NeuroPT - 24 - PD

automaticity

the main function of the basal ganglia is _____________

susstantia nigra

the ____________ is the modulator of the basal ganglia

excitation

the direct loop does net (inhibition/excitation) of the cortex

inhibition

the indirect loop does net (inhibition/excitation) of the cortex

dopaminergic, substantia nigra

the pathophysiology of PD is that there is degeneration of ______________ neurons in the _______________

decr excitation

loss of dopamine means there is a net ___________ of the motor cortex

modulation

with PD there is the loss of __________ of the direct and indirect loops

ATTENTION

PD requires more ___________ for daily motor behaviors that used to be automatic

men

PD is more common in (women/men)

idiopathic

MOST of PD is __________-ish, but has been associated with proximity to golf courses and pesticides, repeated head injuries, and viral brain infections

• tremors (resting tremor)

• rigidity (hypertonicity and hyperreflexia)

• akinesia (HYPOKINESIA, bradykinesia, masked face)

• postural instability (festinating gait, freezing, APC/RPC control)

the main motor symptoms of PD are: (4)

• tremor dominant TD

• postural instability/gait difficulty PIGD

the two clinical sub-types of PD are ____________ and _____________

TD

(TD/PIGD) has a more mild disease progression

PIGD

(TD/PIGD) has a more rapid disease progression

I

hoehn-yahr stage _____ has unilateral symptoms

II

hoehn-yahr stage _____ has bilateral symptoms

III

hoehn-yahr stage _____ has impaired balance

IV

hoehn-yahr stage _____ has severe bradykinesia, rigidity, and festinating gait

V

hoehn-yahr stage _____ is when pts are confined to a bed or wheelchair

external

_________ cues help with freezing of gait

motor

PD is so much more than just a _______ issue

hallucinations

___________ can occur in later stages of PD as a result of the disease itself of as a side effect of the medication

treated, MANAGED

PD cannot be _________, only ____________ with pharmaceuticals and exercise

therapeutic window

the ______________ of carbidopa levodopa narrow as the disease progresses, causing less ON time

dyskinesia

_________ can occur when on LD/CD and when there is too much dopamine in the blood; wiggly involuntary movements

TD

DBS is more effective for ____ PD

• hypokinesia

• SSPC/APC/RPC postural movement

• SSPC/APC deficit in balance confidence

• APD deficit in executive function/multitask

possible movement symptom diagnosis for PD:

• sensory input

• perceptual

two categories of of impairments that would NOT be expected with PD are:

UPDRS

the ___________ is an outcome measure for PD that involves both self reported sections and motor examination portions, and is the GOLD STANDARD for parkinsons

• finger taps

• hand opening

• toe taps

• foot stomping

4 ways to test hypokinesia:

rotational components, activation maneuver

the way to test rigidity is to do ___________ and then add an ___________

ON

skill acquisition for PwPD is enhanced when they’re in _____ time

auditory or visual

external _______ cues can be beneficial for steps and gait with PD

• stop

• stand tall

• shift your weight

• step

the 4 Ss of freezing strategy are: