Anatomy and Physiology Case Study

Sarah Mitchell is a 68-year-old female who is normally healthy. However, about five days ago she began to feel very fatigued and started to experience a burning and tingling sensation on her right thigh.

You ask to see the area and upon visual inspection you notice 3–4 small, red, swollen areas with vesicles on the posterior aspect of her right thigh. She describes the pain to you, saying “it feels like the back of my leg is on fire and it hurts so bad.” She denies being exposed to any excessive heat sources, any changes in her diet, and any changes in the type of body soap, lotion, or laundry detergent she is using. All other physical findings are within normal limits, but her oral temperature is 100.6˚F. She complains about being under a lot of stress for the past three months because she has been helping take care of her husband, who is in the end stages of Alzheimer’s disease. She has no known drug allergies, is a non-smoker, and attends a water aerobics class twice a week. You suspect she may be suffering from a particular viral infection, so you ask if she had chicken pox as a child. Sarah confirms that she had chicken pox and measles during childhood. Her answer confirms your suspicions that she is likely suffering from shingles (herpes zoster) due to varicella-zoster virus infection.

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Define the following terms, used in the case and also in associated questions.
paresthesia
skin vesicle
dorsal
ventral
dormant
The list below classifies sensory receptors by the stimulus that activates them. Using your textbook or other resource, name the receptor for each stimulus type.
activated by touch, pressure, vibration, and stretch.
activated by changes in temperature
activated by light or changes in light wavelengths
activated by changes in chemical concentrations in a solution
activated by tissue injury or situations that may lead to tissue injury
Based on what you know about their stimuli, which type of sensory receptor is activated and causing Sarah’s symptoms of pain and paresthesia?
The virus infecting Sarah lies dormant in the dorsal root ganglion. What part of a neuron is located in the dorsal root ganglion? Does the dorsal root and its ganglion carry sensory input, motor output, or both?
Based on the pattern of skin vesicles and pain, which of Sarah’s peripheral nerves is infected? To which peripheral nerve plexus does this nerve belong?
If Sarah had skin vesicles on the anterolateral region of her neck, which peripheral nerve is infected by the virus? To which peripheral nerve plexus does this nerve belong?
If Sarah had a viral infection that affected neuron function in the ventral root of the same spinal nerve, how would the signs and symptoms be different than those she has now?
If we traced the sensory pathways that carry Sarah’s thigh pain up to her brain, which cerebral lobe AND which part of the cortex would be active when she feels this sensation?

Assignment Expectations

Length: 1500-2000 words

Structure: Include a title page and reference page in APA style. These do not count towards the minimal word amount for this assignment.

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.

Format: Save your assignment as a Microsoft Word document (.doc or .docx).

Anatomy and Physiology Case Study

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  1. Paresthesia – Paresthesia is the abnormal perception of the body, e.g., burning, numbness, or tingling feeling. Additionally, paresthesia can be described as a burning sensation in extremities one experiences in legs, hands, arms, or feet. A patient may describe it as the ‘nails and needles’ sensations after he/she sits or stands on their legs for too long. For example, Sarah Mitchell started to experience a burning and tingling sensation on her right thigh. These signs are generally paresthesia.

Skin vesicle – These are fluid-filled sacs that become visible on the skin. They usually measure 5-10 mm in diameter. If they are larger than this, they are generally referred to as blisters. Skin vesicles measuring at least half a millimeter are known as bullae. E.g., the 3-4 small, red, swollen areas with cysts on the posterior aspect of her thighs are the skin vesicles.

Dorsal – This is the posterior side of the anatomy structure. Dorsal is the opposite of the ventral of a structure. Dorsal parts of the human body include the back, buttocks, hand knuckles, and calves.

Ventral – Refers to the anterior side of a structure. Ventral is the opposite of dorsal. In the human anatomy, ventral structures include the chest, sheen, abdomen, soles, and palms.

