BSC 2346 A&P Case Study Module 6 Complete Solution
QUESTION 1
Donna, a 42-year-old mother of two, has been experiencing intermittent tingling and numbnes
... [Show More] s in both of her feet. She has also had trouble holding a pen while writing. In the past few months, the tingling and numbness in her extremities seemed to subside on its own, so she was not very concerned. Recently, though, the symptoms have spread to her knees and thighs and are persisting.
Yesterday, she stumbled when getting out of bed in the morning. When she tried to stand, her right leg was too weak to hold her weight and she fell again. She noticed that she scraped her right knee during the fall, but does not feel any pain from the wound. Donna notices that she has blurry vision and thinks that might be the reason she fell.
All of the following indicate sensory deficits EXCEPT:
1. Muscular weakness
Tingling in her feet
Numbness in her legs
Blurry vision
QUESTION 2
Donna does not feel the wound on her knee. In a normal situation, describe how this sensory input of a scraped knee would result in the feeling of pain.
A scrape to the knee is categorized as a nociceptive pain, this kind of pain is caused by an injury to the tissues of the body such as a scrape, cut, burn, or fracture (myDr, 2012). Nociceptive pain tends to feel like aching, sharp, or throbbing pain that can be constant or intermittent (myDr, 2012). This pain is recognized by the body due to sensory receptors in the skin. A-beta nerve fibers then send signals through the spinal cord and central nervous system to the brain where the sensation of pain is registered, processed, and perceived (myDr, 2012).
Reference:
https://www.mydr.com.au/pain/pain-and-how-you-sense-it
QUESTION 3
Donna has weakness in her right leg, but her left leg is functioning normally. Which components of the nervous system are involved with skeletal muscle movement? Be specific about how the motor impulse moves through the body.
Muscle movement is controlled by the somatic nervous system. The motor impulse is sent from neuron to another throughout the body by synapse and also moving along motor fibers. A response is then carried out once the signal reaches the muscle.
Reference:
https://biologydictionary.net/somatic-nervous-system/
QUESTION 4
Which of the following correctly defines a motor unit?
A single muscle and its largest associated nerve
All motor units are afferent neurons
A single neuron and all the muscle cells it innervates
A single muscle and all the neurons that innervate it
QUESTION 5
Which of the following statements is true?
Donna is experiencing problems related to sensory neurons only.
Donna’s symptoms are most likely only related to the brain, and not peripheral nerves.
Donna is experiencing problems related to motor neurons only.
Donna is experiencing both motor and sensory deficits.
QUESTION 6
List and describe any and all symptoms in Donna’s history that could be related to a pathology of her motor neurons.
Holding a pen while writing which could be caused by damage to the nerves in the hand or could be caused by neuron syndrome.
Reference:
https://www.buoyhealth.com/symptoms-a-z/hand-weakness/
QUESTION 7
Donna’s primary care physician wants to screen her for Multiple Sclerosis. Which of the following tests would provide the most definitive diagnosis for MS?
MRI
Bone scan
Complete blood count
Muscle strength test
QUESTION 8
If Donna does have MS, the disease is affecting her myelin sheath. Briefly describe what happens to the myelin sheath and how it disrupts nerve function in patients with Multiple Sclerosis.
In MS the T cells attack the myelin sheath which protects nerve fibers, during this process the T cells partially or completely remove the myelin from the fibers which leaves the nerves unprotected and uninsulated (Fernando Dangond, MD, 2019). Because of this the nerves send delayed or distorted messages to the brain and the brain may then misinterpret those messages.
Reference:
https://www.emedicinehealth.com/myelin_and_the_central_nervous_system/article_em.htm#how_is_the_myelin_sheath_destroyed_demyelination
QUESTION 9
Donna later sees a specialist who wants to perform a spinal tap, which is an analysis of cerebrospinal fluid. Where is cerebrospinal fluid (CSF) found?
Inside each neuron’s soma
Peripheral nerves
Surrounding every synapse and neuromuscular junction in the body
Surrounding the structures of the Central Nervous System
QUESTION 10
After extensive testing, Donna’s care team concluded that she does have Multiple Sclerosis and have prescribed steroid treatment. How will steroids help alleviate her symptoms?
Steroids help to decrease inflammation surrounding the damaged nerve and also helps to suppress the immune system (Multiple Sclerosis Trust, 2017).
Reference:
https://www.mstrust.org.uk/a-z/steroids-methylprednisolone
QUESTION 11
Andre is a 68-year-old grandfather who has been struggling with his memory lately. At first, he was simply forgetting an appointment from time to time or forgetting to take his morning vitamins. However, now his spouse and children have noticed that his forgetfulness is progressing. There have been moments where he forgot how to get home, couldn’t remember his own phone number, or the names of his grandchildren. His family is worried he may have Alzheimer’s disease and they are not sure what to do.
Andre’s family decides to do some research about dementia and
Alzheimer’s disease. Which of the following statements is true?
1. Dementia is a normal form of aging, but Alzheimer’s disease is not.
Alzheimer’s disease involves neuron damage and dementia does not.
Alzheimer’s disease is not related to dementia.
