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DU PA Movemente dis

Duke PA Movement Disorders

the three constituents of the central motor system pyramidal, extrapyramidal, and cerebellar
the major outflow from the motor cortex to the spinal cord pyramidal system
lesions of the pyramidal system cause motor weakness (paresis), spasticity, and hyperreflexia
movement disorders are caused by __ dysfunction extrapyramidal and cerebellar function
what neurobehavioral symptom is associated with Huntington's disease dementia
what neurobehavioral symptom is associated with Tourette's disorder obsessive-compulsive, and attention deficit
what neurobehavioral symptom is associated with Parkinson's disease depression
increased muscular tone throughout the range of motion rigidity
the superimposition of tremor on underlying rigidity cogwheel rigidity
velocity-dependant resistance to passive movement. resistance increases as the speed of passive limb displacement increases paratonic rigidity
inability to fully relax a limb for passive rang of motion testing gegenhalten
tendency to help out as the examiner attempts to move the limb passively mitgehen
true rigidity always implies __ on the contralateral side basal ganglia dysfunction
most likely cause of resting tremor in an older patient with rigidity and bradykinesia Parkinson's disese
most likely cause of action tremor in a patient without rigidity or bradykinesia essential tremor
disorders of proprioceptive function may result in __ caused by impairment of the spinocerebellar inputs sensory ataxia
transitory loss of motor tone resulting in rapid movement of a joint asterixis
slow writhing movement athetosis
flailing movement ballism
irregular flicking, dancelike movement chorea
the combination of chorea and athetosis choreoathetosis
the combination of irregular flicking, dancelike movement and slow writhing movement choreoathetosis
sustained contortion resulting from excess muscular activity across a joint dystonia
nonspecific term for hyperkinesia dyskinesia
rapid jerking muscular movement myoclonus
semi-suppressible motor or vocal gestural movement tic
rhythmic oscillating movement tremor
diagnostic criteria for Parkinson's disease tremor, bradykinesia, postural instability, and rigidity
leading cause of neurologic disease in individuals older than 65 Parkinson's disease
Lewy bodies are found in what disease Parkinson's disease
mainstay of treatment for advanced Parkinson's disease carbidopa-levodopa (Sinemet)
__ delays the need for levodopa treatment in patients with early Parkinson's disease selegiline
one surgical treatment for Parkinson's disease is deep brain stimulation of the __ subthalamic nuclei
the most common cause of drug-induced parkinsonism is treatment with __ neuroleptic medication
poorly coordinated, broad-based, lurching gate ataxia
abnormal modulation of speech velocity and volume ataxic dysarthria
irregular placement of voluntary limb or ocular movement dysmetria
movement falling short of the intended target hypometria
movement overshooting the intended target hypermetria
breakdown in precision and completeness of rapid alternating movements dysdiadochokinesis
irregularity of the rhythm of rapid alternating movements or planned movement sequences dysrhythmokinesis
inability to perform movement as a coordinated temporal sequence dyssynergia
decreased resistance to passive muscular extension (seen immediately after injury to the lateral cerebellum) hypotonia
tremor orthogonal to the direction of intended movement (tends to increase in amplitude as the target is approached) intention tremor
rhythmic rocking tremor of the trunk and head titubation
medications for Parkinson's disease anticholinergics, dopamine precursors, dopamine agonists, monoamine oxidase type B, catechol-o-methyltransferase inhibitors
drugs causing bradykinesia or rigidity (established) neuroleptics, metoclopramide, reserpine
drugs causing bradykinesia or rigidity (reported) lithium, phenytoin, ACE inhibitors
the most common cause of tremor essential tremor
unlike in Parkinson's disease this is bilateral and is more prominent with action essential tremor
most useful medications for essential tremor propranolol (Inderal), primidone (Mysoline), and topiramate (Topamax)
Parkinson's disease tremor responds better to __ rather than medications used for essential tremor anticholinergics
rare disease that should be in the differential for new-onset hyperkinesia or parkinsonism in the young adult Wilson's disease
inexorably progressive autosomal dominant neurodegenerative disorder affecting motor function, cognition, and behavior Huntington's disease
movement abnormalities associated with Huntington's disease dystonia, rigidity, postural instability, myoclonus and chorea
involuntary contractions of neck musculature resulting in various combinations of twisting, tilting, extension, or flexion spasmodic torticollis
foul language coprolalia
a substantial proportion of children with learning disorders have __ Tourette's disorder
defined as the history of both motor and vocal tics (for more than one year) with onset before the age of 18 Tourette's disorder
__ is not progressive or fatal Tourette's disorder
rhythmic oscillation of a part of the body around a fixed point tremor
most common. arise when attempting to maintain a fixed position action tremor
seen in normal people in movements requiring a high degree of precision or power. Can be caused by fatigue, anxiety, hypoglycemia, hyperthyroidism, drug withdrawal, caffeine, amphetamines, theophylline, lithium, valproate physiologic action tremor
slower frequency than physiologic tremor essential action tremor
first line treatment for essential tremor beta-blockers (propranolol)
effective but sedating treatment for essential tremor primidone
can be used for anxiety induced tremor. tranquilizers/benzodiazepines (diazepam)
absent at rest and at the start of a movement. Increases when fine adjustments are required ataxic (intention) tremor
caused by disease of the cerebellum or its connections ataxic (intention) tremor
treatment for tics (limited by side effects) haloperidol or pimozide
violent flinging movements hemiballismus
usually the result of an infarct in the contralateral subthalamic nucleus of Luys unilateral hemiballismus
shock like contraction of a group of muscles. irregular in rhythm and amplitude. It may involve a restricted group of muscles or be generalized myoclonus
treatment for myoclonus (both have limited efficacy) clonazepam, valproate
may result from anoxic damage, spinal cord injury, uremia, hepatic encephalopathy myoclonus
torticollis, writer's cramp, blepharospasm are examples of focal dystonias
increasingly common and helpful treatment of dystonia botulinum toxin
rest tremor, cogwheeling, rigidity, bradykinesia, difficulty initiating movements, masked facies, stooped posture and shuffling gait, disturbance of postural reflexes Parkinson's disease
pathophysiology of Parkinson's disease degeneration of the nigrostriatal pathway (connecting the substantia nigra and the striatum). There is a dramatic loss of dopamine containing neurons.
side effects of L-dopa/carbidopa nausea, vomiting, confusion, peak dose dyskinesias and on-off phenomenon
act like dopamine at the dopamine receptor. May allow for reduction in the dose of Sinemet required and may decrease on-off problems dopamine agonists (bromocriptine, pergolide, ropinirole and pramipexole)
may increase dopamine release from nerve terminals. weakly effective amantidine (symmetrel)
may be more effective for the treatment of tremor. Side effects include confusion, constipation, dry mouth, urinary retention anticholinergic drugs
autosomal dominant, varying age of onset. Symptoms often begin with psychiatric disorder (immaturity, impulsivity, and depression). Later apathy and dementia. Chorea, athetosis Huntington's disease
__ can be thought of as a dopamine excess state chorea
treatment for Huntington's disease dopamine receptor blockers such as neuroleptics (haloperidol, chlorpromazine)
iatrogenic disorder from long-term treatment with neuroleptics. tardive dyskinesia
signs of __ are abnormal buccal-lingual movements (tongue thrusting and chewing). Head movements including head turning and bobbing can also occur. tardive dyskinesia
Created by: bwyche