Week 8: Concepts of Neurological and Musculoskeletal Disorders Essay
Week 8: Concepts of Neurological and Musculoskeletal Disorders
The case study depicts a 67-year-old male presenting with a chief complaint of arm tremors. He also reports having some tremors in his leg. The patient is brought by his son, who states that his father happens to be “stiff” and as a result, he takes much longer to carry out simple tasks. Besides, he states the father requires assistance rising from a chair. Positive physical exam findings include tremors in the hands during rest and fingers having “pill-rolling” movement. In addition, the face is immobile and has a mask-like appearance. The patient’s gait is bumpy, causing shuffles when walking and the head, neck, hips, and knees are flexed forward. He has jerky movements. He reports having episodes of excessive sweating and flushing not attributed to activity. Laboratory data is normal he is diagnosed with Parkinson’s disease (PD). The purpose of this paper is to discuss the neurological and musculoskeletal pathophysiologic processes contributing to the patient’s symptoms and racial/ethnic variables that may affect physiological functioning.
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Neurological and Musculoskeletal Pathophysiologic Processes
The patient’s symptoms of rigidity, tremor, abnormally slow movements, gait disturbances, and jerky movements can be attributed to reduced levels of dopamine in the brain. Dopamine is vital for the normal functioning of the extrapyramidal motor system, including support, control of posture, and voluntary motion (Copas et al., 2021). The decreased levels of dopamine can be attributed to degeneration of the pigmented neuronal cells in the substantia nigra located in the brain’s basal ganglia. The substantia nigra’s nuclei transmit fibers or neuronal pathways to the corpus striatum where neurotransmitters are vital in controlling complex body movements (Kouli et al., 2018). Therefore, the degeneration of neurons in the substantia nigra causes depletion of dopamine in the dorsal aspect basal ganglia resulting in most of the motor features of PD (Copas et al., 2021). Besides, the depletion of dopamine stores in the brain’s substantia nigra contributes to a higher amount of excitatory neurotransmitters than inhibitory neurotransmitters.
Any Racial/Ethnic Variables That May Impact Physiological Functioning
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Ethnic factors cause variations in the clinical symptoms of Parkinson’s disease and its treatment. A study by Ben-Joseph et al. (2020) shows that ethnicity may contribute to variations in the motor complications in Parkinson’s disease. For instance, PD patients from Europe and North America present with higher severity of dyskinesia and wearing off compared to PD patients from other regions. Besides, Asians often develop dyskinesia, and thus treatment recommendations include low doses of dopaminergic (Ben-Joseph et al., 2020). On the other hand, Japanese PD patients have the lowest occurrence of dyskinesia. Nevertheless, all PD patients, regardless of race/ethnicity, experience a high burden of non-motor PD symptoms.
How These Processes Interact To Affect the Patient
The neurological and musculoskeletal pathophysiologic processes interact to cause motor and autonomic symptoms, which affect the patient’s wellbeing and quality of life. Motor symptoms include resting tremor, rigidity, postural instability, and slow movements (Kouli et al., 2018). The pathophysiologic processes put patients at risk of falls due to inability to pivot and loss of balance. Autonomic symptoms that affect patients include extreme and uncontrolled sweating, paroxysmal flushing, constipation gastric and urinary retention, and sexual disturbances.
Conclusion
The patient’s PD symptoms are due to depletion of dopamine stores in the substantia nigra resulting in an imbalance that impacts voluntary movement causing gait disturbances. Dopamine depletes due to degeneration of the pigmented neuronal cells in the substantia nigra. Dyskinesia is common among PD patients from Europe and North America, while Japanese have the lowest prevalence.
References
Ben-Joseph, A., Marshall, C. R., Lees, A. J., & Noyce, A. J. (2020). Ethnic Variation in the Manifestation of Parkinson’s Disease: A Narrative Review. Journal of Parkinson’s disease, 10(1), 31–45. https://doi.org/10.3233/JPD-191763
Copas, A. N. M., McComish, S. F., Fletcher, J. M., & Caldwell, M. A. (2021). The Pathogenesis of Parkinson’s Disease: A Complex Interplay Between Astrocytes, Microglia, and T Lymphocytes?. Frontiers in Neurology, 12. https://doi.org/10.3389/fneur.2021.666737
Kouli, A., Torsney, K. M., & Kuan, W. L. (2018). Parkinson’s disease: etiology, neuropathology, and pathogenesis. Exon Publications, 3-26.
NURS-6501
Week 8: Concepts of Neurological and Musculoskeletal Disorders – Part 2
Module 5 Assignment: Case Study Analysis. Due on 1/23/22
An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other.
Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role. An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans.
In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.
To prepare:
By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements†section of the classroom for your assignment from your Instructor.
Assignment (1- to 2-page case study analysis)
In your Case Study Analysis related to the scenario provided, explain the following:
• Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
• Any racial/ethnic variables that may impact physiological functioning.
• How these processes interact to affect the patient.
Day 7 of Week 8
Submit your Case Study Analysis Assignment by Day 7 of Week 8.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.