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Questions and Answers
What age group is most commonly affected by atherosclerosis?
What age group is most commonly affected by atherosclerosis?
- Over 60 years (correct)
- 40-60 years
- 30-40 years
- Under 30 years
Which symptom is NOT considered a cardinal symptom of Parkinson disease?
Which symptom is NOT considered a cardinal symptom of Parkinson disease?
- Rigidity
- Postural Instability
- Hypertension (correct)
- Tremors
What type of tremor is most commonly seen in Parkinson disease?
What type of tremor is most commonly seen in Parkinson disease?
- Essential tremor
- Action tremor
- Resting tremor (correct)
- Psychogenic tremor
What is the main characteristic of rigidity in Parkinson disease?
What is the main characteristic of rigidity in Parkinson disease?
Which of the following symptoms increases with emotional stress in Parkinson disease?
Which of the following symptoms increases with emotional stress in Parkinson disease?
What does the term 'cog-wheel rigidity' refer to in Parkinson disease?
What does the term 'cog-wheel rigidity' refer to in Parkinson disease?
What does the term 'bradykinesia' mean in the context of Parkinson disease?
What does the term 'bradykinesia' mean in the context of Parkinson disease?
In which condition is paralysis most likely to occur?
In which condition is paralysis most likely to occur?
What is one of the primary functions of the extrapyramidal system?
What is one of the primary functions of the extrapyramidal system?
Which area is the origin of the neural pathway leading to the corpus striatum?
Which area is the origin of the neural pathway leading to the corpus striatum?
What type of tremor is most associated with Parkinsonism?
What type of tremor is most associated with Parkinsonism?
What is the effect of emotional stress on tremors associated with extrapyramidal disturbances?
What is the effect of emotional stress on tremors associated with extrapyramidal disturbances?
What is a characteristic feature of bradykinesia in patients with Parkinsonism?
What is a characteristic feature of bradykinesia in patients with Parkinsonism?
Disturbance in which extrapyramidal function leads to hypertonia as described in the content?
Disturbance in which extrapyramidal function leads to hypertonia as described in the content?
Which part of the brain do the fibers from the globus pallidus pass to?
Which part of the brain do the fibers from the globus pallidus pass to?
Which condition is characterized by rhythmic, regular tremors that increase with stress?
Which condition is characterized by rhythmic, regular tremors that increase with stress?
Which of the following strategies is NOT a method for preventing falls?
Which of the following strategies is NOT a method for preventing falls?
What is a primary goal of EMG biofeedback in motor control?
What is a primary goal of EMG biofeedback in motor control?
Which activity is specifically included in gait training strategies?
Which activity is specifically included in gait training strategies?
How can family involvement assist in the treatment of depression in patients?
How can family involvement assist in the treatment of depression in patients?
Which technique is NOT part of functional activity training to overcome falling?
Which technique is NOT part of functional activity training to overcome falling?
Which of the following are components of the basal ganglia?
Which of the following are components of the basal ganglia?
What is the function of the substantia nigra?
What is the function of the substantia nigra?
The brain reward system is activated by which of the following?
The brain reward system is activated by which of the following?
What distinguishes the two parts of the substantia nigra?
What distinguishes the two parts of the substantia nigra?
What happens to the brain when drugs are consumed?
What happens to the brain when drugs are consumed?
One of the main functions of the basal ganglia is to control which of the following?
One of the main functions of the basal ganglia is to control which of the following?
What impact does addiction have on the brain's response to drugs over time?
What impact does addiction have on the brain's response to drugs over time?
Which neurotransmitter is primarily associated with feelings of pleasure in the brain?
Which neurotransmitter is primarily associated with feelings of pleasure in the brain?
Which of the following is NOT a technique used to address Orofacial dysfunction?
Which of the following is NOT a technique used to address Orofacial dysfunction?
What is a recommended strategy for managing rigidity in patients?
What is a recommended strategy for managing rigidity in patients?
