Fundamental Concepts of Musculoskeletal and Neurological Disorders
Fundamental Concepts of Musculoskeletal and Neurological Disorders
Musculoskeletal and Neurological Processes
A 24 years old female patient presents in the ER complaining of a severe right-sided headache that has been recurrent for over two months. The headache is of acute onset and moderate-severe intensity of 10 on a scale of 1-10. The patient states that ibuprofen and acetaminophen slightly relieve her headache. The associating symptoms are impaired concentration, photophobia, nausea, and vomiting. According to the international classification of headache disorders, the patient meets the diagnostic criteria for migraine that include unilateral headache, moderate to severe intensity, pulsating quality, nausea, vomiting, photophobia, and phonophobia (Eigenbrodt, et al, 2021). The patient must experience at least five attacks of the stated symptoms. Fundamental Concepts of Musculoskeletal and Neurological Disorders
Migraine is a neurogenic process resulting from changes in cerebral perfusion or cortical spreading depression, hence interference with the neurotransmitters. Vascular nerve activity releases neurotransmitters like substance P and nitric oxide that interact with the blood vessels causing inflammation and dilatation. This stimulates the trigeminal-cervical complex that induces photophobia, nausea, vomiting, and phonophobia (Eigenbrodt, et al, 2021). Muscle pain often results from ischemia due to the vasoconstriction of cerebrovascular smooth muscles, ultimately resulting in aura migraine and the subsequent vasodilation triggers the headaches.
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Racial and Ethnic Variables Influencing Physiologic Functioning
According to Charleston (2021), migraine headache is more prevalent among Caucasians than African Americans. The black population is the least at 9.2% compared to African Indians, Hispanics, and whites. The ethnic disparities in migraine headaches are due to genetic predisposition, adverse life events, and other comorbidities like depression. The whites are more prone to migraine headaches because of the increased prevalence of lifestyle diseases like hyperlipidemia and hypertension. Fundamental Concepts of Musculoskeletal and Neurological Disorders
How Do These Processes Interact To Affect The Patient?
Migraine headaches are more prevalent in women compared to men because of hormonal fluctuations. The level of estrogen hormone plays a vital role in stimulating the trigeminal nerve that produces the autonomic symptoms of headache (Burch, 2020). Additionally, a drop in estrogen causes excitability of the brain cortex. Migraine headaches are common in women during ovulation, pregnancy, and post-menopause due to decreased estrogen production.
Neurological and musculoskeletal pathophysiologic processes
The patient has been suffering from a severe right-sided headache for two to three days, as well as nausea, vomiting, and photophobia. Based on the history of the presenting ailment, the signs and symptoms are more likely to be caused by migraine. Migraine is a neurological condition marked by recurrent headaches ranging in severity from moderate to severe (Lipton et al., 2018). The headaches are pulsating in nature, and additional symptoms include nausea, vomiting, difficulty speaking, and sensitivity to light, smell, and sound. Migraine attacks may continue from a few hours to three days and may occur in waves. Migraines affect individuals of all ages and are often hereditary. Adenosine and other neuromodulators are believed to have a function in migraine due to their elevated concentrations during migraine attacks (Ashina et al., 2021). Others include calcitonin-related peptides, which have a role in the pathogenesis of migraine headache due to their increased levels during attacks. Fundamental Concepts of Musculoskeletal and Neurological Disorders
Racial/ethnic variables and their impact physiological functioning
In this case, migraine prevalence differs significantly between men and women, as well as by race. Migraines are more prevalent in women and more prevalent among Caucasian women in the United States, accounting for 20% of all instances, African American women accounting for 16%, and Asian American women accounting for 10%. Males exhibit a similar trend, with Caucasian men accounting for 8%, African American men accounting for 7%, and Asian American men accounting for 4%. Although African Americans reported experiencing severe headache pain, they were less likely to report nausea and vomiting as presenting symptoms (Allais et al., 2020). Caucasians were more likely than African Americans to be hindered by migraine attacks. According to research, dietary variances, race-related differences, genetics, socioeconomic status, and nutrition all have a role in the prevalence of migraine across various races.
Process interaction
During migraine attacks, changes in the brainstem and its interaction with the trigeminal nerve create a major pain pathway, as well as an imbalance in brain chemicals such as serotonin, which are critical components of the nervous system because they help manage pain (Dilbaz and Bülbül, 2021). Migraine can be triggered by a variety of factors, including stress at home and at work, sensory stimuli such as strong light, strong smells, and loud noises, hormonal changes in women during menstruation, pregnancy, and menopause, beverages such as alcohol and caffeinated beverages, medication such as oral contraceptives and vasodilators, foods including aged cheese and salty processed foods, food additives, weather changes, sleeping changes, and physical activity.
This week, you will examine fundamental concepts of neurological and musculoskeletal disorders. You explore common disorders that impact these systems and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients. Assignment (1- to 2-page case study analysis) Paper format: APA format reflective of the 7th edition. Review APA intext citation for correct format when citing 3 or more authors. Review APA for the maximun number of authors that must be listed in a cited reference. Start with a 1-2 sentence introduction followed by stating: The purpose of the paper will be to…… (each bullet point should reflect its own sentence)……In addition, …….Lastly, …….. Subject headings should reflect APA format and not written in a sentence format. Review WU grading rubric prior to submitting to ensure you are fulfilling WU learning objectives. If searching the literature for research, I will be specifically looking for an article reflective of research and how the research relates to the topic of discussion. Fundamental Concepts of Musculoskeletal and Neurological Disorders
Assigned Case Scenario: Patient is a 24-year-old female administrative assistant who comes to the emergency department with a chief complaint of severe right-sided headache. She states that this is the sixth time in the last 2 months she has had this headache. She says the headaches last 2–3 days and have impacted her ability to concentrate at work. She complains of nausea and has vomited three times in the last 3 hours. She states, “the light hurts my eyes.” She rates her pain as a 10/10 at this time. Ibuprofen and acetaminophen ease her symptoms somewhat but do not totally relieve them. No other current complaints. 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. Day 7 of Week 8 Submit your Case Study Analysis Assignment by Day 7 of Week 8. Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary/conclusion, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). Fundamental Concepts of Musculoskeletal and Neurological Disorders
