HLT100 Semester 2 Case Study: Joyce's Anatomy, Physiology and Health

This case study analyzes the health challenges of Joyce, a 77-year-old woman, focusing on the interplay of her integumentary, digestive, muscular, and skeletal systems. The assignment explores Joyce's bone fractures due to a fall, her skin integrity issues, and the delayed wound healing process. It delves into the impact of medications on her digestive system, leading to constipation, and discusses potential natural remedies. The case study further examines Joyce's diagnosis of osteoporosis, explaining the condition in simple terms and identifying the factors contributing to her bone loss, including vitamin D deficiency, calcium loss, and reduced estrogen levels. Finally, it addresses the recommended vitamin D supplementation and its role in calcium absorption and bone health, providing a comprehensive overview of Joyce's health issues and the physiological mechanisms involved. The assignment references the case study brief which specifies the need to demonstrate knowledge of the anatomy and physiology of the Integumentary, Digestive, Muscular and Skeletal body systems; and describe the complex interactions between these body systems to maintain health, wellbeing and homeostasis for the individual in the chosen scenario.

Running Head: ANATOMY IN HUMANS
ANATOMY IN HUMANS
Name of the Student
Name of the University
Author Note

1ANATOMY IN HUMANS
1. Joyce is a 70 years old woman who lives all alone in her home. Joyce recently has a
fall that resulted in her fracture of bones and that was taking time for the recovery.
A) This can be explained by the loss of structural integrity of her skin. The loss of
structural integrity is due to the number of clinical conditions that can start from the skin
disorders like pruritus and also due to melanoma and carcinoma (Farage et al. 2013). The
structural and functional deterioration in skin can also occur due to aging among the
individuals. These degenerative changes in the skin of Joyce can be well understood by the
analysis of the cellular and the molecular level changes. The loss of both the structural and
the functional stability of the skin starts with aging that is due to the both intrinsic and the
extrinsic processes (Holmes et al. 2013). These factors contribute continuously for the
progressive loss of skin integrity. The intrinsic aging starts with the genetically defined rate
that is primarily due to the accumulation of the cellular metabolism products that are
damaging. This is also stimulated by the increasing aging of cells (Kottner, Lichterfeld and
Blume 2013).
B) The process of wound healing can be delayed by the effects of skin damage. That
is affected by the result of using warfarin for the treatment of the skin problems. This can
even cause skin necrosis and can result in thrombophilic abnormalities (Holmes et al. 2013).
When there is a start of the warfarin therapy there is a very fast of the level of protein C.
Thus, if the patient has a deficiency of the protein or any kind of impairment in the pathway it
can cause severe skin disorders (Kottner, Lichterfeld and Blume 2013). This is seen in the
delaying of wound healing that can happen after falling among the older adults. The poor
wound healing can be due to the trauma, surgery, chronic disease condition or acute illness.
Thus, failure of any of the processes causes disruption of the cellular processes that can
hamper the healing pathophysiology that ultimately affects the wound healing. There are a
number of other factors that affect the process of wound healing along with skin integrity

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includes nutrition, hydration level, depth of wound and other co-morbidities (Farage et al.
2013).
2. As Joyce had a fall and was affected by the skin disintegration she was on a number
of medicines that has the potential to cause diarrhea or constipation.
A) This can be explained by the fact that the medicines that are used to treat skin
problems fall into a number of category like antibiotics, antifungal, non-steroidal drugs that
have the ability to modulate the immune system of the patient (Ford, Brenner and Schoenfeld
2013). This immune system stimulation often causes the problems in the gut of the patient
resulting in constipation or diarrhea. As the drugs that are being used in high doses or are
applied directly into skin they are directly absorbed into the blood stream that results in the
easier assimilation within the digestive system that results in the gut problems (Wald 2016).
These problems can also arise when there is oral consumption of the drugs as well as the non-
steroidal drugs can alter the gastrointestinal system that can result in the diarrhea. Thus, it is
clear that the digestive system and the drug therapy have a reciprocal relation as certain drugs
alter the metabolism and absorption of drugs (Emmanuel et al. 2013).
b) There are certain potential natural ways that can Joyce to relieve constipation.
These remedies include drinking more water as it can help to induce a better bowel
movement (). Dehydration is the most common cause of constipation and thus, drinking a lot
of water can be helpful for resolving the symptoms. Joyce can also take a lot of yogurt that
contain probiotics which are microorganisms. Probiotics are the good bacteria that helps in
the gut improvement and helps in the better digestion of food (Emmanuel et al. 2013). Thus,
Joyce can take food that contains a lot of probiotics and fibers for the treatment of
constipation. She can also take meals that is rich in pulses as they promote digestion and
reduces constipation. The meal taken by Joyce should also contain clear soups that are

