Neurological And Musculoskeletal Disorders Essay Example

Neurological And Musculoskeletal Disorders Essay Example

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Introduction
Musculoskeletal disorders are conditions that affect the bones, joints, muscles, and connective tissues resulting in pain and progressive loss of function and disability if poorly managed. In this paper, the author will be discussing the pathophysiology of some of the musculoskeletal disorders.
Pathophysiology of Gout
Gout is the commonest chronic inflammatory arthritis and is caused by the deposition monosodium urate crystal in tissues like the joints and bones. Several factors are implicated in the pathophysiology of gout including genetic factors, metabolic disorders, immune mechanisms, and chronic inflammatory processes that lead crystal formation and deposition. Genetic and metabolic disorders that lead to hyperuricemia are the main factors contributing to gouty arthritis (Narang & Dalbeth, 2020)Neurological And Musculoskeletal

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Disorders Essay Example. This is because excess uric acid in blood can precipitate monosodium urate crystals formation through reduced urate solubility. When the crystals are deposited in joints and other tissues, an inflammatory response is triggered whereby macrophages phagocytose the crystals leading to cytokine production. The inflammatory response causes further joint inflammation and destruction hence the pain and swelling.
Why a patient with gout is likely to develop renal calculi
The kidneys play a major role in the excretion of uric acid. Therefore, people with gout have a higher risk of developing kidney stones from excess uric acid. This is because these people have very high levels of uric acid and a lower urinary ph (Leslie & Manish, 2022)Neurological And Musculoskeletal Disorders Essay Example. These conditions increase the formation of uric acid stones as compared to patients without gout.
The pathology of Osteoporosis
Osteoporosis is a bone disease characterized by low bone mineral density caused by alteration in the bone structure. This leads to weak and fragile bones that easily fracture from low impacts. Osteoporosis generally occurs in older patients with the pathophysiology being described as endocrine disorders such as estrogen deficiency, vitamin D deficiency, and hyperparathyroidism. These conditions lead to an imbalance between osteolastic bone formation and osteoclastic bone resorption hence deficits in bone mass and strength.
Rheumatoid Arthritis
Rheumatoid arthritis is autoimmune inflammatory condition that affects the joints and other tissues. In the joints, it usually affects the synovial joints beginning with the small peripheral joints then progresses to the proximal joints (Koarada et al., 2018)Neurological And Musculoskeletal Disorders Essay Example. The inflammatory process causes destruction of the joints and cartilage and bone erosion. The inflammatory process leads to joint pains, swelling, and stiffness.
Rheumatoid arthritis differs from osteoarthritis in that rheumatoid arthritis is an autoimmune condition resulting from the immune system attacking the joint tissues whereas osteoarthritis is due to the wearing away of the joint cartilage and usually takes years to develop.
Multiple Sclerosis
Multiple sclerosis is a chronic autoimmune condition affecting the nervous system by causing inflammation that leads to demyelination and neuronal loss (Tafti et al., 2022). This leads to neurological symptoms such as visual impairment, numbness and tingling sensation, focal weakness, loss of bladder and bowel control, and cognitive dysfunction.

References
Koarada, S., Ono, N., & Tada, Y. (2018). Basic knowledge of rheumatoid arthritis. Rheumatoid Arthritis: A Systematic Approach, 1-3. https://doi.org/10.2174/9781681086613118030003
Leslie, S. W., & Manish, K. C. (2022). Uric Acid Nephrolithiasis. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK560726/
Narang, R. K., & Dalbeth, N. (2020). Pathophysiology of gout. Seminars in Nephrology, 40(6), 550-563. https://doi.org/10.1016/j.semnephrol.2020.12.001
Rosen, C. J. (2020). The Epidemiology and Pathogenesis of Osteoporosis. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK279134/
Tafti, D., Ehsan, M., & Xixis, K. L. (2022). Multiple Sclerosis. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK499849/#:~:text=Multiple%20sclerosis%20(MS)%20is%20an,and%20in%20different%20CNS%20locations Neurological And Musculoskeletal Disorders Essay Example

In this exercise, you will complete a 5-essay type question Knowledge Check to gauge your understanding of this moduleâ€s content. Each answer must contain at least one source/reference citation.

QUESTION 1
Scenario 1: Gout
A 68-year-old obese male presents to the clinic with a 3-day history of fever with chills, and Lt. great toe pain that has gotten progressively worse. Patient states this is the first time that this has happened, and nothing has made it better and walking on his right foot makes it worse. He has tried acetaminophen, but it did not help. He took several ibuprofen tablets last night which did give him a bit of relief.
HPI: hypertension treated with Lisinopril/HCTZ .
SH: Denies smoking. Drinking: “a fair amount of red wine” every week. General appearance: Ill appearing male who sits with his right foot elevated.
PE: remarkable for a temp of 100.2, pulse 106, respirations 20 and BP 158/92. Right great toe (first metatarsal phalangeal [MTP]) noticeably swollen and red. Unable to palpate to assess range of motion due to extreme pain. CBC and Complete metabolic profile revealed WBC 15,000 mm3 and uric acid 9.0 mg/dl. Neurological And Musculoskeletal Disorders Essay Example
Diagnoses the patient with acute gout.
Question: Explain the pathophysiology of gout.

