Joanne Just Celebrated Her 50th Birthday And Knows That She ✓ Solved

Joanne just celebrated her 50th birthday and knows that she

Joanne just celebrated her 50th birthday and knows that she should probably see her physician for a physical. She’s generally in good health, but has been experiencing some odd symptoms lately. Joanne has been experiencing mild to moderate headaches once or twice a week, usually in the morning hours. She feels that her mental acuity “isn’t what it used to be” and forgets the day of the week occasionally.

Her husband often complains that she has the TV too loud, but Joanne thinks it’s a normal volume. She has noticed that her feet and toes are colder and she has to wear socks and slippers around the house to be comfortable. A few nights a week, she wakes up in the middle of the night with tingling and numbness in her right hand. Joanne works at a desk all day and she notices a sharp, and sometimes throbbing, pain in her feet bilaterally after a long workday. She was thinking that her symptoms were just part of aging, but wonders if it could be abnormal. She has no history of major trauma, alcoholism, cancer, or inherited diseases.

Which of the following choices would best describe the symptoms in Joanne’s feet? Sensory neuron dysfunction, Motor neuron dysfunction, Both sensory and motor neuron dysfunction, Permanent neuron damage to the sympathetic nervous system.

Which of Joanne’s symptoms could be related to peripheral neuropathy?

All of the following are possible causes for peripheral neuropathy EXCEPT: Hemorrhage, Intervertebral disk herniation, Medications, Vitamin B deficiencies.

If Joanne’s neuropathy is related to diabetes, what are some complications she can expect (and try to avoid)? List and describe at least three complications.

All of the following might be explanations for Joanne’s right hand symptoms, EXCEPT: Cervical disc herniation, Carpal tunnel syndrome, Sleeping on her right shoulder, causing pressure on the brachial plexus, Lumbar disc herniation.

If Joanne’s hand symptoms are caused by carpal tunnel syndrome, which nerve would be affected? Median nerve, Radial nerve, Axillary nerve, Ulnar nerve.

If Joanne’s hand symptoms are caused by carpal tunnel syndrome, which of her fingers would be affected by the numbness? 1st digit only, All digits, 1st – 3rd digits, 1st-3rd digits and medial half of the 4th digit.

How might Joanne’s lower extremity symptoms be related to her job? Briefly describe how ergonomics might be related to the pathophysiology she is experiencing.

Dysfunction of the following structures would explain Joanne’s numbness? Ventral root, Dorsal root, Lumbar plexus, Corticospinal tract.

Dysfunction of which of the following structures may be the cause of Joanne’s lower extremity symptoms? Brachial plexus, Sacral plexus, Lumbar plexus, Cervical plexus.

Georgia is 20 years old. She works at a stressful full-time job, co-parents a four-year-old, and is attending evening courses to finish her bachelor degree. She has no history of significant trauma or health concerns, other than well-managed type I diabetes. She woke up one morning feeling a little off. When she looked in the mirror, she noticed that her right eye looked droopy and she was unable to smile fully. She panicked, called 911, and ran to her neighbor’s house to ask for a ride to the hospital.

Georgia remembers learning in one of her first aid courses that face drooping was a sign of a stroke, so she was very worried. It is unlikely that Georgia is experiencing a stroke. List and explain at least three reasons why a stroke is unlikely in this case.

When she arrives at the hospital, the attending physician believes she may be experiencing Bell’s palsy. Which of the following Cranial Nerves is affected by Bell’s palsy? Oculomotor Nerve, Vagus Nerve, Facial Nerve, Trigeminal Nerve.

Which of the following statements is true regarding Cranial Nerve VII? CN VII contains sensory neurons relating to vision only, CN VII contains motor neurons only, CN VII contains both sensory and motor neurons, CN VII contains sensory neurons only.

Georgia’s physician decides she does, indeed, have Bell’s palsy. The physician tells Georgia that until the disorder resolves, she may experience a lack of taste on which part of her tongue? Posterior 2/3rds, Lateral portions, Anterior, Sublingual.

Besides the Facial Nerve, which of the following also controls motor function of the facial muscles? Glossopharyngeal Nerve, Optic Nerve, Olfactory Nerve, Trigeminal Nerve.

If Georgia lost the sense of taste on her entire tongue, which of the other cranial nerves may be damaged? Vagus Nerve, Accessory Nerve, Hypoglossal Nerve, Glossopharyngeal Nerve.

In this case study, you are only given one symptom that Georgia experienced- facial drooping. Now that you know she has been diagnosed with Bell’s palsy, list and explain at least 3 other symptoms that she may be experiencing.

Bell’s palsy is often linked to each of the following causes, EXCEPT: Mononucleosis, Influenza, Herpes simplex, Lead poisoning.

Georgia has several risk factors for Bell’s palsy. List and describe at least two risk factors given in this case study.

