Neurological and Musculoskeletal Disorders and Variables that Impact Physiological Function

Module 5 Assignment: Case Study Analysis
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Patient Symptoms
The patient presented with symptoms which included tremors in his arms and leg, face and body stiffness, uneven gait, shuffling when walking, head, hips, and knees flexed forward, jerky movement, and episodes of sweating and flushing at rest.
Neurological and Musculoskeletal Pathophysiologic Processes that cause the Symptoms
The neurological and musculoskeletal changes associated with Parkinson's disease include losing dopamine, a neurotransmitter. The degeneration of nerve cells begins in the vagus nerve and the olfactory bulbs at the dorsal motor nucleus (Vriend, 2018). The locus coeruleus then wears out, followed by the substantia nigra (Emamzadeh & Surguchov, 2018). Cortical regions are affected later as the disease progresses. Dopamine is secreted in the nerve cells of substantia nigra, which relay messages that control body movement. Dopamine loss occurs slowly with the normal aging process, while in Parkinson's disease, the degeneration occurs faster. The symptoms occur once 80% of dopamine is lost. The remaining dopamine is inadequate to transmit impulses across the synapse leading to movement disorders. As the disease progresses, loss of dopamine reduces the action of GABA, glutamate, and serotonin (Vriend, 2018). Abnormal protein aggregates called Lewy bodies (composed of alpha-synuclein) form inside the nerve cells of people with the disease.
  The ganglia are composed of interlinked nerve cells that affect movement. The striatum, together with the substantia nigra transmits impulses from the spinal cord to the brain and vice versa. The information is then sent to the muscles. The cerebellum and the basal ganglia ensure smooth movement (Raza & Anjum, 2019). Inadequate stimulation of dopamine receptors in the striatum leads to overstimulation or insufficient stimulation of parts of the basal ganglia (Vriend, 2018). The nucleus in the subthalamic becomes overstimulated and inhibits the globus pallidus internal, causing muscular rigidity. Overstimulation of the globus pallidus internal inhibits the functioning of the thalamus, causing tremors. As a compensatory mechanism, h...