Alzheimer’s disease is a form of dementia.
QUESTION 12
Which of the following is NOT a typical symptom of Alzheimer’s disease?
Mood and behavior change
Disorientation to time and place
Forgetting appointments, but remembering them later
Difficulty recalling recently learned information
QUESTION 13
Which of the following scenarios is considered a normal age-related change in memory?
Having trouble remembering the rules of a favorite game
Paying less attention to grooming and/or cleanliness
Avoiding social activities, hobbies, or sports
Misplacing items occasionally and needing to retrace steps to find them
QUESTION 14
What are the indications in Andre’s history that would support a diagnosis of Alzheimer’s disease?
Some indications from Andre’s history in question 11 are that he has had moments that he has forgotten how to get home, he couldn’t remember his grandchildren’s names, and could not remember his own phone number. These are indicators that there is something going on with his memory and it could very well be Alzheimer’s.
Reference:
Case Study Question 11
QUESTION 15
What other Alzheimer’s disease risk factors might exist that are not given in Andre’s history? List and describe at least 5 risk factors.
• The greatest risk factor from Alzheimer’s is increasing age. As we get older, we naturally become forgetful such as maybe misplacing things or occasionally forgetting an appointment (I tend to do this now and I am just turning 24 haha). With Alzheimer’s increasing age is a high risk because the normal forgetfulness that comes with age increases which can be dangerous.
• Family history is a risk factor as well because if a person’s mom, dad, or sibling have Alzheimer’s then that person is at a higher risk of developing the disease. If more than one person in the family has it then there is an even higher risk.
• Head injury can cause the future risk of dementia, so it is important to protect your brain at all times.
• Heart-head connection it has been shown that brain health is linked to heart health. Those with heat disease, diabetes, stroke, high blood pressure, and high cholesterol are at a greater risk for Alzheimer’s or vascular dementia.
• Latinos and African-Americans in older age are at a greater risk of developing Alzheimer’s or dementia than Caucasians. Researchers believe this is due to the higher rates of heart disease in these groups of people.
Reference:
https://www.alz.org/alzheimers-dementia/what-is-alzheimers/causes-and-risk-factors?utm_source=google&utm_medium=paidsearch&utm_campaign=google_grants&utm_content=alzheimers&gclid=CjwKCAjw7anqBRALEiwAgvGgm-Yb9nBvbf9AJlQmAF4CIXEyUCcGfoqeolpH9wQ-UAcwmgwx-wEkdxoCdXMQAvD_BwE
QUESTION 16
As Alzheimer’s disease progresses, the brain produces less and less of which neurotransmitter?
Acetylcholine
Calcium
Dopamine
Serotonin
QUESTION 17
Alzheimer’s disease is diagnosed using all of the following tools EXCEPT:
Brain scans
Blood tests, urine tests, and spinal fluid analysis
Tests to measure memory, problem solving, attention, and language
Peripheral nerve biopsy
QUESTION 18
Describe how the plaques found in Alzheimer’s disease disrupt nerve impulses.
Amyloid plaques are produced and broken down by the body. In Alzheimer’s the plaques are not broken down they instead become hard plaques that are insoluble and attach between neurons which causes a block in the nerve impulses and makes it so that the nerve impulses are unable to travel between neurons.
Reference:
https://www.brightfocus.org/alzheimers-disease/infographic/progression-alzheimers-disease
QUESTION 19
There is no cure for Alzheimer’s disease, but cholinesterase inhibitors can be used to treat symptoms like memory loss or language issues. Briefly discuss how this type of medication affects the physiology of neurons and nerve impulses.
The inhibitors block the breaking down of acetylcholine between the neurons at the synapse. Because there is more break down of acetylcholine than there is production the inhibitor compensates for that by causing a delay in the memory decline in Alzheimer’s.
Reference:
https://www.alz.org/alzheimers-dementia/treatments/medications-for-memory
QUESTION 20
Andre’s primary care physician will likely refer him to a specialist. Which type of specialist treats Alzheimer’s disease? With the information you are given about Andre, how do you think his specialist will proceed? List and describe at least 3 treatments, tests, or other options that would make sense for Andre’s stage of memory loss.
Andre would see a neurologist because of Alzheimer’s being a neurological disease. Andre will most likely undergo one or more of these tests in order to be provided a definitive diagnosis. A CT or MRI will be done to determine if there are any abnormal structures, volume loss, white matter disease, masses, or vascular abnormalities. Cerebrospinal Fluid Test (CSF) may also be done to test the amyloid and tau proteins, if the results are abnormal it is considered a “biomarker” for Alzheimer’s disease. There are also neuropsychological assessment tools that are used to determine the current cognitive difficulties that Andre is facing, as well as keep track of where he is currently and compared to where he is in a few months.
Reference:
https://www.brightfocus.org/alzheimers/article/diagnostic-tests-alzheimers-disease?gclid=CjwKCAjw7anqBRALEiwAgvGgmzzYV4OJPXXkYaKvCawOTjf4TYXZYvDyXNhgKJwShOG6ocEjOtcUbxoChlAQAvD_BwE [Show Less]
