ANATOMY AND PHYSIOLOGY CLASS
Anatomy and Physiology Class
Joints refer to the junctions within the body which links the bones together. Joint structure is comp0sed of the hinge, pivot, ball in the socket, ad any other formation is important in the movement in different directions. Within the joint, there is a cartilage which cushions the interactions between bones. The cartilage is also important in absorbing the synovial fluid which as a very crucial lubricant which assists in the protection of the bones that have been worn away over time by the friction process. Joins are also important in binding the skeleton together thus giving the structure and allowing the muscles to move freely to perform functions like running, reaching, and grasping (Konarzewska, 2018).
There are different types of joints and most of them are synovial joints and they include knee, hip, elbow, shoulder, and the fingers. There are other uncommon joints and they include the fibrous and the cartilaginous. Fibrous joint includes skull and it does not have the movement characteristics. The cartilaginous joints include those of the pelvis which are having very little movement.
These roles are important to the human being; however, they can be interfered with due to the occurrences of some disorders. Some of the disorders of the joint include neurogenic arthropathy, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and reactive arthritis among many others. In this paper, the goal would be to provide a discussion on neurogenic arthropathy and osteoarthritis while looking at the two case studies.
This is a chronic arthropathy which is associated with the disruption and the possible loss of the joint cartilage along with other changes in the joint such as bone hypertrophy. This disorder is becoming symptomatic in the 40s and 50s and it is nearly universal by the age of 80 years. Out of the individuals affected by this disease, only half of them with the pathologic changes of this disorder are having symptoms. The classification of the osteoarthritis is based on whether it is primary or secondary. The primary osteoarthritis is localized to some joints for example chondromalacia patellae are a mild form of this disorder which is affecting young individuals. The primary osteoarthritis is subdivided based on their site of involvement such as hands, feet, knee, and the hip. On the other hand, the secondary form of this disorder is caused by the conditions which lead to the change in the microenvironment of the cartilage and them can include trauma, metabolic defects, infections like those causing post-infectious arthritis, congenital joint abnormalities, and other disorders which leads to the alteration of the normal structure as well as the functions of the hyaline cartilage (Glyn-Jones, Palmer, Price, & Vincent, 2015).
The symptom of the osteoarthritis is gradual and it begins with a single joint. The earliest symptom is pain which can be described as a deep ache. This is then followed by stiffening which lasts for 30 minutes and is weakened with movement. As the disease progresses, the joint motion becomes restricted leading to the development of the tenderness, crepitus or the grating sensations. There is also a proliferation of the bone, cartilage, tendon, ligament, capsules, and the synovium thus leading to the enlargement of the characteristic of the osteoarthritis. The diagnosis is through X-rays to reveal the marginal osteophytes, narrow joint space, increased density of the subchondral bone, and the cyst formation. The treatment involves non-drug therapy through education and supportive measures.
Mrs. Kerry is 72 years old and is living independently in her house with her husband who is 80 years old and he is her main carer. Mrs. Kerry is having osteoarthritis of the knees, hips, and hands. She is also having hypertension and diabetes. She is taking four drugs for her medication and 2 and half years ago, she was admitted at the emergency department for the urine infection. Following her discharge from the facility, the evaluation revealed that she is at risk of being readmitted again because of numerous pathology, polypharmacy, and the previous admission. She received a below standard care and poor management before being admitted. Mrs. Kerry’s GP referred this case to the community matron who is working with other groups of healthcare practitioners as well as her husband to assists in the coordination her care so as to minimize the risk of the future admissions. The community matron helped Mrs. Kerry for a period of two months. The coordination process was later handed back to Mrs. Kerry’s GP.
In this case, the management of the pain which was being experienced by Mrs. Kerry is effectively managed through the combination of the pharmacological and the non-pharmacological interventions such as individual evaluation. Based on this therapeutic procedure, the pain which affected her is no longer there because she reported normal sleeping patterns as well as showing no signs of depression. Based on this case study, it is evidence that caring for and managing the chronic conditions needs to address the needs and the expectations of the individual. This goal is important as it is aimed at reducing the impacts of the osteoarthritis over time.
This disorder is associated with the rapid destruction due to the impaired pain perception and the sensor position. The result of this is the different underlying disorders such as diabetes and the stroke. The most widely recognized manifestations of this disorder are swelling, effusion, deformity, and the instability. The impaired deep pain is affecting the normal protective reflexes which frequently allow trauma and the minute fractures to be unrecognized. There is also increased blood flow to the bone from the reflex vasodilation which causes active bone resorption which leads to the damages of the bone and the joints.
The symptoms of this disorder do not usually appear immediately following its onset but it takes years as it progresses faster leading to the disorganization of the joint. Pain is usually experienced at the early symptom; nevertheless, since the sensitivity to pain is impaired, the intensity of the pain is all of a sudden becoming mild for the intensity of the joint damage. Other symptoms which are common during the early days include hemorrhagic, effusion, and the subluxation as well as instability of the joint (Park, Moon, & Lee, 2015).
In this case study of the neurogenic arthropathy disorder, a 65-year-old female patient goes to the clinic as she complains of the pain and a reduced range of movement in the left shoulder for the past three weeks. Based on her medical history, she has been examined by a doctor 12 years ago with complaints of the numbness as well as the swelling of the left hand and the leg. She has also been previously diagnosed with the syringomyelia between the levels of C2-L1. Her complaints by this patient had improved two days ago. Based on the physical examination, hypoalgesia hypoesthesia was observed at the left shoulder with a cape like distribution. There was also erosion and the fracture at the left proximal humerus with the plain radiographs.
Based on the history and the clinical as well as the radiology findings, she was diagnosed with the neuropathic shoulder arthropathy. The upper extremities were affected and the shoulder is the most commonly involved part in this kind of infection. The symptoms of the neuropathic arthropathy had masked the symptoms of the syringomyelia and therefore this might make the physician see the patient for the orthopedic assessment. In this case, surgical decompression of the syringomyelia can be done if it is the cause. The reconstruction process can be done following the stop of the osteolytic process (Konarzewska, 2018).
References Glyn-Jones, S., Palmer, A., Price, A., & Vincent, T. (2015). Osteoarthritis. The Lancet, 386 (9991), 376-387. Konarzewska, A. (2018). Diabetic foot syndrome: Charcot arthropathy or osteomyelitis? Part I: Clinical picture and radiography. Journal of Ultrasonography, 18 (72), 42. Park, J., Moon, J., & Lee, Y. (2015). Neuropathic arthropathy of the shoulder associated with cervical syringomyelia: A case report in shoulder & elbow. 18 (4). Tomas, K., Haroun, H. S., & Pavel, S. (2016). Charcot neuropathic arthropathy of the foot: a literature review and the single center experience. Journal of Diabetes Research, 2016, 1-10.