Scenario: 74-year-old male with a history of hypertension and smoking, is having dinner with his wife when he develops sudden onset of difficulty speaking, with drooling from the left side of his mouth, and weakness in his left hand. His wife asks him if he is all right and the patient denies any difficulty. His symptoms progress over the next 10 minutes until he cannot lift his arm and has trouble standing. The patient continues to deny any problems. The wife sits the man in a chair and calls 911. The EMS squad arrives within 5 minutes. Upon arrival in the ED, patient‘s blood pressure was 178/94, pulse 78 and regular, PaO2 97% on room air. Neuro exam – Cranial nerves- Mild left facial droop. Motor- Right arm and leg extremity with 5/5 strength. Left arm cannot resist gravity, left leg with mild drift. Sensation intact. Neglect- Mild neglect to left side of body. Language- Expressive and receptive language intact.
Mild to moderate dysarthria. Able to protect airway.
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.
Solution:
Both the neurological and musculoskeletal pathophysiologic processes
The 74-year-old patient in this case study is found to have mild-moderate dysarthria. As described by Mitchell et al. (2017), dysarthria is a collection of neurogenic speech disorders that present abnormalities in speed, strength, tone, accuracy, or steadiness of movement necessary for phonatory, breathing, resonatory, prosodic, and articulatory aspects of speech production. Dysarthria occurs following interruption or reduction of blood and oxygen flow to the brain, causing neurological impairment. Considering musculoskeletal pathophysiology, the reduced blood and oxygen flow to the brain causes muscle decline characterized by remodeling disorder, bone loss, low BMD/BMC, increase the risk for fracture, atrophy, increased catabolic activity, altered inflammatory signaling, functional disability, and myofiber phenotype shift. They occur due to sympathetic activation and immobility (Mitchell et al., 2017)………To access the solution click the icon below to purchase at $10