Topic 1: Case Study
Case Study Posting Requirements
- Make sure all of the topics in the case study have been addressed.
- Cite at least three sources—journal articles, textbooks or evidenced-based websites to support the content.
- All sources must be within five years.
- Do not use .com, Wikipedia, or up-to-date, etc., for your sources.
Case Study 1
Organization and Control of Neural Function
Riku is a 19-year-old college student. One morning, after a long night of studying, Riku woke up and made himself a hot cup of coffee and toast.
Much to his surprise, when he brought the cup to his mouth to drink, the coffee spilt onto the table. Riku went to the bathroom mirror and noticed the left side of his face seemed to droop. He quickly got dressed and ran to the medical clinic on the college campus. As he ran, his left eye began to feel scratchy and dry, but he could not blink in response. The physician at the clinic listened to Riku’s story and then did a careful cranial nerve examination. She concluded that Riku had Bell palsy, an inflammatory condition of the facial nerve most likely caused by a virus.
- What are an afferent neuron and efferent neuron? What are efferent components of the facial nerve and their actions?
- Under certain circumstances, axons in the peripheral nervous system can regenerate after sustaining damage. Why is axonal regeneration in the central nervous system much less likely?
- At a healthy myoneural junction, acetylcholine is responsible for stimulating muscle activity. What mechanisms are in place to prevent the continuous stimulation of a muscle fiber after the neurotransmitter is released from the presynaptic membrane?
Case Study 2
Somatosensory Function, Pain, and Headache
Ramandeep is an active 23-year-old. She works as a part-time nurse during the day and is studying for a postgraduate certificate in the evening. Ramandeep started to wear a bite plate at night after she began to experience jaw pain and headaches. Sometimes the pain radiated to her ear, and she would apply a hot water bottle to it to ease the discomfort. Her husband mentioned to her that he heard her grinding her teeth at night while she was sleeping. She knew then that her headaches might be from temporomandibular joint syndrome, and she went to her dentist to confirm her thoughts. In addition to the bite plate, the dentist also recommended she should continue with the application of heat, use NSAIDs when needed, and incorporate regular relaxation exercises throughout her stressful days.
- What effect does heat have on nociceptors so that it makes a good nonpharmacologic treatment for pain?
- Heat and cold treatment are both hypothesized to have an effect on the release of endogenous opioids. What are these chemicals, and why are they hypothesized to be beneficial in the body?
- Using your knowledge of physiology, how do NSAID analgesics function in the management of pain?
Case Study 3
Disorders of Motor Function
John is 63 years old and receives home care by an occupational therapist twice a week. His therapist is currently working with John on maintaining joint flexibility and balance. John demonstrates resting tremor, so his therapist is also working on adaptive techniques, so John can continue to use his hands to write, use the computer, and cook simple meals. John’s wife assists with his mobility and walks slowly beside him, holding his arm. Sometimes she needs to help him open his prescription bottles, so he can take his medicine, a combination of levodopa and carbidopa.
- What motor disease does John demonstrate? One of his signs is resting tremor. What is the difference between a resting tremor and an intention tremor?
- What is the advantage of combining levodopa with carbidopa? What is the benefit of anticholinergic drugs in the management of Parkinson disease?
- Parkinson disease involves the destruction of the substantia nigra and the nigrostriatal pathway. Where are these structures anatomically?
- The patient with Parkinson disease typically presents with a masklike facial expression. Why does he or she have a masklike facial expression? How are the eyes, mouth, and laryngopharynx affected by this disease?
Case Study 4
Disorders of Brain Function
Bonnie is a 70-year-old woman who lives alone. One evening, she felt light-headed and dizzy. When her head began to ache, she decided to take an analgesic and go to bed early. The following morning, upon awakening, she was unable to move the bed sheets with her right arm. At this point she was experiencing tingling sensations in her limbs, and she had difficulty keeping her balance. She dialed 911 for help, and by the time the ambulance arrived, she was confused and unable to articulate her words although she knew what information he was asking of her. In the hospital, she was examined and treated for ischemic stroke.