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nutritious and very easy for the proper digestion (Ford, Brenner and Schoenfeld 2013). They
help to add the required amount of moisture to the fecal products. Joyce should also intake a
number of fruits and vegetables like apples and vegetables that contain several compounds
which help for the proper digestion of the food that includes sorbitol, fructose and fibers. The
fruits also contain a high amount of amount in them that helps in reduction of constipation
(Wald 2016).
3. Joyce has recently been diagnosed with osteoporosis.
a) This can be explained to Joyce’s son Matthew in very simple context that
highlights the fact that his mother is suffering from the bone disorders. Osteoporosis is a
condition of the bones which becomes brittle and fragile leading to higher risk of breakage
(Cosman et al. 2014). This usually happens when there is a loss of the bone minerals most
importantly calcium that is lost much more quickly than the rate at which it is again formed
in the body. Osteoporosis is a very common disorder among the older adults and hip is a very
common site for the osteoporosis (Tella and Gallagher 2014). In older women it is very
common as the estrogen levels drop after the menopause and that results in the loss of the
bone speed. Thus, osteoporosis is a common problem among older women. Osteoporosis has
a distinct pathophysiological link with sarcopenia which an age-related issue that results in
the loss of muscle mass, function or strength (Sattui and Saag 2014).
b) Three reasons that could have resulted in the loss of bone strength in Joyce include
the reduction of the vitamin D, loss of calcium level and the lack of the hormone estrogen
(Cosman et al. 2014). A lot of research has been done that focuses on the role of vitamin D in
the development of osteoporosis. As vitamin D is needed to help in the absorption of calcium,
scientists and doctors generally rely on the fact that you enough calcium and vitamin D is
needed throughout the life in order to develop healthy bones and also to reduce the risk of

4ANATOMY IN HUMANS
developing osteoporosis (Tella and Gallagher 2014). The other reason for the development of
osteoporosis involves the loss of calcium level and thus a lifelong deficiency of calcium plays
an important role in the development of osteoporosis. The low calcium intake contributes to
the diminished bone density, early loss of bone and also an increased risk of fractures (Sattui
and Saag 2014). The last reason for the osteoporosis development is the reduction of the
hormone levels in the older women. The lowered hormone levels tend to weaken bone and
thus the reduction of estrogen levels in women at menopause is one of the highest risk factors
for the development of osteoporosis (Cosman et al. 2014).
4. It has been recommended for Joyce that the nursing home provides her with
vitamin D supplement that will help her to get the daily dietary dose of calcium (Weaver et
al. 2016). This has been suggested by the clinicians by keeping in mind the fact the Joyce
was suffering from osteoporosis and it has been seen that she was suffering from lower
calcium levels. The low level of vitamin D is the reason for the high blood calcium as the low
vitamin D causes the parathyroid glands to become over-active (Bolland et al. 2014). This
causes the increase of calcium level in the blood to a point that it becomes unable for the
bone to absorb the same and thus, the calcium uptake by the bone remains low. When the
body needs calcium, parathyroid gland makes parathyroid hormone (PTH) (Bjelakovic et al.
2014). The body reacts by absorbing more calcium from food and keeps it from leaving through
the urine. All patients with hyperparathyroidism will get osteoporosis if the parathyroid tumor
is not removed. The insufficient intake of calcium leads to secondary hyperparathyroidism
that increases the rate of remodelling in the bone in order to maintain a normal serum calcium
level (Bolland et al. 2014). There are certain populations who are at an increased risk of
vitamin D deficiency that includes obese people due to the decreased bioavailability of
vitamin D, the individuals who are living far away from the equator due to the reduced
exposure of sun and finally the elderly people who have impaired intestinal absorption and

