Neuromuscular Diseases

  1. The meninges of the brain and spinal cord become inflamed due to an infectious organism
  2. Can be bacterial or viral in origin
  3. Vaccines are now available to help protect against __________
    Haemophilus influenzae type B (HiB) infection
  4. The inflammatory response can result in hydrocephalus, edema, and increased intracranial pressure Increased risk of infarction (obstruction of local circulation resulting in necrosis of tissue)
  5. Stretch or pressure to the meninges will cause the cardinal sign of meningitis
    Headache, throbbing pain in neck
  6. Meningitis typically caused by __________ found in the upper respiratory tract
  7. Neurological deficits remain in approximately ____%of people with bacterial meningiti
  8. As inflammation progresses in bacterial meningitis, flexion of the neck will produce pain in the hips and knees (_____________ sign), due to tension on the meninges and neural structures
  9. Bacterial meningitis may have pain with combined hip flexion and knee extension (Kernig’s sign), due to tension on the meninges and neural structures________
    (Kernig’s sign), due to tension on the meninges and neural structures
  10.  Bacterial meningitis is treated with
    broad spectrum antibiotics
  11.  Antibiotics must be able to cross the ______ _____________ and achieve sufficient concentrations within the cerebrospinal fluid (CSF)
    blood-brain barrier
  12. Treatment for viral meningitis is typically
  13. An acute inflammatory disease of the tissue of the brain caused by direct viral invasion or hypersensitivity initiated by the virus.  Inflammation primarily of the gray matter
  14. Encephalitis, an acute inflammatory disease of the tissue of the brain caused by direct viral invasion or hypersensitivity initiated by the virus.  Inflammation primarily of the _____ matter
  15. Encephalomyelitis can result from other viral infections:
    ◦ Measles ◦ Mumps ◦ Rubella ◦ Varicella
  16. Clinical manifestations of encephalitis depend on the causal agent but can include
    ◦ Headache ◦ Nausea ◦ Vomiting ◦ Altered conciousness  Treatment varies dep
  17. Rare forms of spongiform  encephalopathies  transmitted by prions  (infectious proteins that are abnormal forms of normal cellular proteins) that include: ◦Creutzfeldt-Jakob Disease ◦Bovine spongiform encephalopathy
    Prion disease
  18. The _______contains no nucleic acid but can replicate within the nervous system
  19. Accelerated death of _______cells (nerve cells in the middle layer of the cerebral cortex )resulting in ataxia (the inability to coordinate voluntary muscular movements)
  20. purkinje’s cells
    nerve cells in the middle layer of the cerebral cortex
  21. the inability to coordinate voluntary muscular movements
  22. treatment for prion diseases;
    only symptomatic and supportive care
  23. Once diagnosed, rapid progression typically occurs and eventually fatal
    Prion Disease
    Degenerative Diseases of the CNS
  25. Cause is unknown and characterized by degeneration and scarring of the motor neurons in the lateral aspect of the spinal cord, brainstem, and cerebral cortex
    Amyotrophic Lateral Sclerosis (ALS)
  26. “Most physically devastating of the neurodegenerative diseases”
  27. More commonly known as Lou Gehrig’s disease
  28. Peripheral nerve changes result in muscle fiber atrophy
  29. Familial ALS (FALS) occurs in ____% of all ALS cases (inherited ________ trait)
    5-10: autosomal trait)
  30. ALS effects the pyramidal cells (pyramid shaped cells in the cerebral cortex) of the _____________and the surrounding premotor areas, sensory cortex and temporal cortex. Extensor muscles become weaker than flexor muscles
    cerebral cortex
  31. May see ________signs (neurons originating in the medulla) ◦ Difficulty with articulation ◦ Difficulty chewing ◦ Difficulty swallowing
  32. Inability to hold the eye closed against pressure is a standard clinical
    test for ALS
  33. Fasciculations (_____________) of the tongue are present with lower motor neuron dysfunction
    muscular twitching
  34. Dysarthria associated with ____ dysfunction ◦ Inability to shout or sing ◦ Hoarse voice quality
  35. In ALS death usually occurs in ___ years after diagnosis, primarily from pneumonia related to respiratory compromise
  36. Progressive dementia characterized by a slow decline in memory, language, visual spatial skills, personality and cognition
  37. Incidence increases with age  Growing evidence of relationship between AD and vascular disease  May have a genetic component
  38. No single cause  Loss of neurons  Changes in neurotransmitter
  39. region of the brain involved in forming, storing and processing memory
  40. Amygdala
    a region of the basal ganglia
  41. First brain structure to show pathologic findings is the cerebral cortex ◦Select neurons: pyramidal cells with __________ __ _________ projections
    corticocortical or hippocampal
  42. Two characteristic brain findings of AD
    ◦Neurofibrillary tangles ◦Senile plaques
  43. Prognosis: fatal in 7-11 years
  44. No cure, only symptomatic and supportive care  Often first functional sign is the inability to learn new information
  45. Progressive hereditary disease characterized by abnormalities of movement, personality disturbances, dementia
    Huntington's disease
  46. Choreic movement:
    brief, purposeless, involuntary and random
  47. Autosomal dominant disease; all that inherit the gene will develop symptoms of the disease
    Huntington's disease
  48. Risk of Huntington's disease in each child of an affected adult
  49. Ventricles enlarge as a result of the atrophy of the _______ ______ in Huntington's disease.
    basal ganglia
  50. Extensive loss of small and medium sized neurons  Atrophy of the putamen correlates with neurological symptoms  Early on, involuntary movements may be thought of as “restlessness” (face and UEs)
    Huntington's disease
  51. In Huntington' disease, atrophy seen in the __________ and putamen
  52. Chorea is increased by activities that require concentration or by increased emotions or task complexity. How do you test?
    ask patient to perform rapid tongue movements
  53. Neuropsychologic and psychiatric disorders are a part of Huntington’s disease:
    ◦ Personality changes ◦ Behavioral changes ◦ Irritability ◦ Depression ◦ Decreased work performance ◦ Violence ◦ Impulsivity ◦ Emotional lability (rapid emotional changes)
  54. ____% of persons affected with Huntington’s disease will attempt suicide
  55. Patient education regarding safety issues  If bradykinesia present, may have tendency to “freeze”   Motor learning may be limited due to the disease processes  Positioning important
    Implications for PTA intervention-Huntington's disease
  56. Hallmark: Sclerotic plaques distributed throughout CNS (Central Nervous System)
  57. In MS demyelization is ?
    myelin sheath of the nerves is replaced by fibrous scarring, interfering with the transmission of messages along the nerves
  58. In MS there is primarily _______ matter damage or lesions
  59. lesions slow or block neuronal transmission resulting in
    Weakness Sensory loss Visual dysfunction
  60. MS occurrence in females:males is
  61. In US approximately __________ people are affected by MS
  62. Uncommon before adolescence. Incidence rises from teen years through age 35 and declines gradually
  63. MS a disease of ___________climates. In both hemispheres, prevalence ___________ with decreasing latitude
    temperate: decreases
Card Set
Neuromuscular Diseases
PTA Patho Exam 2