Parkinson's Disease - Pathophysiology

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mizzoupt
ID:
70733
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Parkinson's Disease - Pathophysiology
Updated:
2011-03-04 15:17:53
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Pathophysiology Parkinson\'s Disease
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Parkinson's Disease in Exam 2 of Pathophys
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  1. The cause of Parkinson's Disease is _________
    Unknown
  2. Risk Factors for P.D.
    • Age
    • Gender
    • Genetic
    • Exposure to environmental toxins
  3. Risk Factors for P.D.:
    Age
    Over 60 years old, risks double from 1-2% to 2-4%
  4. Risks Factors for P.D.:
    Gender
    Men are 1.5 times more likely to develop PD than women
  5. Risk Factors for PD:
    Genetic
    • Around 5% of PD cases are familial or inherited.
    • 13 genes associated with PD, all play a role in dopamine-secreting cell function
  6. PD results in the following movement and postural abnormalities:
    • Resting tremors
    • Trouble initiating movement
    • Rigidity/Increased muscle tone
    • Stooped posture
  7. Pathophysiology of PD
    • Disruption of the extrapyramidal system
    • Extrapyramidal tracts associated with basal ganglia, which plays a role in movement
    • Substantia Nigra is a component of basal ganglia
    • Substantia Nigra is filled with dopamine-secreting neurons which are destroyed or stop working
    • Dopamine is an inhibitory neurotransmitter which helps to control movement
    • Decreased levels of dopamine cause remaining neurons to be overly excited
  8. PD damages __________
    • Norepinephrine-secreting neurons
    • Decreased norepinephrine affects the autonomic nervous system
    • This leads to constipation, skin and urinary problems, sexual dysfunction
  9. There is also the presence of _____ ______ in PD
    • Lewy Bodies
    • Lewy bodies are clumps of proteins found in the brains of most PD patients
    • Leads to dementia and memory loss
  10. Early signs and symptoms of PD
    • Fatigue
    • Muscle weakness
    • Muscle aching
    • Decreased flexibility
    • Less spontaneous in facial expression
  11. More obvious signs of PD
    • Resting tremors - pill rolling. Affects one side before the other
    • Increased muscle rigidity
    • Difficulty initiating movement
    • Bradykinesia
    • Loss of automatic movements like smiling, blinking, moving arms while walking
  12. Type of posture in PD
    • Stooped posture
    • Leaning forward with head and neck flexed
  13. Type of gait in PD
    • Festination/Propulsion gait
    • Short/shuffling steps that increase in speed over time - leads to falls
  14. "Freezing Period" in PD patients
    Person feels stuck and finds it difficult to start moving again
  15. Tremors in PD affects what first and then what next?
    • Affects hands, arms, and legs first
    • Moves to the jaw, tongue, forehead, and eyelids next
  16. Clinical features of PD that are non-motor functions
    • Dysarthria
    • Voice bcomes low and devoid of inflection
    • Chewing/swallowing difficult
    • Masked face - reduced blinking, blank staring face
    • Autonomic Dysfunction - urinary retention, constipation, orthostatic hypotension, skin problems, sexual dysfunction
    • Pain
    • Memory loss
  17. Co-morbidities of PD
    • Dementia-develops late in course of 20% of affected persons
    • Urinary tract and respiratory infections
    • Mood and anxiety disorders - depression, fear, anxiety
    • Disturbed sleep, fatigue, and compulsive behavior such as gamblin
  18. Diagnostic Testing of PD
    Currently no diagnostic testing known for PD
  19. Physician can perform what tests in PD
    • Medical history
    • Physical Examination
    • Observation
  20. 5 common stages of PD
    • Stage 1 - unilateral symptoms
    • Stage 2 - bilateral symptoms
    • Stage 3 - balance problems develop, no ssistive device needed
    • Stage 4 - assistance needed during ambulation
    • Stage 5 - wheel chair bound or bed ridden
  21. Juvenile Parkinson's Disease
    • Extremely rare
    • Symptoms begin before age 20
  22. Early-Onset Parkinson's Disease
    • Farely rare
    • Symptoms begin between 20-40 years old
  23. Medications used in treating PD
    • Carbidopa/Levodopa - Levodopa converted into dopamine and Carbidopa helps it get past blood brain barrier
    • Dopamine agonists
    • Anticholinergics
    • MAO-B inhibitors
    • COMT inhibitors
    • Glutamate (NMDA) blocking drugs
  24. Treatments for PD
    • Medications
    • Deep brain stimulation
    • PT and OT improve muscular function, gait, and balance, and ADLs
    • Speech Therapists help with speaking and swallowing problems
    • Dietary modification to avoid constipation
    • Massage
    • Yoga
    • Tai Chi
    • Exercise

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