Term
| What do Degenerative Neurologic Disorders do to the body? |
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Definition
| Affect the CNS & peripheral nerves by progressively disrupting cognitive processes or motor function. |
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Term
| List 5 examples of Degenerative Neurologic Disorders. |
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Definition
1. Alzheimer's Disease
2. Multiple Sclerosis
3. Parkinson's Disease
4. Huntington's Disease
5. Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease) |
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Term
| What 2 things is Alzheimer's characterized by? |
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Definition
| Two brain abnormalities: Amyloid plaques & Neurofibrillary tangles |
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Term
| What are the 4 common causes of vascular dementia? |
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Definition
1. Brain damage from CVA & cardiovascular problems
2. Endocarditis
3. Vasculitis
4. Profound hypotension |
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Term
| What is the cause of Lewy Body Dementia? |
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Definition
| Brain cells die & remaining cells contain abnormal structures called Lewy bodies. |
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Term
| What characterizes Frontotemporal Dementia (Pick's disease)? |
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Definition
*Young age
*Personality changes = inappropriate actions |
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Term
| What are normal age related changes to the brain? |
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Definition
* Decreased size & weight
* Increased size of ventricle
* Decrease in dopamine, acetylcholine, serotonin |
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Term
| What cognitive functions remain stable with dementia? |
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Definition
* Wisdom
* Judgement
* Creativity
* Common sense
* Coordination of facts & ideas
* Breath of knowledge
* Experience |
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Term
| What cognitive functions decline with dementia? |
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Definition
* Abstraction
* Naming objects
* Verbal comprehension
* Calculation
* Spatial orientation
* Short term memory |
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Term
| What is the clinical criteria for identifying dementia? |
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Definition
*DSM-IV-TR Criteria
* Cognitive deficits manifested by both memory impairment and one (or more) of the following: Aphasia, Apraxia (Coordination), Agnosia (recognize familiar items), Disturbance of executive functioning |
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Term
| What are normal memory lapses associated with aging? |
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Definition
*Forgetting a name
*Leaving the kettle on
*Finding the right word
*Forgetting the date or day |
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Term
| What are memory lapses that signal dementia? |
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Definition
*Not recognizing a family member
*Forgetting to serve meal just prepared
*Substituting inappropriate words
*Getting lost in own neighborhood |
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Term
| What Cortical Functions does dementia affect? |
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Definition
*Calculations
*Learning capacity
*Language
*Judgment
*Emotional Control
*Social Behavior
*Motivation |
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Term
| What is Alzheimer's Disease? |
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Definition
| A progressive, irreversible deterioration of general intellectual functioning |
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Term
| What are Beta-amyloid plaques? |
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Definition
| Dense deposits of protein and cellular material that accumulate outside and around nerve cells |
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Term
| What are neurofibrillary tangles? |
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Definition
| Twisted fibers that build up inside the nerve cell |
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Term
| What are the speculated etiologies of Alzheimer's? |
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Definition
*Decresed choline acetyltransferase activity
*mutation for encoding amyloid precursor protein
*Alterations in apolipoprotein E
*Possible gene defects on chromosomes 14, 19, 21
* Protein kinase C
*Link c aluminum
*Viral causes
*Mitochondrial defects |
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Term
| What are the risk factors for Alzheimer's Disease? |
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Definition
*Advanced age
*Family hx
*Smoking, ETOH
*Atherosclerosis
*High cholesterol & plasma homocsteine levels
*Diabetes
*Mild Cognitive impairment
*Down syndrome |
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Term
| What is the diagnosis and care of Alzheimer's Disease? |
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Definition
*Diagnosis of exclusion
*Definitive dx only on autopsy
*Mental status testing
*Care provides environment that matches abilities
*No cure |
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Term
| What medications are used with Alzheimer's Disease? |
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Definition
*Tacrine hydropholoride (Cognex)
*Aricep, Excelon, Namenda, Razadyne
*Antidepressants
*Tranquilizers
*Vitamin E, anti-inflamms, anti-HTN |
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Term
| What medication should be avoided with Alzheimer's? Why? |
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Definition
*Antihistamines
*Tricyclic antidepressants
*Work in the brain |
