“My Leg is on Fire”: A Case Study on Spinal and Peripheral Nerve Anatomy

“My Leg is on Fire”: A Case Study on Spinal and Peripheral Nerve Anatomy

Sarah Mitchell is a 68-year-old female who is normally healthy. However, about five days ago she began to feel very fatigued and started to experience a burning and tingling sensation on her right thigh.

You ask to see the area and upon visual inspection you notice 3–4 small, red, swollen areas with vesicles on the posterior aspect of her right thigh. She describes the pain to you, saying “it feels like the back of my leg is on fire and it hurts so bad.” She denies being exposed to any excessive heat sources, any changes in her diet, and any changes in the type of body soap, lotion, or laundry detergent she is using. All other physical findings are within normal limits, but her oral temperature is 100.6°F. She complains about being under a lot of stress for the past three months because she has been helping take care of her husband, who is in the end stages of Alzheimer’s disease. She has no known drug allergies, is a non-smoker, and attends a water aerobics class twice a week. You suspect she may be suffering from a particular viral infection, so you ask if she had chicken pox as a child. Sarah confirms that she had chicken pox and measles during childhood. Her answer confirms your suspicions that she is likely suffering from shingles (herpes zoster) due to varicella-zoster virus infection.

Short answer questions

1. Define the following terms, used in the case and also in associated questions.

a. paresthesia
b. skin vesicle
c. dorsal
d. ventral
e. dormant

2. The list below classifies sensory receptors by the stimulus that activates them. Using your textbook or other resource, name the receptor for each stimulus type.
a. activated by touch, pressure, vibration, and stretch.
b. activated by changes in temperature
c. activated by light or changes in light wavelengths
d. activated by changes in chemical concentrations in a solution
e. activated by tissue injury or situations that may lead to tissue injury

3. The virus infecting Sarah lies dormant in the dorsal root ganglion. What part of a neuron is located in the dorsal root ganglion? Does the dorsal root and its ganglion carry sensory input, motor output, or both?

5. Based on the pattern of skin vesicles and pain, which of Sarah’s peripheral nerves is infected? To which peripheral nerve plexus does this nerve belong?

Reflective Journal

Directions: Please answer the following steps according to the reflections presented. Feel free to write as much as you wish. It is best to carefully think about the situation, reflect on the situations using information you have learned from the appropriate chapters, and then respond to the reflections.

Note: Answer as if you are the care provider, NOT the person in the study.

Reflective Cycles

1. Goal: What is the goal of understanding the physiology of nervous tissue?
Answer Here

2. Issue: What happens to damaged nervous tissue?
Answer Here

3. Evidence: What evidence identifies damage to the nervous tissue?
Answer Here

4. Conclusions: What is the conclusion you draw from reading the case study?
Answer Here

5. Principle: What pathological principles are in play? Include affects to systems discussed so far.
Answer Here

6. Assumptions: What are the signs and symptoms that led to the diagnosis?
Answer Here

7. Consequences: What would be the patient outcome if misdiagnosed?
Answer Here

8. Self-Perspective: Based on the scenario, what happened to the patient, what are long- and short-term effects, and what could be the possible health outcomes?
Answer Here

9. Why is this case study important, and how will it affect your future?
Answer Here

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