Case Summary
A 72-year-old female patient is brought to the clinic by her daughter who reports that her mother had an acute onset of slurred speech that morning, but it resolved within an hour. About an hour later her mother was a lethargic and speechless. When she attempted to get her mother to stand, her mother slumped over to the right side and couldn’t seem to push herself to an upright position or stand. The mother had a stroke 2 years ago and exhibited similar symptoms resulting in a 5-day hospital stay followed by intensive rehabilitation after which she returned to normal functioning. The patient is alert, ambulating, and has 4/5 strength bilaterally in the upper and lower extremities. DTRs are 2+ bilaterally. A CT of the head reveals an old left sided infarct within the temporal region. A CT of the carotids reveals a 35% blockage on the left and 40% on the right. Blood pressure is 134/84, P 84, and respirations 18. Labs tests reveal a cholesterol of 306, HDL of 36, and an LDL of 140.
Purpose of the Paper
The purpose of the paper is to explain the patient’s neurological and musculoskeletal pathophysiological processes after a stroke. In addition, it addresses racial and ethnic variables impacting physiological function. Lastly, the paper describes how these processes interact to affect the particular patient. The symptoms the woman experiences, including problems with balance, restricted body movements, speaking issues, and dizziness, support the hypothesis that he patient from the case study had a stroke.
Neurological and Musculoskeletal Pathophysiologic Processes Associated with Symptoms
The patient from the case study experiences pathophysiological processes connected with stroke. Typically, a stroke results from the impossibility of the blood supply to the brain that is connected with the appearance of atherosclerotic plaques (Doria, & Forgacs, 2019). The most widespread consequences of stroke include walking problems because it damages the neuromuscular skeletal control (Doria & Forgacs, 2019). Issues with the motor cortices are among the typical adverse effects of the stroke that result in the individual’s impairment of balance and gait (Doria & Forgacs, 2019). Therefore, the clinical description of stroke is typical, facilitating its diagnosis.
The patient’s state is consistent with the described musculoskeletal and neurological pathophysiologic processes. For instance, the deep tendon reflex (DTR) is 2+, which is the adequate response (Caprio & Sorond, 2019). At the same time, the patient has blocked carotids, resulting from a high cholesterol level. The patient’s low-density lipoprotein (LDL) is 140 mg/dL, while the norm is maximum 100 mg/dL (Caprio & Sorond, 2019). Therefore, the patient has an increased cholesterol level, aggravating her neurological state. The results of high-density lipoprotein (HDL), regarded as good cholesterol, are lower than the norm, constituting 60 mg/dL (Caprio & Sorond, 2019). The patient, in her turn, has 36 mg/dL of high-density lipoprotein, which shows why the blood supply to the brain was damaged (Caprio & Sorond, 2019). Hypertension the patient has also corresponds to the pathophysiologic characteristics of stroke. The woman’s blood pressure is 134/84 mm/Hg, while the norm is 120/80 mm/Hg. The previous damage of the left temporal region of the brain leads to problems with speech (Caprio & Sorond, 2019). Therefore, the presenting symptoms correspond to stroke’s neurological and musculoskeletal pathophysiologic processes.
Racial or Ethnic Variables Impacting Physiological Function
The case study does not contain information about the racial and ethnic background of the patient. The demographic data presented in the description features the patient’s gender (female) and age (72 years old). At the same time, the racial factor is essential in understanding the physiological function and incidence of strokes. According to the estimates, African American and Hispanic populations suffer strokes more often than white Americans (McCance & Huether, 2019). The researchers explain this controversy with socioeconomic disparities that influence the lifestyle habits of individuals, including dieting, level of physical activity, and stress (McCance & Huether, 2019). It is possible to hypothesize that the patient’s age, high cholesterol level, hypertension, and cardiovascular issues are primary factors in the development of stroke compared to her racial and ethnic background.
How These Processes Interact to Affect the Patient
It is vital to mention that the risks of stroke increase with the individual’s age. Older adults have significant risks of developing this health condition, especially when they are diagnosed with hypertension and have problems with cholesterol and the cardiovascular system (Tater & Pandey, 2021). In addition, the previous stroke increases the chances of developing negative symptoms in the future (Tater & Pandey, 2021). The patient from the case study has all the symptoms mentioned earlier, illustrating how these diagnoses interact and negatively affect the patient.
References
Caprio, F. Z., & Sorond, F. A. (2019). Cerebrovascular disease: Primary and secondary stroke prevention. The Medical Clinics of North America, 103(2), 295–308. Web.
Doria, J. W., & Forgacs, P. B. (2019). Incidence, implications, and management of seizures following Ischemic and hemorrhagic stroke. Current Neurology and Neuroscience Reports, 19(7), 37. Web.
McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Tater, P., & Pandey, S. (2021). Post-stroke movement disorders: Clinical spectrum, pathogenesis, and management. Neurology India, 69(2), 272–283. Web.