2 Explain both the neurological and musculoskeletal pathophysiologic processes of why the patient presents these symptoms. Parkinson’s disease (PD) generally affects the neurons in the nervous system (Caviness, 2014). This damage and neural deaths in various parts of the body leads to the development of various related symptoms. The 67-year-old male patient is experiencing such symptom as impaired movement and balanced. This is as a result of the loss of dopamine-producing neurons found in the substantia nigra pars compacta (Gröger, Kolb, Schäfer, & Klose, 2014). The patient required help to rise from bed, had uneven gait and even shuffles when he walks with the head/neck, hips, and knees flexed forward. The patient portrayed a cogwheeling or jerky movement. The cells that control movement would not send proper messages to the muscles due to lack of dopamine; hence the patient demonstrates tremors in the hands at rest and fingers exhibit "pill-rolling" movement. Moreover, he experienced episodes of sweating and flushing not associated with an activity. This is as a result of damage by of the autonomic nervous system which controls such functions. The musculoskeletal processes are also affected by the PD since it causes rigidity. Rigidity in PD alters the flexor and extensor muscles can interfere with movement (Takakusaki, 2017). This explains the stiffness experienced by the patient and also the immobile mask-like face. Explain how the highlighted processes interact to affect the patient. These processes, therefore, interact to affect the patient in various ways. For example, the rigidity can alter communication since the masked face appearance will make others unsure of the emotional reaction that the patient exhibit during communication (Bantjes, 2017). The patient will therefore find hard communicating even with the spouse. This may cause unstable
3 relationship and affect the patient more. Together with neurological damage, rigidity also affects movement. This affects the patient’s life since walking and turning would be difficult and unsafe. For example, in the case scenario the patient remains stiff, and also has unbalanced movements. Moreover, eating and rising from a chair as exhibited by the patient in the case study would be hard for the patient. Overall, the patient would find a rough time while performing the activities of daily living which include communication, eating and drinking, bathing and toileting, and walking. Explain any racial/ethnic variables that may impact physiological functioning. According to the largest epidemiological study of Parkinson’s disease in the United States, the disease is more prevalent in the Northsea and the Midwest and strikes the whites and Hispanics twice as compared to blacks and Asians (Elbaz, Carcaillon, Kab, & Moisan, 2016). The most likely reason for the effect in the two regions is environmental risk factors since they are involved in agriculture and metal processing and the chemicals used in the process. It is also thought that the African or Asian ancestry exhibit genes that protect them from the environmental risk factors or that they may be experiencing fewer exposure to the risk factors. This is because the environment is not polluted by the chemicals as much as it will be for the regions involved in the agriculture and metal processing. They may get exposed directly or indirectly through the air they breath and the products that they consume, hence impacting on the physiological functions.
4 References Elbaz, A., Carcaillon, L., Kab, S., & Moisan, F. (2016). Epidemiology of Parkinson's disease.Revue neurologique,172(1), 14-26. Bantjes, C. (2017).The experience of people living with Parkinson's disease(Doctoral dissertation, University of Pretoria). Caviness, J. N. (2014). Pathophysiology of Parkinson's disease behavior–a view from the network.Parkinsonism & related disorders,20, S39-S43. Gröger, A., Kolb, R., Schäfer, R., & Klose, U. (2014). Dopamine reduction in the substantia nigra of Parkinson's disease patients confirmed by in vivo magnetic resonance spectroscopic imaging.PloS one,9(1). Takakusaki, K. (2017). Functional neuroanatomy for posture and gait control.Journal of movement disorders,10(1), 1.