HS5509: Jenny is diagnosed with multiple sclerosis, just like her mother at the age of 44 years. Recently she started experiencing fatigue: Anatomy Case Study, NYP, Singapore

Case study 1

Jenny is diagnosed with multiple sclerosis, just like her mother at the age of 44 years. Recently she started experiencing fatigue and inability to move from bed in the morning. She also complained of tingling, numbness.

As a clinic nurse, you need to explain to Jenny about the disease. You have learned that multiple sclerosis is a demyelinating disease that affects the myelin sheath.

• With the help of a diagram, explain the structure of neurons in the central nervous system
• Describe the physiology of nerve conduction and relate it to the symptoms
  Jenny is experiencing.

Case study 2

Baby M, born with a large head, was diagnosed with hydrocephalus antenatally. At birth, you notice a large head, and eyes sunken downwards. Over the next few hours, The baby is not feeding adequately and has poor muscle tone.

As a ward nurse, you need to explain to the parents of Baby M about the disease. You have learned that hydrocephalus is due to excessive cerebrospinal fluid in the ventricles.

• Describe the production, circulation, and reabsorption of cerebrospinal fluid.
  Indicate the functions of cerebrospinal fluid.
• Based on your understanding of the physiology, explain the symptoms of Baby
  M.

Case study 3

Mr. T and Mr. B are mahjong buddies, admitted to Neuro-ICU with ischemic stroke. Hypothetically they have different arteries blocked due to embolism.

Mr. T who is right-handed has left middle cerebral artery affected. Mr. B who is also right-handed has the right anterior cerebral artery affected.

As an ICU nurse, you need to explain to the relatives of Mr. T and Mr. B about the disease and why they have different symptoms.

• Describe the blood supply of the brain.
• Based on your understanding of the physiology, assuming there is no collateral
  circulation, explain the difference in the presenting symptoms in Mr. T and Mr. B.