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decreased cutaneous production of vitamin D (Bjelakovic et al. 2014). The insufficiency of
vitamin D also leads to hyperparathyroidism that increases bone loss. The imbalance between
the resorption and the formation of bone leads to the increased loss of bone tissue. This is the
reason for the intake of vitamin D supplements so that the bone can absorb more calcium and
thus, reducing the risk of osteoporosis (Weaver et al. 2016).

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References
Bjelakovic, G., Gluud, L.L., Nikolova, D., Whitfield, K., Wetterslev, J., Simonetti, R.G.,
Bjelakovic, M. and Gluud, C., 2014. Vitamin D supplementation for prevention of mortality
in adults. Cochrane database of systematic reviews, (1).(4)
Bolland, M.J., Grey, A., Gamble, G.D. and Reid, I.R., 2014. The effect of vitamin D
supplementation on skeletal, vascular, or cancer outcomes: a trial sequential meta-
analysis. The lancet Diabetes & endocrinology, 2(4), pp.307-320.(4)
Cosman, F., de Beur, S.J., LeBoff, M.S., Lewiecki, E.M., Tanner, B., Randall, S. and
Lindsay, R., 2014. Clinician’s guide to prevention and treatment of
osteoporosis. Osteoporosis international, 25(10), pp.2359-2381.(3)
Emmanuel, A., Quigley, E.M., Simrén, M., Feng, Y., Müller-Lissner, S., Urbain, D., Tack, J.,
Bredenoord, A.J., Sabaté, J.M., Yiannakou, Y. and Andresen, V., 2013. Factors affecting
satisfaction with treatment in European women with chronic constipation: An internet
survey. United European gastroenterology journal, 1(5), pp.375-384.(2)
Farage, M.A., Miller, K.W., Elsner, P. and Maibach, H.I., 2013. Characteristics of the aging
skin. Advances in wound care, 2(1), pp.5-10.(1)
Ford, A.C., Brenner, D.M. and Schoenfeld, P.S., 2013. Efficacy of pharmacological therapies
for the treatment of opioid-induced constipation: systematic review and meta-analysis. The
American journal of gastroenterology, 108(10), p.1566.(2)
Holmes, R.F., Davidson, M.W., Thompson, B.J. and Kelechi, T.J., 2013. Skin tears: care and
management of the older adult at home. Home Healthcare Now, 31(2), pp.90-101.(1)
Kottner, J., Lichterfeld, A. and Blume‐Peytavi, U., 2013. Maintaining skin integrity in the
aged: a systematic review. British Journal of Dermatology, 169(3), pp.528-542.(1)

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Sattui, S.E. and Saag, K.G., 2014. Fracture mortality: associations with epidemiology and
osteoporosis treatment. Nature Reviews Endocrinology, 10(10), p.592.(3)
Tella, S.H. and Gallagher, J.C., 2014. Prevention and treatment of postmenopausal
osteoporosis. The Journal of steroid biochemistry and molecular biology, 142, pp.155-170.
(3)
Wald, A., 2016. Constipation: advances in diagnosis and treatment. Jama, 315(2), pp.185-
191.(2)
Weaver, C.M., Alexander, D.D., Boushey, C.J., Dawson-Hughes, B., Lappe, J.M., LeBoff,
M.S., Liu, S., Looker, A.C., Wallace, T.C. and Wang, D.D., 2016. Calcium plus vitamin D
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