The patient is a 62 year old Caucasian female who had a partial obstruction in the carotid artery on the right side for over two years and had a stroke in the right hemisphere 6 months ago. The main common carotid artery splits into the external carotid artery and the internal carotid artery. The external carotid artery supplies blood to the exterior features outside of the skull, primarily the exterior of the face and the neck. The internal carotid artery supplies blood to the interior of the skull, including the anterior of the brain, the eyes and its appendages. The first main branch of the internal carotid is the ophthalmic artery which further branches into the central retinal artery.…
12/16/15 Progress Report documented that the patient has left foot pain, which is described as stabbing, aching pain, which shoots up the leg with excessive walking and standing. The patient benefited greatly from a sympathetic nerve block. She was able walk and sensitivity of the foot was restored. The pain is rated 3/10-scale level with medications. There are no side effects, no aberrant behavior to the meds. The med provide good pain relief. She is currently taking Oxycodone, Norco and Gabapentin. The musculoskeletal exam revealed joint pain, swelling, muscle cramps, muscle weakness and stiffness. Treatment plan included Sympathetic nerve block for RDS. Follow-up is in 1 month.…
1. What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations.…
Her muscle testing for the left upper extremity is 5-/5. Right upper extremity strength is 4/5. She requires moderate to maximum assistance with activities of daily living and transfers. Impression includes mobility and self-care deficits secondary a fall with progressive cervical myelopathy, status post 09/06/16 posterior decompression and fusion at C3-7; neurogenic pain; and increased risk of deep vein thrombosis. It was noted that because of her mobility and self-care deficits, she requires 24-hour rehabilitation nursing care. MD will obtain bilateral venous surveillance Dopplers of the lower extremities. Patient will be instructed on how to do heel pumps. She will be seen by PT, occupational therapy, rehabilitation nursing, case management and physiatry. She will undergo interdisciplinary rehabilitation receiving therapy at least 3 hours a day, 5 days a week. Ultimate goal is to obtain a level of modified independence in all activities of daily living, transfers, ambulation, and assistive device to increase her strength and endurance and get back home safely with the husband. Estimated length of stay is 18-21 days. She will continue on Norco and Percocet. Lyrica will be added for neurogenic…
For approximately a year and a half, she has suffered from a gait disturbance. She has been seen in consultation (01:11 ___) the gait disturbance would due to the multiple factors, including degenerative joint disease and peripheral neuropathy. It was also thought she has an early Parkinson’s disease. No specific medication was advised. During the preceding years, she had suffered several falls. A fall one year ago had a result in a right humeral fracture.…
Alert gentleman, no acute distress who appears healthy, and walking without great difficulty. Blood pressure 126/76. Pulse 76. Respiratory rate 19. Temp 36.9. Weight 208. Palpation of the left SI joint is tender. Spine nontender. Right SI joint nontender. Negative straight leg test. _____(ETR/EPR)'s are +1 in the knees, and trace in the ankles. Sensation intact. No edema. Great toe and leg extensions _____(remain) intact.…
It is important for Multiple Sclerosis patients to stretch to be able to participate in everyday activities and also prevent injury to the body. Stretches should be performed in a sitting or lying position allowing gravity to help with particular muscles. The movements need to be slow and gentle because if the stretch is performed at a fast rate spasticity will increase. When muscles are spastic, the muscle fibers with in the muscle decrease in size. Stretching should be performed at least three times a day to stay on top of the spasticity episodes. Each stretch should be held anywhere from 30-60 seconds. The more frequently stretching is performed will allow the muscles to be more mobile. Without a daily stretching program, the muscles will continue to increase in stiffness, decrease in size and lead to contractures, overall decreasing the functional mobility of the…
D: These characteristics are ineffective because drinking every night and not getting enough sleep will affect his work performance…
In the context of this paper, the patient will be referred to as “Mrs. V.” Mrs. V is a seventy-two year old female. On August 12, 2014 Mrs. V’s life changed considerably. She was fairly independent with her ADLs prior to that day. She was ambulating with a walker for the last four years. She was able…
Different care strategies can be used to support a person that has MS and type 1 diabetes…
Multiple sclerosis (MS) is a chronic, inflammatory, autoimmune disease of the central nervous system; it is characterized by demyelination of axons in the brain and spinal cord, with axonal damage or destruction. 1 MS affects predominately patients aged 20-40 years. The symptoms of MS vary, depending in part on the location of lesions within the CNS. Common symptoms include sensory disturbances in the limbs, optic nerve dysfunction, pyramidal tract dysfunction, bladder or bowel dysfunction, sexual dysfunction, ataxia, and diplopia.2 Although there is large variability in symptom manifestation and disease progression, MS is still the most common cause of non- traumatic disability in young adults and is associated with an average reduction in…
Neurological disorders are diseases of the brain and the nerves. Everybody knows that the brain is the most important organ of the body. The brain is the Part of the central nervous system that is made up of the nerves which are connected to the body through the spinal cord. The human brain is responsible for all the mental and physical processes According to MedlinePlus If the brain is in a good condition it works automatically, but if problems appear brain will lose its ability to control the body system. There are several neurological disorders that can affect the brain and the most common type is Multiple Sclerosis. This essay will describe what the disease does and will explain in details the most common type of Multiple Sclerosis (MS).…
The goal of treatment is to maintain the person's optimal physical and emotional health by preventing joint and spinal deformities. This prolongs the ability to walk. Doctors may introduce assisted breathing as needed, and lifelong physiotherapy is necessary. You may need orthopedic devices may be needed for support. Hydrotherapy, such as continuous tub baths, may help maintain a full range of joint motion. Physical, occupational, respiratory, and speech therapy may also help patients manage the symptoms of MD. Some clinicians recommend submaximum aerobic exercise, especially in the early course…
Juryńczyk, Maciej., Immune regulation of multiple sclerosis by transdermally applied myelin peptides, http://onlinelibrary.wiley.com/doi/10.1002/ana.22219/full, Retrieved December 3,…
Multiple Sclerosis is a “chronic inflammatory, demyelinating disease of the central nervous system” (Susan B. O’Sullivan, Physical Rehabilitation, p. 776). Multiple Sclerosis is a “disease where your body attacks itself, specifically the fatty coating called the myelin sheath on nerves in the brain, spinal cord, and eye area” (2016 EMD Serono,…