What does a score of 3 indicate regarding tremor severity?
What does a score of 3 indicate regarding tremor severity?
Which method is effective in controlling tremors?
Which method is effective in controlling tremors?
When addressing bradykinesia, what is a crucial step to help the patient transition from supine to sitting?
When addressing bradykinesia, what is a crucial step to help the patient transition from supine to sitting?
Which assessment technique involves checking muscle tone?
Which assessment technique involves checking muscle tone?
Which of the following techniques is used in cardiopulmonary training strategies?
Which of the following techniques is used in cardiopulmonary training strategies?
Which of the following symptoms is NOT indicative of advanced Parkinsonism?
Which of the following symptoms is NOT indicative of advanced Parkinsonism?
What is an appropriate treatment option for Parkinsonism?
What is an appropriate treatment option for Parkinsonism?
What is a common approach to alleviate restless leg syndrome?
What is a common approach to alleviate restless leg syndrome?
Which strategy can be used to improve balance and prevent falls?
Which strategy can be used to improve balance and prevent falls?
Which factor is assessed during the mental examination in Parkinsonism?
Which factor is assessed during the mental examination in Parkinsonism?
Hyporeflexia in Parkinsonism may be associated with which condition?
Hyporeflexia in Parkinsonism may be associated with which condition?
Which intervention is specifically aimed at managing tremors?
Which intervention is specifically aimed at managing tremors?
What describes the posture often observed in patients with Parkinsonism?
What describes the posture often observed in patients with Parkinsonism?
What is the primary goal of the 'Examination of Bradykinesia'?
What is the primary goal of the 'Examination of Bradykinesia'?
Flashcards
Basal Ganglia
Basal Ganglia
A group of subcortical nuclei located at the base of the forebrain and top of the midbrain, responsible for regulating movement, muscle tone, and emotional expression.
Parkinsonism
Parkinsonism
A neurological disorder marked by tremors, rigidity, bradykinesia, and postural instability, caused by the degeneration of dopamine-producing neurons in the substantia nigra.
Static Tremor
Static Tremor
A type of tremor that is rhythmic and regular, typically increasing with emotional stress and fatigue, often seen in Parkinsonism.
Rigidity
Rigidity
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Bradykinesia
Bradykinesia
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Rubrospinal Tract
Rubrospinal Tract
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Dysrhythmic Tremor
Dysrhythmic Tremor
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Extrapyramidal System
Extrapyramidal System
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What are the components of the striatum?
What are the components of the striatum?
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What is the globus pallidus?
What is the globus pallidus?
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What is the ventral pallidum?
What is the ventral pallidum?
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What is the subthalamic nucleus?
What is the subthalamic nucleus?
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What is the substantia nigra?
What is the substantia nigra?
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What are the pars compacta and pars reticulata of the substantia nigra?
What are the pars compacta and pars reticulata of the substantia nigra?
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What is the brain reward system?
What is the brain reward system?
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What is dopamine and its role?
What is dopamine and its role?
