BSC 2346 A&P Case Study Module 7 Complete Solution
Scott, a 37-year-old elementary teacher, is seeing his general practitioner for complaints ... [Show More] of general weakness, especially in his lower extremities. He has also been feeling very fatigued lately and has trouble keeping up with his students throughout his work day. His physician notes that he has lost a significant amount of weight in the last 6 months. Scott reports that even simple tasks, such as brushing his hair and getting dressed, can seem like a chore. He has trouble climbing stairs because of his weakness and notices that his speech is slurred, especially at the end of the day.
Scott’s physician uses a tongue depressor during his physical examination and Scott begins to gag and has difficulty swallowing. His physician notes muscle wasting and abnormal spasticity in upper and lower extremities bilaterally. All reflexes are normal except the Babinski reflex. Scott’s toes fan out when the sole of his feet are stroked with the reflex hammer.
Scott’s symptoms are primarily related to problems with:
1. Neurons of the autonomic nervous system only
Both sensory and motor neurons
Because Scott’s symptoms are progressively getting worse over a period of several months, we can rule out which of the following diagnoses?
Amyotrophic Lateral Sclerosis
Traumatic spinal cord hemisection
Scott’s physician believes he may have ALS. Briefly describe this condition in your own words.
ALS is a progressive disease that attacks the nerve cells in a person’s brain and spinal cord which eventually weakens muscle and causes deterioration of physical functions.
Which of the following is NOT an early symptom of ALS?
Loss of balance
What are the major differences between ALS and MS, physiologically? Describe any pathological differences you find in your research.
• ALS is a hereditary disease that affects 1 in 10 people because of mutated protein.
• MS is an autoimmune disease that results in mental impairment whereas ALS results in more of physical impairments.
• MS in its late stages is almost never debilitating or leads to death, but ALS in its late stage is debilitating, can lead to paralysis, and death.
• MS is more common in women and ALS is more common in men.
• ALS is not an autoimmune disease but MS is
• ALS attacks nerve cells while MS attacks the myelin sheath
Scott has a positive Babinski reflex. What is the significance of this? What does a positive Babinski reflex mean in adult patients?
A positive Babinski reflex in an adult helps prove that there is an underlying nervous system or brain condition that is causing an abnormality in his reflexes.
ALS stands for Amyotrophic Lateral Sclerosis. What does “amyotrophic” mean? What is happening to the body (physiologically) if it is experience “amyotrophic” changes?
Amyotrophic means “no muscle nourishment” what happens to the body during amyotrophic is the muscle is not receiving nourishment is begins to waste away or it “atrophies”
ALS stands for Amyotrophic Lateral Sclerosis. What is the word “lateral” referring to in this case?
The neurodegeneration affects the lateral portion of the cerebrum.
The symptoms only affect one side of the body.
The disease only affects the lateral part of the body.
The neurodegeneration affects the lateral columns of the spinal cord.
The motor neurons affected by ALS are found in the spinal nerves and peripheral branches of those spinal nerves only.
Which of the following statements regarding ALS is true?
ALS cannot be cured, but medication can stop the progression and sometimes reverse the effects of ALS.
Diagnosing ALS can involve a spinal tap, electromyography, X-rays, MRI, muscle and nerve biopsies, and blood tests.
The average survival time for a patient diagnosed with ALS is 20-25 years post-diagnosis.
The familial type of ALS is the most common and accounts for 80% of all ALS cases in the U.S.
Russell is 72 years old and is still working part-time as a professor. He has noticed some arm and hand shaking in the past year, but assumed it must be related to low or high blood sugar levels because he has had some issues with that in the past. However, the shaking/twitching has become more consistent lately and does not seem to be correlated with his diet. Russell’s doctor said that the stress of his job could be the problem, so he took the entire summer off from teaching.
When he returned to work in the fall, Russell and his students noticed that his handwriting has become nearly illegible. Drinking a cup of coffee without spilling had also become a challenge. Russell returned to his doctor, who performed a physical exam and a few tests. Here are the notable results: shuffling gait, mild bradykinesia, mild voice tremor, intermittent rigidity of the limbs, and normal EEG.
If Russell is having symptoms in his upper extremities, lower extremities, and his speech is slurred, which of the following body regions is most likely experiencing a pathology?
1. Spinal nerves
Brain and spinal cord
Russell’s physician suspects that he may have Parkinson’s disease. List at least two other diagnoses that could fit Russell’s history and test results.
Two more diagnoses that fit Russell’s history could be progressive supranuclear palsy and multiple system atrophy
Which of Russell’s physical exam findings could be related to a brain condition?
shuffling gait, mild bradykinesia, mild voice tremor, intermittent rigidity of the limbs
Shuffling gait is often associated with Parkinson’s disease. Which of these symptoms is NOT another common sign of Parkinson’s disease?
Russell’s physician decides to follow-up with an MRI. If he does have Parkinson’s disease, his MRI may show degeneration in which part of the brain?
Parkinson’s disease involves the loss of a particular neurotransmitter. Which neurotransmitter is involved and how is it associated with the motor symptoms of Parkinson’s disease?
The neurotransmitter associated with Parkinson’s disease is dopamine. Dopamine is connected to the motor symptoms associated with Parkinson’s because it is responsible for sending messages that plan and control muscle and body movement. With no or lack of dopamine our motor functions become impaired.
Which of the following is NOT a treatment option for Parkinson’s disease?
Deep brain stimulation
If Russell is diagnosed with Parkinson’s disease and chooses not to pursue treatment, what is his prognosis?
The prognosis he most likely received was neither bad nor good due to Parkinson’s not being life threatening. Although, Parkinson’s is not life threatening it does affect a person’s quality of life. There is no cure so treatment focuses on the symptoms, but if symptoms are left untreated they can lead to falls and other complications.
What does the term “neurodegenerative” mean? Briefly describe this term in your own words. (Do not copy a definition.)
Neurodegeneration occurs over a period of time, during this time neurons lose their structure, function, or even die.
Which of the following statements is true regarding Parkinson’s disease?
It is possible to reverse the effects of Parkinson’s disease.
Parkinson’s disease is typically diagnosed before 40 years of age.
The loss of neurons is often accompanied by the necrosis of astrocytes and an increase in microglia.
Brain imaging typically shows degeneration of neurons in the temporal lobe. [Show Less]