Posted: April 20th, 2022

Page 1“Wearing on Her Nerves” by Brown and Ellerton

Page 1“Wearing on Her Nerves” by Brown and Ellerton

by Kathleen G. Brown, Nursing Division Sharon S. Ellerton, Organic Sciences and Geology Queensborough Group Faculty, Metropolis College of New York

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Half I – Rise and Shine? Kathy, a 20-year-old girl, awakens one morning to a tingling, numb sensation protecting each of her toes. Th is has occurred to her quite a lot of occasions all year long. Previously, when experiencing this sensation, inside a few days to every week the numbness would subside, and so she will not be too involved. A few week later, she notices that the numbness and tingling not solely persists, however has additionally unfold as much as her knees. Once more, she ignores the irregular sensation. By the tip of a month’s time, the numbness spreads to the midline of her physique. At this level, she turns into alarmed.

Kathy sees the nurse at her faculty who tells her that she ought to see a health care provider. Kathy calls her physician’s offi ce to schedule an appointment, however the soonest slot is in two weeks. She makes the appointment and goes about her every day routine.

Th e subsequent morning, Kathy wakes, however when she makes an attempt to get away from bed, she comes crashing to the fl oor. As a result of she remains to be groggy from sleep, she doesn’t actually perceive what has simply occurred. As she tries to face up, the muscle tissues of her left leg interact, however as she additionally makes an attempt pushing up together with her proper leg, she once more falls to the fl oor. She sits in bewilderment as she tries to make sense of what has simply occurred and realizes that she has significantly scraped her knee in her fall. She doesn’t really feel the ache from her wound.

Kathy thinks about how odd this yr has been. She remembers one other medical difficulty she had earlier within the yr when she had misplaced listening to in her proper ear and wonders if there’s a connection to her present situation. At the moment, Kathy underwent intensive testing, however the ear, nostril, and throat specialist remained baffl ed. He thought that a extreme inside ear an infection may have destroyed her potential to listen to on that aspect, however there was no conclusive proof to help this. In an try to recuperate any listening to he may, the physician prescribed very excessive dosages of steroids; he informed Kathy that she in all probability wouldn’t see a change, however there have been uncommon occurrences the place steroids helped. To each Kathy and her physician’s shock, after a couple of week of steroids, she utterly regained listening to in her proper ear. It was a “miracle.”

Kathy wonders whether or not she will be able to depend on a brand new miracle to heal her present medical points.

Questions

1. What elements of the nervous system are concerned in bodily sensation? How does sensory impulse transfer all through the physique?

2. What elements of the nervous system are concerned in skeletal muscle motion? How does motor impulse transfer all through the physique? What’s a “motor unit”?

three. What actions are concerned within the motion of standing up? What muscle tissues have to contract to carry out these actions?

Sporting on Her Nerves: Exploring the Interrelation between the Nervous and Muscular Methods

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Page 2“Sporting on Her Nerves” by Brown and Ellerton

four. What are the diff erent ranges of group of a muscle all the way down to myofi laments? What’s a “sarcomere” and how are its proteins organized?

5. Ranging from the discharge of acetylcholine by the motor neuron, what are the steps in muscle contraction? How is contraction ended?

6. Are Kathy’s medical issues associated to her sensory neurons, motor neurons, or each? What in Kathy’s medical historical past helps your reply?

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Page three“Sporting on Her Nerves” by Brown and Ellerton

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Half II – Prognosis and Remedy Kathy realizes that she can’t wait till her appointment to obtain medical care; she rapidly goes to the emergency room. After a mountain of questions on Kathy’s signs and medical historical past, the docs determine to confess her for additional testing. She is transferred to the neurology unit and the docs request she bear a sequence of laboratory assessments, together with an MRI and a spinal faucet. Within the meantime, the docs prescribe excessive dosages of steroids to Help alleviate the signs.

Upon reviewing Kathy’s medical historical past and the outcomes of the assorted laboratory assessments, the neurologists diagnose her with A number of Sclerosis (MS). Th ey clarify to Kathy that MS is an autoimmune illness and that her personal immune system has been attacking the myelin sheath that surrounds the nerves of her central nervous system. She stays within the hospital for every week till sensation is totally recovered in her decrease physique and power is restored in her legs. She is discharged from the hospital and schedules a comply with up appointment with the neurologist.

When she returns to the neurologist, they talk about Kathy’s diff erent choices for remedy. As a result of there is no such thing as a remedy for the illness, choices in medicine differ enormously. She decides to attempt every day injections of Copaxone, a medicine that’s comparable in construction to a protein present in myelin.

Kathy continues to see the neurologist on an everyday foundation and provides herself an injection each night. Over the course of seven months of remedy, she solely experiences one prevalence of numbness, which subsides after a few days. She tries to remain optimistic and tries to reduce the illness’s affect on her life.

Questions

7. What’s myelin and how does it aff ect the transmission of nerve impulses? Establish the cells liable for the formation of myelin.

eight. What are the “scleroses” in A number of Sclerosis and the place do they happen? How does this infl uence nerve transmission?

9. How do an MRI and spinal faucet Help confi rm the prognosis of A number of Sclerosis? 10. Why did steroids Help alleviate Kathy’s signs? 11. How does Copaxone work as remedy for A number of Sclerosis? How do different kinds of medicines diff er? 12. Why did Kathy expertise the altered sensation in her decrease physique? Was there one thing unsuitable together with her pores and skin?

Why couldn’t she stand? Was there one thing unsuitable with the muscle tissues of her proper leg? 13. Did Kathy’s listening to loss have something to do with the A number of Sclerosis? Why/Why not?

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Page 1 of Brown and Ellerton’s “Sporting on Her Nerves”

Nursing Division, Kathleen G. Brown Sharon S. Ellerton, Queensborough Group Faculty, Metropolis College of New York, Organic Sciences and Geology

INNN S SCIICIENNENE CECECE NATIONAL CENTER FOR CASE STUDY TEACHING

Half I – Are You Able to Rise and Shine? Kathy, a 20-year-old girl, wakes up with a tingling, numb sensation protecting each of her toes one morning. This has occurred to her a number of occasions over the course of the yr. When she’s had this sensation earlier than, the numbness would go away inside a number of days to every week, so she’s not too involved. She notices that the numbness and tingling has not solely persevered however has additionally unfold as much as her knees every week later. She’s accomplished it earlier than.

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