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Parkinson's Disease
Parkinson's Disease
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Pill-Rolling Tremor
Pill-Rolling Tremor
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Rigidity in Parkinson's
Rigidity in Parkinson's
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Hypertonia in Parkinson's
Hypertonia in Parkinson's
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Festinating Gait
Festinating Gait
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Akinesia/Bradykinesia
Akinesia/Bradykinesia
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Parkinson's Disease and Dopamine
Parkinson's Disease and Dopamine
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Lead Pipe Rigidity
Lead Pipe Rigidity
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Stage III Parkinson's Disease
Stage III Parkinson's Disease
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Stage IV Parkinson's Disease
Stage IV Parkinson's Disease
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Stage V Parkinson's Disease
Stage V Parkinson's Disease
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Levo-Dopa
Levo-Dopa
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Levo-Dopa + Carbidopa
Levo-Dopa + Carbidopa
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Dopamine Agonists
Dopamine Agonists
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Anticholinergic Drugs
Anticholinergic Drugs
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Amantadine Hydrochloride
Amantadine Hydrochloride
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Orofacial Dysfunction
Orofacial Dysfunction
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Tremor in Parkinson's
Tremor in Parkinson's
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Breaking Down Complex Tasks
Breaking Down Complex Tasks
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PNF for Parkinson's
PNF for Parkinson's
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Group Therapy for Parkinson's
Group Therapy for Parkinson's
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Serial Casting for Parkinson's
Serial Casting for Parkinson's
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Balance & Postural Problems: Fall Prevention Strategy
Balance & Postural Problems: Fall Prevention Strategy
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Gait Training Strategies
Gait Training Strategies
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EMG Biofeedback
EMG Biofeedback
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Functional Activities for Fall Prevention
Functional Activities for Fall Prevention
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Depression: Family Involvement in Treatment
Depression: Family Involvement in Treatment
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Study Notes
Parkinsonism (Parkinson Disease)
- Tremors are a persistent symptom, even at rest.
- Shuffling gait, characterized by small, uneven steps, and an unbalanced posture.
- Parkinsonism, or Parkinson's disease (PD), is a chronic, progressive neurodegenerative disease.
- Decreased dopamine production in the substantia nigra is linked to the disease.
- Most cases of Parkinson's disease are idiopathic, meaning the cause is unknown.
Extrapyramidal Tracts
- Originates from areas 6 and 4 of the brain.
- Descends to the corpus striatum, part of the basal ganglia.
- Then to the globus pallidus, also part of the basal ganglia.
- Fibers from the globus pallidus then project to the reticular formation, vestibular nuclei, red nucleus, and tectum of the midbrain.
- These nuclei are involved in extrapyramidal tracts.
Components of Basal Ganglia
- The basal ganglia include the caudate nucleus, putamen, and globus pallidus (with external and internal segments).
- The subthalamic nucleus and substantia nigra are also functionally related to the basal ganglia.
- The amygdala, located in the temporal lobe has similar embryonic origins but is functionally part of the limbic system.
Functions of the Extrapyramidal System
- Regulates and integrates voluntary motor activity
- Regulates and maintains muscle tone
- Regulates and maintains emotional and associative movements
Disturbances of the Extrapyramidal System
- Leads to disturbances in voluntary motor activity, resulting in static tremors.
- Tremors can be rhythmic (Parkinsonism) or dysrhythmic (chorea, athetosis, dystonia).
- Tremors generally worsen with anxiety, stress, and fatigue and improve during sleep and voluntary movement.
- Result in hypertonia, commonly described as rigidity.
- Leads to bradykinesia, resulting in a mask-like face (lack of expression) and a decrease in arm swing during walking.
Basal Ganglia
- A group of subcortical nuclei located at the base of the forebrain and top of the midbrain.
- These nuclei have varied origins.
- The main components are the striatum (dorsal and ventral), globus pallidus, ventral pallidum, subthalamic nucleus, and substantia nigra.
Substantia Nigra
- A basal ganglia structure located in the midbrain.
- The name literally translates to "black substance," due to its appearance from the high levels of neuromelanin in the dopaminergic neurons.
- Composed of two components (pars compacta and pars reticulata), each with distinct connections and functions.
- Plays a critical role in eye movement, motor planning, motor learning, reward, and addiction.
Dopamine Neurotransmitter
- A neurotransmitter involved in the brain's reward system, which regulates feelings of pleasure.
- Released in response to pleasurable activities, such as eating delicious food and falling in love.
- Drugs mimic the brain's reward system by producing a similar surge in dopamine, leading to a potentially potent "pleasure effect," which can be longer-lasting than natural highs, and motivate continued use, which can result in addiction.
Parkinson's Disease (Idiopathic)
- A chronic, progressive neurodegenerative disease.
- Due to the degeneration of pigmented cells (neuromelanin) in the substantia nigra pars compacta, leading to dopamine deficiency affecting the brain.