QUESTION 2
Scenario 1: Gout
A 68-year-old obese male presents to the clinic with a 3-day history of fever with chills, and Lt. great toe pain that has gotten progressively worse. Patient states this is the first time that this has happened, and nothing has made it better and walking on his right foot makes it worse. He has tried acetaminophen, but it did not help. He took several ibuprofen tablets last night which did give him a bit of relief.
HPI: hypertension treated with Lisinopril/HCTZ .
SH: Denies smoking. Drinking: “a fair amount of red wine” every week. General appearance: Ill appearing male who sits with his right foot elevated.
PE: remarkable for a temp of 100.2, pulse 106, respirations 20 and BP 158/92. Right great toe (first metatarsal phalangeal [MTP]) noticeably swollen and red. Unable to palpate to assess range of motion due to extreme pain. CBC and Complete metabolic profile revealed WBC 15,000 mm3 and uric acid 9.0 mg/dl. Diagnoses the patient with acute gout.
Question: Explain why a patient with gout is more likely to develop renal calculi. Neurological And Musculoskeletal Disorders Essay Example

QUESTION 3
Scenario 2: Osteoporosis
A 78-year-old female was out walking her small dog when her dog suddenly tried to chase a rabbit and made her fall. She attempted to try and break her fall by putting her hand out and she landed on her outstretched hand. She immediately felt severe pain in her right wrist and noticed her wrist looked deformed. Her neighbor saw the fall and brought the woman to the local ER for evaluation. Radiographs revealed a Colles’ fracture (distal radius with dorsal displacement of fragments) as well as radiographic evidence of osteoporosis. A closed reduction of the fracture was successful, and she was placed in a posterior splint with ace bandage wrap and instructed to see an orthopedist for follow up.
Question: Discuss what is osteoporosis and how does it develop pathologically?

QUESTION 4
Scenario 3: Rheumatoid Arthritis
A 48-year-old woman presents with a five-month history of generalized joint pain, stiffness, and swelling, especially in her hands. She states that these symptoms have made it difficult to grasp objects and has made caring for her grandchildren problematic. She admits to increased fatigue, but she thought it was due to her stressful job.
FH: Grandmothers had “crippling” arthritis.
PE: remarkable for bilateral ulnar deviation of her hands as well as soft, boggy proximal interphalangeal joints. The metatarsals of both of her feet also exhibited swelling and warmth.
Diagnosis: rheumatoid arthritis.
Question: The pt. had various symptoms, explain how these factors are associated with RA and what is the difference between RA and OA? Neurological And Musculoskeletal Disorders Essay Example

QUESTION 5
Scenario 5: Multiple Sclerosis (MS)
A 28-year-old obese, female presents today with complaints for several weeks of vision problems (blurry) and difficulty with concentration and focusing. She is an administrative para-legal for a law firm and notes her symptoms have become worse over the course of the addition of more attorneys and demands for work. Today, she noticed that her symptoms were worse and were accompanied by some fine tremors in her hands. She has been having difficulty concentrating and has difficulty voiding. She went to the optometrist who recommended reading glasses with small prism to correct double vision. She admits to some weakness as well. No other complaints of fevers, chills, URI or UTI
PMH: non-contributory
PE: CN-IV palsy. The fundoscopic exam reveals edema of right optic nerve causing optic neuritis. Positive nystagmus on positional maneuvers. There are left visual field deficits. There was short term memory loss with listing of familiar objects. DIAGNOSIS: multiple sclerosis (MS).
Question: Describe what is MS and how did it cause the above patientâ€s symptoms? Neurological And Musculoskeletal Disorders Essay Example

COURSE RESOURCES:
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: the biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Chapter 15: Structure and Function of the Neurologic System
Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function (stop at Sleep); Summary Review
Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function (start at Acute confusional states and delirium) (stop at Alterations in neuromotor functions); (Parkinsonâ€s Disease); Summary Review

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Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction (stop at Degenerative disorders of the spine); (start at Cerebrovascular disorders) (stop at Tumors of the central nervous system); Summary Review
Chapter 44: Structure and Function of the Musculoskeletal System (stop at Components of muscle function); Summary Review
Chapter 45: Alterations of Musculoskeletal Function (stop at Bone tumors); (start at Disorders of joints); Summary Review
Chapter 47: Structure, Function, and Disorders of the Integument (section on Lyme Disease)Neurological And Musculoskeletal Disorders Essay Example

Chin, L. S. (2018). Spinal cord injuries. Retrieved from https://emedicine.medscape.com/article/793582-overview#a4