NORWICH NR548 2022 January Week 10 Discussion Latest

NR548 Advanced Pathophysiology

Week 10 Discussion

Question(s):

Pick one of the following three cases and present your case summary:

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 it spilled 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. You are the NP in the clinic and took a careful history and completed a cranial nerve exam. You concluded that Riku had Bell palsy, an inflammatory condition of the facial nerve most likely caused by a virus.

What are the differences between afferent and efferent neurons? What are the efferent components of the facial nerve and their actions?

At 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?

An 18-year-old college freshman presents to the health clinic for evaluation of a "bump below my left knee." He plays soccer for the college team and, during a game, was recently hit hard by another player directly below his knee. Subsequently, he noticed excruciating deep pain that would wake him even when sleeping and had difficulty weight bearing on his leg. He saw his team's trainers who told him to stay off the limb and take ibuprofen for the pain. He has been using crutches, but cannot get rid of the intense pain, and feels that his leg is just not healing. He does not want to miss anymore of the soccer season and says his coach told him to come have his knee checked out at the clinic.

After the evaluation, the clinicians are discussing the next step, suspecting a possible osteosarcoma. The patient overhears their discussion, and when you walk into the room, very concernedly asks you, "Osteosarcoma. That's a cancer right? Why do you think I have cancer?" How would you respond to him?

After hearing your answer, he urgently asks you, "But if I do have it, will this ruin my soccer season? I have an athletic scholarship, and if I don't play, I'll lose it." How would you minimize his concerns while giving him truthful answers?

Devon, age 64 years, is a veteran who received extensive burns over half his body when his ship was bombed. As a complication from burns, Devon required an above-knee amputation of his right leg 19 years ago. Devon complains of constant feeling of coldness and shooting pain in his right foot. To what extent are the concepts of somatosensory function and pain interrelated here?

Describe the pathophysiology of this type of pain.