the receptors of the motor end plate at myoneural junction (decreased impulse transmission)
What are manifestations of ocular MG?diplopia, ptosis (drooping eyelid), ocular palsy
What are manifestations of bulbar MG?dysphagia, aspiration pneumonia
What are manifestations of generalized MG?proximal muscle weakness that progresses through the day
What is Bell’s palsy?acute paresis or paralysis of facial cranial nerve (C7) – possible viral origin
How does Bell’s palsy present?unilaterally: facial weakness, droop, diminished eye blink

Section 6 Cerebral Palsy

Question Answer
How is Cerebral Palsy characterized?Lifelong, non-progressive, encephalopathic damage to the brain present/occurs at birth
What factors may lead to CP?prenatal infection/toxin, trauma to head at birth, hypoxia/hypoglycemia, premature/low birth weight
What are common manifestations of CP?Seizures, varying intellectual impairment, visual/hearing problems, bowel/bladder problems, orthopedic problems
How does spastic (most common) CP present?increased muscle tone/rigidity, exaggerated deep tendon reflex, contractures, spastic paralysis
How does dyskinetic CP present?purposeful movement difficulties (jerky, uncontrolled) due to damage to basal ganlia
How does ataxic CP present?hypotonia with stiffness of trunk muscles, gait disturbances/instability