Week 8: Concepts of Neurological and Musculoskeletal Disorders – Part 2
As homeowners know all too well, there is a continuous need for maintenance and repair. Some efforts are precautionary in nature, while others are the result of issues that surface over time.
Similarly, musculoskeletal disorders can develop over time. For some disorders, such as osteoporosis, precautionary treatments are a potential option. But much like issues that surface in a home over time, many musculoskeletal issues can be very serious concerns, and they can have a significant impact on patients’ lives.
This week, you continue to 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.

Learning Objectives
Students will:

• Analyze processes related to neurological and musculoskeletal disorders
• Identify racial/ethnic variables that may impact physiological functioning
• Evaluate the impact of patient characteristics on disorders and altered physiology 
• 
  Assignment: Module 5 Case Study Analysis due by day 7
  Scenario: 74-year-old male with a history of hypertension and smoking, is having dinner with his wife when he develops sudden onset of difficulty speaking, with drooling from the left side of his mouth, and weakness in his left hand. His wife asks him if he is all right and the patient denies any difficulty. His symptoms progress over the next 10 minutes until he cannot lift his arm and has trouble standing. The patient continues to deny any problems. The wife sits the man in a chair and calls 911. The EMS squad arrives within 5 minutes. Upon arrival in the ED, patient‘s blood pressure was 178/94, pulse 78 and regular, PaO₂ 97% on room air. Neuro exam – Cranial nerves- Mild left facial droop. Motor- Right arm and leg extremity with 5/5 strength. Left arm cannot resist gravity, left leg with mild drift. Sensation intact. Neglect- Mild neglect to left side of body. Language- Expressive and receptive language intact.
  Mild to moderate dysarthria. Able to protect airway.
  
  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.

Week 8: Concepts of Neurological and Musculoskeletal Disorders – Part 2

As homeowners know all too well, there is a continuous need for maintenance and repair. Some efforts are precautionary in nature, while others are the result of issues that surface over time.

Similarly, musculoskeletal disorders can develop over time. For some disorders, such as osteoporosis, precautionary treatments are a potential option. But much like issues that surface in a home over time, many musculoskeletal issues can be very serious concerns, and they can have a significant impact on patients’ lives.

This week, you continue to 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. 

Learning Objectives

Students will:

• Analyze processes related to neurological and musculoskeletal disorders
• Identify racial/ethnic variables that may impact physiological functioning
• Evaluate the impact of patient characteristics on disorders and altered physiology 

Learning Resources

Note: The below resources were first presented in Week 7. If you have previously reviewed them, you are encouraged to read or view them again here. 

Required Readings (click to expand/reduce)

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

• Chapter 15: Structure and Function of the Cardiovascular and Lymphatic Systems (stop at Aging and the nervous system)
• Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function (stop at Sleep); Summary Review
• o   Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function; pp. 504–511, pp. 516–530 (start at Acute confusional states and delirium) (stop at Alterations in neuromotor functions); (Parkinson’s Disease); Summary Review
• Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction (stop at Degenerative disorders of the spine); (start at Cerebrovascular disorders) (stop at Tumors of the central nervous system); Summary Review
• Chapter 44: Structure and Function of the Musculoskeletal System (stop at Components of muscle function); Summary Review
• Chapter 45: Alterations of Musculoskeletal Function (stop at Bone tumors); (start at Disorders of joints); Summary Review 

Chin, L. S. (2018). Spinal cord injuries. Retrieved from https://emedicine.medscape.com/article/793582-overview#a4

Required Media (click to expand/reduce)

Khan Academy. (2019b). Ischemic stroke. Retrieved from ttps://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/stroke/v/ischemic-stroke

Note: The approximate length of the media program is 8 minutes.

Osmosis.org. (2019, June 12). Osteoporosis – causes, symptoms, diagnosis, treatment, pathology [Video file]. Retrieved from https://www.youtube.com/watch?v=jUQ_tt_zJDo

Note: The approximate length of the media program is 9 minutes.

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 15, 16, 18, and the sections of Chapters 44 and 45 that relate to the neurological and musculoskeletal systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Module 5 Assignment: Case Study Analysis

• An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other.
  Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role.
• 
• Photo Credit: jijomathai – stock.adobe.com

An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (1- to 2-page case study analysis)

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, 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). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “M5Assgn+last name+first initial.(extension)” as the name.
• Click the Module 5 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Module 5 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M5Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following:

Explain both the neurological and musculoskeletal pathophysiologic processes of why the patient presents these symptoms.

28 (28%) – 30 (30%)

The response accurately and thoroughly describes the patient symptoms.

The response includes accurate, clear, and detailed explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms and is supported by evidence and/or research, as appropriate, to support the explanation.

Explain how the highlighted processes interact to affect the patient.

28 (28%) – 30 (30%)

The response includes an accurate, complete, detailed, and specific explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation.

Explain any racial/ethnic variables that may impact physiological functioning.

23 (23%) – 25 (25%)

The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.