Diagnose where the location of the injury occurs based on the patients’ symptoms
ID: 128397 • Letter: D
Question
Diagnose where the location of the injury occurs based on the patients’ symptoms. Need to include side of body, region in brain or spinal cord, and if needed specific tract or sensation being altered. a. Patient #1 - complete loss of sensation on right side, but no problems with increasing heart rate, no problem moving right or left leg b. Patient #2 - muscles controlling eye movement are impaired but no loss of vision, also impaired parasympathetic output c. Patient #3 - can’t regulate parasympathetic output or move right hips or butt; all sensory information from right hips and butt is perfectly fine d. Patient #4 – problem with pain and temperature in his left arm, but no problem with the knee-jerk reflex in his right leg e. Patient #5 - lateral corticospinal tract on the right side in the thoracic region f. Patient #6 – can’t cause constriction of blood vessels in the upper digestive tract upon exercise, but can move both legs g. Patient #7 – can’t feel touch or pressure on right arm but feel pain and temp in on the left side of neck; able to move left leg and right abdominal area h. Patient #8 - loss of pain and temperature sense in the right leg, but no problem with 2-point discrimination or response in touch in either leg i. Patient #9’s - the right primary cortex controlling the lateral corticopsinal tract in the lumbar region j. Patient #10’s - dorsal column on the right side of the spinal cord in the thoracic spinal cord
Explanation / Answer
Patient 1:
Diabetic neuropathies are a family of nerve disorders caused by diabetes.
People with diabetes can, over time, develop nerve damage throughout the body.
Some people with nerve damage are asymptomatic. Others may have symptoms such as pain, tingling, or numbness—loss of feeling—in the hands, arms, feet, and legs.
Patient 2:
Oculomotor nerve palsy or third nerve palsy is an eye condition resulting from damage to the third cranial nerve or a branch thereof. The oculomotor nerve supplies the majority of the muscles controlling eye movements. Thus, damage to this nerve will result in the affected individual being unable to move his or her eye normally.
Patient 3:
Tension myositis syndrome (TMS), also known as tension myoneural syndrome or mindbody syndrome is characterized by psychogenic musculoskeletal and nerve symptoms, most notably back pain.
Patient 5:
The damage below the pyramidal decussation will result in ipsilateral motor deficits. For example, spinal cord damage on the left side of the lateral corticospinal tract at the thoracic level can cause motor deficits to the left side of the body.
The corticospinal tract represents the highest order of motor function in humans and is most directly involved in control of fine, digital movements. This tract arises in pyramidal neurons of layer V of the precentral gyrus, the "primary motor cortex." Betz cells are the largest of these pyramidal neurons.
Patient 6:
Atherosclerosis progresses and blockage becomes more severe, pain may occur in the feet even when at rest. This pain, known as rest pain, occurs because the arteries of the leg can no longer deliver adequate blood flow to the feet, even at rest. Rest pain generally worsens when the legs are elevated, such as when lying in bed at night.