Evidence-Based Change, health and medicine
July 11, 2019
Integrated Safety Management Systems
July 11, 2019

Case Study 4

Disorders of Musculoskeletal Function: Rheumatic Disorders

Rick is a 27-year-old who works in an accounting firm. He had started to experience lower back pain and stiffness that he thought were a result of the long hours he spent at his desk. More recently, however, he began to have sleep difficulties. He found that he often woke up during the night feeling hot and sometimes sweaty. Furthermore, his back pain disrupted his sleep, particularly when it radiated around his pelvis and into his thighs. When his lack of sleep began to interfere with his work, he went to an osteopath to see what was wrong. She listened to his case history carefully. Upon physical examination, she noted a slight decrease in his lumbar lordosis and a reduced range of movement in his lumbar spine. His blood tests revealed the presence of HLA-B27, an elevated ESR, and absence of RH. His radiograph showed evidence of sacroiliitis.

  1. What is the likely diagnosis Rick received? What are the common clinical presentation and manifestations of the disease?
  2. Why is osteoarthritis of the hips a potential secondary complication of this disease? What are the structural changes that occur in the articular cartilage of an osteoarthritic joint?
  3. What is the effect of advanced ankylosing spondylitis on lung function?

Case Study 5

Structure and Function of the Skin

Yael is an 18-year-old college student who is bothered by excessive perspiration. She knew she sweat a lot under her arms and kept antiperspirant in her schoolbag to use throughout the day. Yael’s problem was not limited to under her arms, however. Her hands and feet also perspired heavily, and it embarrassed her. She did not like holding her boyfriend’s hand if her hands were particularly sweaty, and she had problems grasping her pen while in class because her palm became slippery. Yael suffered from a condition called primary focal hyperhidrosis, a condition involving hyperactive sweat glands in certain areas of the body.

  1. What are the anatomical and functional differences between eccrine and apocrine glands?
  2. What autonomic nervous system controls the function of thermoregulation of the skin? How do goosebumpsgoose bumps contribute to heat conservation?
  3. Describe the location of the blood plexuses in the skin. How is blood circulation to the skin involved in thermoregulation?

 

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