While waiting to be discharged from the hospital, Georgia looked up some symptoms of cranial nerve dysfunction and found something called “tic douloureax”. She asked her nurse if she should expect to experience this painful symptom and her nurse said no because tic douloureax is usually only associated with dysfunction of ______. CN V, CN VIII, CN VII, CN I.

Paper For Above Instructions

Joanne’s symptoms indicate a potential underlying condition that requires medical evaluation. The most prominent symptoms she experiences include cold feet, tingling and numbness in her right hand, headaches, and a decline in her mental acuity. To assess her symptoms accurately, it's crucial to understand the types of nerve dysfunction these complaints may represent.

The symptoms in Joanne’s feet can best be described as sensory neuron dysfunction. Sensory neuropathy occurs when there is damage to the sensory nerves, causing a reduction in sensation, numbness, or pain in the feet. This aligns with Joanne's experience of cold feet and the necessity to wear warmer garments indoors.

Joanne’s symptoms could also be related to peripheral neuropathy, a condition often characterized by weakness, numbness, and pain, usually in the hands and feet. Symptoms like cold extremities and insomnia due to numbness fall within the characteristic presentations of peripheral neuropathy. Peripheral neuropathy can arise due to various factors, including diabetes, which Joanne may be at risk for given her age and symptoms.

The potential causes of peripheral neuropathy are extensive, including vitamin deficiencies, particularly Vitamin B12, which is known to impact nerve health adversely. However, hemorrhage is not typically listed among the causes of peripheral neuropathy. Intervertebral disk herniation can also cause peripheral nerve compression, but it is not directly linked to peripheral neuropathy.

If Joanne's peripheral neuropathy is indeed related to diabetes, she should be aware of complications such as neuropathic pain, increased risk of foot ulcers, and loss of motor function in her lower extremities, which can lead to mobility issues. Neuropathic pain can manifest as burning or discomfort in the feet, foot ulcers result from a lack of sensation leading to injury, and muscle weakness can hinder mobility.

For her right-hand symptoms, which could originate from carpal tunnel syndrome (CTS), it is important to recognize that the median nerve could be affected. Patients with CTS often exhibit symptoms such as numbness and tingling in the fingers supplied by the median nerve, which primarily affects the 1st to 3rd digits and the medial half of the 4th digit.

Ergonomics plays a crucial role in the discomfort Joanne experiences, particularly as they involve her work at a desk. Poor ergonomic positioning can lead to undue pressure on nerves, potentially exacerbating her hand symptoms and contributing to neuropathy in her lower extremities, thereby increasing her discomfort after extended periods of work.

Additional dysfunction in related neural structures may exacerbate Joanne's symptoms. For instance, issues with the dorsal root can lead to sensory deficits, much as problems in the lumbar plexus could affect her lower body mobility.

In the case of Georgia, her symptoms of a drooping face and inability to smile indicate a likely diagnosis of Bell's palsy. This condition is often caused by inflammation or damage to the facial nerve (Cranial Nerve VII), which is responsible for motor control in the face. In this context, stroke becomes unlikely due to the absence of significant risk factors such as advanced age, sudden onset other than Georgia’s acute episode, and absence of accompanying neurological deficits often associated with a stroke.

Furthermore, the presence of droopy features alongside a few other symptoms common in Bell's palsy—such as loss of the ability to smile fully and potential alteration of taste—distinctly point to this diagnosis rather than stroke. Her age and well-managed Type 1 diabetes add complexity but not immediate concern for stroke.

Complications associated with Bell’s palsy can include chronic facial weakness, synkinesis, or involuntary movements, and altered taste sensation in the anterior portion of the tongue, a consequence of the facial nerve damage.

Georgia's risk factors for Bell’s palsy may include her stress, which is known to exacerbate neurological conditions, and her relatively young age, as it preferably affects younger populations. Other possibilities include genetic predispositions or prior infections like viral illnesses.

In conclusion, both Joanne and Georgia present complex cases requiring tailored evaluation and management based on their unique sets of symptoms and underlying health conditions. Understanding the interplay between neural function and symptomatology is vital in guiding appropriate interventions.

References

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• American Diabetes Association. (2020). Standards of Medical Care in Diabetes – 2020. Diabetes Care, 43(Supplement 1), S1-S232.
• Whitaker, H.A. (2019). Carpal Tunnel Syndrome: An overview. Physical Medicine and Rehabilitation Clinics of North America, 30(2), 295-304.
• Huisman, M. (2021). Bell's Palsy: Diagnosis and treatment. American Family Physician, 105(3), 224-230.
• Griffin, J.W., & Cornblath, D.R. (2019). Peripheral Neuropathy. In J. A. McGee & M. E. Novak (Eds.), Handbook of Clinical Neurology (Vol. 160, pp. 379-392). Elsevier.
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