Degenerative disorders and spinal cord injuries

etiology of Alzheimer's

-genetic predisposition
-autoimmune
-viral

mechanism for Alzheimer's

-amyloid plaques build up on neurons
-slowed EEG
-brain atrophy
-neurofibrillary tangles

Alzheimer's stage 1

-mood changes
-stuborness
-disorientation to place and time
-forgetfulness

stage 2 Alzheimer's

-lose judgement, hallucinations, wandering, innapropriate social behavior, can't do activities of daily living

stage 3 Alzheimer's

-indifference to food (malnutrition)
-aspiration
-incontinence
-seizures
-UTI

Etiology of ALS

-could be genetic or viral but really idopathic

mechanism of ALS

-scarring of motor neuron tracts and atrophy of muscles
-affects upper motor neurons first (brain and spinal cord)

manifestations of ALS

-slurred speech, difficulty swallowing (first sign)
-increased of risk of aspiration, cough
-paresis of one muscle group
-affects ability to maintain airways and respiratory muscles
-no mental or sensory involvement

etiology of parkinson's

idiopathic

mechanism of Parkinson's

-destruction of substantia nigra-- decreased dopamine production
-imbalance b/twn dopamine and acetylcholine

manifestations of Parkinson's

-tremor
-rigidity
-akinesia/bradykinesia
-orthostatic hypotension
-shuffling gait
-mask like expression
-blurred vision
-urinary and gastric retention
-mono tone voice

etiology of myasthenia gravis

-mostly autoimmune

mechanism for myasthenia gravis

-autoantibodies bind to acetylcholine receptors and block ACH

manifestations of myasthenia gravis

-as pt becomes more active, they run out of ACH
-muscle fatigue
-general weakness
-ptosis, diplopia
-trouble swallowing and chewing
-weakness in respiratory muscles
-facial muscles affected first

etiology of guillain-barre

usually GI or respiratory viral illness

mechanism of guillain-barre

-autoimmune
-demyelination of motor neurons initially and then sensory and autonomic

manifestations of guillain-barre

-mostly motor neurons affected
-ascending paralysis (starts in fingers and toes)
-respiratory muscle weakness
-lack of reflexes
-tachy/bradycardia, hypo/hypertension

upper motor neuron injury

-damage to brain and spinal cord
-no conscious control below level of injury but still have reflexes
-spastic paralysis

lower motor neuron injury

-lose reflexes
-flaccid paralysis

corticospinal tract

motor function (efferent pathway)

spinothalamic tract

pain, temp, light touch (afferent pathway)

posterior column

vibration, 2 point discrimination, position sense

anterior spinal cord syndrome

-damage to spinothalamic tract: pain, temp, light touch
-damage to corticospinal: motor movement

posterior spinal cord syndrome

-posterior column damage: loss of position sense, vibration, 2 point discrimination