- Characterized by a gradual onset occurring usually after the age of 50.
- Men and women are equally affected.
Parkinson's Disease (Symptomatic)
- Parkinsonism with a known cause, without changes in basal ganglia or substantia nigra.
- Inflammatory (encephalitis), Vascular (cerebral atherosclerosis), Toxic, Neoplastic (tumors of basal ganglia), and Traumatic (repeated head trauma.
Common Causes of Parkinsonism
- Paralysis agitans, Post-encephalitic, and Atherosclerosis.
Cardinal Symptoms of Parkinson's Disease
- Tremors, Rigidity, Slowness of movement (bradykinesia/akinesia-kinesia paradoxica), and Postural instability
Secondary Motor Manifestations of Parkinson's Disease
- Freezing, Micrographia, Loss of emotional and associative movements, Immobile face, Monotonous speech, Loss of arm swing, Unwanted accelerations, Impaired motor dexterity, Impaired motor coordination, Akathisia, Speech and swallowing disturbance, Hypophonia, Monotonic speech and Drooling Dysphasia.
Gait and Posture Disturbances in Parkinson's Disease
- Slow gait, Short step, Shuffling gait, Festination (increased walking speed), Decreased arm-swing, Turning "en bloc," and Stooped forward-flexed posture.
Diagnosis of Parkinsonism (Parkinson's Disease)
- Clinical Rating Scales (UPDRS) are used in clinical assessments of Parkinsonism.
- The UPDRS includes four subscales: 1 (mentation, behavior, mood), 2 (daily activities), 3 (motor assessment), and 4 (therapy complications).
- Data for subscales 1, 2, and 4 is elicited from patients and caregivers, while data for subscale 3 is examination-based.
Yahr Classification of Parkinsonism Stages
- I: Minimal or absent, unilateral symptoms if present.
- II: Minimal bilateral or midline involvement, balance is not impaired.
- III: Impaired righting reflexes/unsteadiness when turning/rising from chair; some activities are restricted but independent living is possible.
- IV: All symptoms present and severe. Some daily living activities require assistance.
- V: Confined to bed or wheelchair unless aided.
Medical Treatment of Parkinsonism
- Levodopa, Levodopa + Carbidopa, Dopamine agonists, Anticholinergic drugs, and Amantadine hydrochloride.
Assessment of Parkinson's Disease by Inspection
- Involuntary movements (tremors), Skeletal deformities, and Posture (flexion attitude).
Tremor Assessment
- 0: No tremor.
- 1: Mild tremor, minimal impairment of writing, drawing and daily activities.
- 2: Moderate tremor, moderate impairment in some activities
- 3: Significant tremor, severe impairment in activities
- 4: Severe tremor, extensive functional limitations.
Skeletal Deformities Assessment
- Stooped posture, flexed elbows & wrists, tremors of extremities.
Motor Assessment by Palpation
- Muscle tone (rigidity), Muscle strength, A- and B-functional muscle testing, Postural reactions, Balance examination, and Joint ROM, Sensation (pain), Coordination testing, Functional examination, and Examination of bradykinesia.
Examination of Muscles Tone & Reflexes
- Hypertonia, Hyporeflexia (deep reflexes may be reduced).
Management of Parkinson's Disease
- Orofacial dysfunction, Rigidity, Bradykinesia, Tremors, Cardiopulmonary training, Restless Leg Syndrome, Balance and Posture problems, Gait training strategies, EMG Biofeedback, Icing, Functional activities, Depression, and Role of family.
Additional Information
- The images provided illustrate examples of the symptoms and conditions associated with Parkinson's disease.
- There are different aspects of this disease (pathophysiology, symptoms, diagnosis, and treatment) and management procedures.
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Description
Test your knowledge on Parkinson's disease, including its symptoms, characteristics, and the impact of emotional stress on patients. This quiz covers key concepts and terms like bradykinesia and cog-wheel rigidity to enhance your understanding of this condition.