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Term
| What are the most important interventions for Alzheimer's Disease? |
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Definition
*Promote positive orientation
*Redirect, distract, reorient
*Anticipate their needs
*Maintain functional ability
*Promote maximum involvement in ADLs
*Follow a routine |
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Term
| What is Parkinson's Disease? |
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Definition
| Disease of substantia nigra = controls posture and coordination of voluntary movment |
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Term
| What are the 7 cardinal signs of Parkinson's Disease? |
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Definition
1. Tremors at rest
2. Rigidity
3. Bradykinesia = slow start to mvmt
4. Hypokinesia = slow/diminished mvmt
5. Flexed posture
6. Loss of postural reflexes
7. Freezing phenomenon = stop in tracks |
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Term
| What are the manifestations of Parkinson's Disease? |
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Definition
*Tremor
*"pill-rolling"
*Imp. fine motor control
*Cogwheel rigidity
*Diff. starting, continuing or coordinating mvmt
*Masklike face
*Softened/muffled voice
*Abnormal posture
*Autonomic & Neuroendocrine effects
*Mood & cognition
*Sleep disturbances |
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Term
| What are the treatments of Parkinson's Disease? |
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Definition
*Selegiline (Eldeprypl)
*Levodopa plus carbidopa (Sinemet)
*Amantadine
*Deep Brain Stimulation
*Surgical Thalamotomy
*Pallidotomy
*ROM, warm baths, massage |
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Term
| What is Multiple Sclerosis? Onset? |
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Definition
*Chronic demyelinating neurologic disease of the CNS.
*Onset btwn 20-50 yrs old |
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Term
| What are the 4 classifications of Multiple Sclerosis? |
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Definition
1. Relapsing-remitting
2. Primary progressive
3. Secondary progressive
4. Progressive-relapsing |
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Term
| What are the manifestations of MS? |
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Definition
*Visual defects = blurring, fogginess, haziness, imp. color perception
*Brainstem lesions = cognitive dysfx: concentration, short-term memory, word finding
*Mood Alterations = depression more than euphoria |
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Term
| What are the manifestations of spinal multiple sclerosis? |
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Definition
*Weakness and/or numbness
*Upper motor neuron involvement
*Bladder/bowel dysfx |
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Term
| What are the manifestations of cerebellar multiple sclerosis? |
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Definition
*Nystagmus
*Ataxia = lack of musc. coord
*Hypotonia = low musc. tone |
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Term
| What is a manifestation of amaurotic MS? |
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Definition
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Term
| What is the treatment of MS? |
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Definition
*Immunomodulators
*Adrenalcorticosteroids
*Muscle relaxants
*Immunosuppressants
*Surgery = severe spasticity = releases contractures
*Ketogenic diet = high fat diet = promotes myelination
*Rehabilitation |
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Term
| What are some causes of Peripheral Nervous System Disorders? |
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Definition
*Autoimmune disorders
*Viruses
*Environmental toxins = heavy metals
*Nutritional deficiencies |
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Term
| What is Myasthenia Gravis? |
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Definition
| Chronic autoimmune neuromuscular disorder characterized by fatigue & severe weakness of skeletal muscles |
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Term
| What are the manifestations of Myasthenia Gravis? |
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Definition
*Ocular & Facial = Ptosis(drooping eyelid), Diplopia(double vision), Facial weakness, Dysphagia, Dysarthria(slow/distorted speech)
*Musculoskeletal = Weakness, Fatigue, Decreased motor fx
*Resp = Weakening intercostal musc, Decreased diaphragm mvmt, dyspnea, poor gas exchange
*Nutritional = Inability to chew/swallow, Decreased ability to move tongue, Weight loss |
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Term
| What is Trigeminal Neuralgia? What else is it called? |
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Definition
*Tic douloureux
*Chronic disease of cranial nerve V
*Causes sever facial pain |
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Term
| What is the manifestation of Trigeminal neuralgia? |
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Definition
*Brief attacks of unbearably sever pain over sensory dist. of trigeminal nerve
* "Facial seizure" |
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Term
| What is the treatment of trigeminal neuralgia? |
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Definition
*Medications = antiseizure or muscle relaxants
*Surgery = rhizotomy (severs the nerve root) |
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Term
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Definition
*Disorder of the 7th cranial nerve
*Causes unilateral paralysis of facial musc. |
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Term
| What are the manifestations of Bell's Palsy? |
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Definition
*Hemiparesis of face
*Loss of corneal reflex of eye
*Loss of taste
*Increased tearing |
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