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N Parkinsons
lecture notes
| Term | Definition |
|---|---|
| life expectancy of Parkinsons pt | around 30 years so not very different from non-Parkinsons |
| causes of Parkinsons dx | usually idiopathic. occasionally-encphalitis, alcohol abuse, ext exposure to toxins, TBI, vascular insults, phychotorphic drugs |
| Parkinsons pathology | dopamine producing cells die (regulates posture & mvmt) 70-80% of neurons that produce dopamine are damaged & replaced w/lewy bodies before onset of symptoms-contain neurophilaments & hyaline |
| 4 cardinal signs of Parkinsons | rigidity, bradykinesia, tremor, postural instability |
| Parkinsons rigidity | resist to passive mvmt, speed doesnt matter), leadpipe(constant resist), cogwheel (let go then catch) leads to fatigue |
| Parkinsons bradykinesia | akinesa(trouble starting mvmt), hypokinesia (decrease speed, ROM), freezing |
| Parkinsons freezing circumstances | break in pattern, trying to go thru door, negotiat an obstacle, turn almost to bed or chair, multitask |
| Parkinsons managing strategies for freezing | step over line on floor, rhythm, music, sing to self, 4 step strategy (1 stop, 2 put wt on heels, 3 lat wt shift 4 think abt taking BIG step) |
| Parkinsons tremor | resting/pill rolling (1st symptom initially seen unilaterally, progresses to all 4 limbs) |
| Parkinsons postural instability/balance | loss of auotmatic postural adjustments, delay, decrease, loss of equilibrium rx (inner ear), they are fall risk |
| Parkinsons posture | fwd head, lose trunk ext, increase kyphosis, more shd ADD & IR, hip & knee flex contracture, ankle plantarflex (walk on toes), later bedridden w/elbow, wrist & hand contractures |
| Parkinsons gait | loss of reciprocal arm mvmt & trunk rotation, slow, small shuffling steps (balls of feet), festinating gait (chase COG), may freeze, will start to have bed mob probs |
| Parkinsons rest of clinical pic | masked face, dysphagia, drooling, voice changes (quiet, slur), dementia in 1/2, decrease attn &concentration, depression, micrographia, pn, slow processing of info, fatigue, decond, decrease chest mob, contractures |
| Parkinsons dx | 2 out of 4 cardinal signs, no major test |
| Parkinsons meds | 1ST-selegiline, then sinemet. sinemet main one, only works 5-7 yrs, comb levadopa (Ldopa) & carbidopa, has kind of on/off cycle if used a long time, off periods have dykenesia & psychotic episodes |
| Parkinsons prognosis | gradual decline-death from pneumonia or infection (from being bedridden) |
| Parkinsons sx | pallidotmy-remove or disconnect globus pallidous. deep brain stimulator-decrease symptoms (stimulates brain kind of like dopamine) |
| Parkinsons progression- early | at home, Ind w/ADL, start to have difficulties, may be seen in OP or given HEP, work on fall prevention, educate on energy conservation |
| Parkinsons progession- moderate | decrease in functional mob, may start to use AD or WC, not out in community as much, decrease bed mob & trsfs, increase assist from caregivers, increase adaptation for compensatory strategies & equip, increase falls & injuries, more energy conservation |
| Parkinsons types of mvmts | big mvmt, encourage ext, trunk & extremity rot, wt shift, rocking, reciprocal mvmt |
| Parkinsons motor learning strategies | help them understand what they need to be working on, mentally rehearse, parts to whole, rhythmic initiation, rhythmic rotation, start proximal |
Created by:
jessigirrl4
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