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Homework answers / question archive / 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

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

Health Science

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.

Explain the following:

1. Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.

2. Any racial/ethnic variables that may impact physiological functioning.

3. How these processes interact to affect the patient.

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Answer:

  1. Pathophysiology of a stroke
  2. Smoking increased the risk of stroke. Certain ethnicities are more at risk for stroke. Also, the patients age puts him at risk.
  3. Risk factors of stroke

Step-by-step explanation

  1. Strokes can happen when a blood vessel in the brain becomes blocked (ischemic) or when a blood vessel bursts or breaks (hemorrhagic) cutting of the blood supply to different parts of the brain. This causes certain parts of the brain to die (sometimes only temporarily if blood flow is resumed quick enough). As we all know the brain is what controls the body. When certain pieces of the brain lose blood supply and essentially "die" they are no longer to send the messages to other parts of our body. The message center is destroyed to simplify. Cognitively the impulse is there but it unable to be sent to the part of the body that needs to perform the task. Therefore, the musculoskeletal system is affected as well. The components of the musculoskeletal system are intact, but the impulses to use them are absent.
  2. The scenario does not present the ethnicity of the patient, but African Americans are more susceptible to strokes (50 percent more likely). Since this patient is over 55 and a smoker those are additional risk factors. https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113
  3. . African americans are more likely to have strokes then other ethnicities because they have more risk factors. Per the numbers African Americans have higher percentages of high blood pressure and obesity than other ethnicities. The deficits the patient has will indicate what portion of the brain is the stroke occurred in.

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