Dormant – This is the phase in an organism’s life cycle whereby the physical activities, growth, and development are temporarily stopped. Dormancy is usually a mechanism to conserve energy. Organisms typically go into a dormancy stage due to environmental conditions.

 

  1. All sensory receptors depend on chemoreceptors, thermoreceptors, mechanoreceptors, and photoreceptors to detect changes in the surrounding environment. The sensory receptors responsible for the following stimulus include:
  2. The sensory receptors activated by touch are mechanoreceptors.

The sensory receptors activated by changes in pressure are the baroreceptors.

The sensory receptors that activate changes in vibration are mechanoreceptors.

The sensory receptors affecting stretch are also mechanoreceptors.

  1. The sensory receptor activated when there is a temperature change is the thermoreceptors.
  2. The sensory receptor activated when there is light or changes in light wavelength are the photoreceptors.
  3. The sensory receptors activated when there is a change in chemical absorptions in a solution are the chemoreceptors.
  4. The sensory receptors activated when an injury in the tissue or situations leading to injuries in the tissue is the nociceptors.

 

  1. The nociceptor is the sensory receptor activated when Sarah experiences symptoms of pain and paresthesia.
  2. The sensory neuron is the part that is positioned in the dorsal root ganglion and is responsible for the transfer of data and information from the periphery to the spinal code. The sensory neurons are pseudo-unipolar and comprise axon-like procedures that split with one branch spreading toward the periphery and the other branch extending toward the grey matter of the spinal code (Martini et al., n.d.). The dorsal root ganglion accepts sensory input from nociceptors, mechanoreceptors, and other exterior sensory transducers. Fibers heading towards the exterior of the sensory neuron exits the ganglion via the spinal nerve running together with motor fibers. The dorsal root and the ganglion transmit sensory and motor yield. Sensory nerves transmit motor and sensory data amid the spinal code and the rest of the body. These sensory neuron cell bodies are grouped in the structures of the dorsal root ganglia.
  3. Skin vesicles affect the fibular nerves. The fibular nerves belong to the peroneal sacral plexus. This nerve has both the sensory and motor nerve that actuates the muscles of the skin and foot. More so, the fibula nerves have the artillery branches that actuate the tarsal and ankle joints. Additionally, fibula nerves actuate motor ventral and parallel leg compartments. (“Common fibular (peroneal) nerve”, 2021)
  4. If Sarah has skin vesicles on the anterolateral area of the neck, then the nerve with the viral infection will be the transverse cervical nerve located in the anterior triangle (Catala and Kubis, 2013). This transverse cervical nerve passes straight through the anterior triangle. Others have subdivisions that give rise to branches that innervate other structures in the anterolateral skin of the neck and upper sternum. The peripheral nerve plexus of the transverse cervical nerve in which the nerve belongs is the cervical plexus
  5. If Sarah had a viral infection that affected neuron function in the ventral root of the spinal nerve, how would the signs and symptoms be different from those she has now? The signs and symptoms would include inflammation, skin rash, fever, sudden loss of muscle tone, sudden loss of reflexes, arms or leg weakness, pain in the arms and the legs. Additionally, the patient may feel tingling or numbness and the inability to pass urine. (“Viral Infection of the Spinal Cord and Roots,” 2021)
  6. The cerebral lobe that carries Sarah’s aching to her brain is the parietal lobe. The part of the cortex that is lively when she feels the pain is the primary somatosensory area of the cortex situated in the area of the postcentral gyrus. The postcentral gyrus is responsible for processing information on touch.

 

 

References

Catala, M., & Kubis, N. (2013). Sciencedirect. Retrieved 24 May 2021, from https://www.sciencedirect.com/topics/neuroscience/dorsal-root-ganglion.

Martini, F., Nath, J., & Bartholomew, E. Fundamentals of anatomy & physiology.

The common fibular (peroneal) nerve. (2021)., from https://www.kenhub.com/en/library/anatomy/common-fibular-nerve

Viral Infection of the Spinal Cord and Roots. (2021)., from https://radiologykey.com/viral-infection-of-the-spinal-cord-and-roots

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