Concepts of Neurological and Musculoskeletal Disorders

Concepts of Neurological and Musculoskeletal Disorders

Different neurological and musculoskeletal disorders can affect a person’s ability to perform daily activities such as mobility and speech. These disorders mostly impair normal cognitive, skeletal, neurological, and muscular functioning. For instance, neurological conditions like multiple sclerosis and cerebral palsy may affect movement and coordination. Musculoskeletal disorders also cause pain and joint stiffness that may affect a person’s mobility and daily functioning. In the presenting case, the patient presents with movement and coordination challenges and speech deterioration. The presenting symptoms indicate impairment of normal neurological and musculoskeletal functioning. The presenting symptoms can thus be explained by reviewing the pathophysiologic process of neurological and musculoskeletal disorders.

The neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.

The pathophysiological processes of neurological and musculoskeletal disorders are mostly linked to impairment in the normal functioning of parts of the brain that control daily human functioning, such as mobility and speech. For example, the patient presents with mild to moderate dysarthria. Dysarthria is mainly caused by neurological damage, which affects the regular functioning of nerves, thus impairing the process of sending signals to muscles involved in speech production. It may damage different brain parts, such as the cranial nerves or the motor regions of the cortex (Jankovic, Mazziotta, & Pomeroy, 2021). The patient also presents mild drift on the left leg, and his left arm cannot resist gravity. The symptoms can be linked to potential mild stroke or paralysis. These symptoms indicate a deficient supply of blood and oxygen to the brain. The patient’s blood pressure is also high, which could have potentially caused leaky blood vessels, thus impairing muscle movements and mobility (Kuriakose & Xiao, 2020). The presenting symptoms further indicate possible damage to the central nervous system, affecting the normal functioning of nerves and muscle coordination. For instance, the middle left facial droop indicates damage to the cranial nerves, which help taste, smell, and feel sensations.

Racial/ethnic variables that may impact physiological functioning.

Besides the neurological and musculoskeletal pathophysiological processes, various factors may impact the patient’s physiological functioning. Examples of racial and ethnic variables that can negatively impact health include racism and ethnic discrimination. Studies have shown that ethnic discrimination may cause changes in physiological arousal and adverse health outcomes (Grasser & Jovanovic, 2022). For instance, exposure to discrimination is linked to high blood pressure due to complex interactions with coping styles. Cultural values can also affect physiological processes. It has been shown that persons with materialistic desires beyond their means or those who espouse values that differ from the community consensus may have high blood pressure levels. In the presenting case, the patient’s blood pressure levels are relatively high, which can be attributed to a physiological response to racial or ethnic variables such as discrimination. Racial and ethnic variables may also cause chronic stress and affect inflammatory responses (Neblett, 2022). Such impacts may affect the normal functioning of the central nervous system and nerves, hence the presentation of secondary symptoms such as mild left facial droop.

How these processes interact to affect the patient

Hypertension and smoking are key risk factors for the patient’s stroke. Chronic hypertension weakens the integrity of blood vessels in the brain and predisposes the patient to hemorrhagic stroke (Kuriakose & Xiao, 2020). On the other hand, smoking increases the risk of formation of plaque in blood vessels (Kuriakose & Xiao, 2020). As such, the risk of thrombotic stroke is increased. Both hemorrhagic and ischemic strokes impair nerve and muscular function; hence, the patient manifests with dysarthria and paralysis (Kuriakose & Xiao, 2020). Based on ethnicity, the risk of stroke is highest among Hispanic whites and African Americans (Kuriakose & Xiao, 2020). Furthermore, African Americans have the highest prevalence of hemorrhagic stroke.

 References

Grasser, L. R., & Jovanovic, T. (2022). Neural impacts of stigma, racism, and discrimination. Biological psychiatry: cognitive neuroscience and neuroimaging.

Jankovic, J., Mazziotta, J. C., & Pomeroy, S. L. (2021). Bradley’s Neurology in Clinical Practice E-Book. Elsevier Health Sciences.

Kuriakose, D., & Xiao, Z. (2020). Pathophysiology and treatment of stroke: present status and future perspectives. International journal of molecular sciences, 21(20), 7609.

Neblett, E. (2022). Racism, Relationship Quality, and Health: Further Reflections on Ong et al. (2022). Psychological Science, 33(8), 1340-1342. https://doi.org/10.1177/09567976221105214.

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In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factored into the diagnosis and explain the implications to patient health.

A 74-year-old male with a history of hypertension and smoking is having dinner with his wife when he develops sudden onset of difficulty speaking, with drooling from the left side of his mouth and weakness in his left hand. His wife asks him if he is alright, and the patient denies any difficulty. His symptoms progress over the next 10 minutes until he cannot lift his arm and has trouble standing. The patient continues to deny any problems. The wife sits the man in a chair and calls 911. The EMS squad arrives within 5 minutes. Upon arrival in the ED, the patient‘s blood pressure was 178/94, pulse was 78 and regular, and PaO2 was 97% on room air. Neuro exam – Cranial nerves- Mild left facial droop. Motor- Right arm and leg extremity with 5/5 strength. The left arm cannot resist gravity; the left leg has mild drift. Sensation intact. Neglect- Mild neglect to the left side of the body. Language- Expressive and receptive language intact. Mild to moderate dysarthria. Able to protect the airway.
Assignment (1- to 2-page case study analysis)
In your Case Study Analysis related to the scenario provided, explain the following:
• Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
• Any racial/ethnic variables that may impact physiological functioning.
• How these processes interact to affect the patient.