بسم اللة الرحمن الرحيم اللهم اغفر لخلود و ارحمها وجميع المسلمين

parkinsonism -anatomy of basal ganglia -connection of basal ganglia -functions of basal ganglia

Etilogy 1-heridofamelial 2-traumatic 3-inflamatory 4-vascular 5-degeneration 6-demylination 7-toxic 8-powerful tranquilizer 9-metabolic 10-idiopathic

Pathology 1-loss of inhibitory mechanism 2-neuro chemical mechanism

Clinical manifestation 1-Rigidity 2-brady kinesia 3-tremor 4-impaired postural reaction 5-weakness,easy fatiguability 6-mask face 7-flexed rigid attitude

8-gait abnormality 9-autonomic symptom;flushing, sweating,excessive salivation,excessivesebaceous secretion 10-mentality is normal in most cases

Assessment and physical problems; 1- hand held dynamometer for detecting muscle power 2-ROM 3-ADL activities 4-EMG 5-co ordination test 6-flexability tests

6-round measurment 7-balance assessment 8-gait assessment 9-fixed or mobile deformity

Physical problems; 1-disuse atrophy 2-muscle weakness 3-shortening of ;hip and knee flexors,hip adductor,planter flexors,upper chest,dorsal,lumbar spine,neck flexors,shoulder adduction and internal rotators,forearm pronators,wrist and finger flexors

4-deformity;forward head posture and kyphosis,in some patients scliosis 5-osteoprosis 6-poor balance 7-decreased of vital capacity 8-oedema of feet and ankle 9-loss of weight 10- incoordination

Treatment 1-vestibular EX;rocking chair,horse drawn,balnce board,medical ball,telting table for relaxation,reducing rigidity,improve mobility 2-ROM EX 3-GA EX 4-positioning 5-PNF 6-stretching of tight muscle

7-joint mobilization 8-particular concentration on activating extensor muscle to counteract the tendency of flexion attitude 9-balance training 10-coordination ex 11-isometric ex with minimal resistance

12-breathing ex 13-gait training