Saturday, May 18, 2019
A Spill at Parsenn Bowl Essay
Part I The Slopes patch enjoying a day on the move slopes at Winter park the long-suffering fell exiting the go lift. Patient was able to get up unassisted however, as she adjusted her stance the human knee wrestle and she fell again resulting in an external rotation of the right knee. Patient account no vexation at this time, but due to instability she was transferred by Ski Patrol down the slope on a sled. For the forbearings dead body to maintain homeostasis throughout the duration of exposure to the extreme cold, thermo receptors within the skin frantic sending signals to the hypothalamus. In turn the cutaneous blood vessels constricted and shivering commenced in an attempt to accumulate and produce additional body heat. (Minerva Union, 2011, 2). During the time of exposure to the extreme cold alone distal extremities and any exposed tissues would be vulnerable to the occurrence of frostbite.(Minerva Union, 2011)Part II The Emergency inhabitUpon arrival at the eme rgency room the diligent was shivering which deal be seen as an previous(predicate) indication of hypothermia. At this time the patient was instructed to remove her parka in an effort to avoid barely heat mischief, resulting from an accumulation of moisture from the conditions outdoors. To assist in regulation of homeostasis the patient was wrapped in blankets and condition hot chocolate. Pulse was taken at the Dorsalis Pedis to check the patients circulatory response. (The EMT Spot, 2014, 7). Pain reported by the patient was localized to the medial surface of the right knee,noticeable inflammation present due to the leaking of fluids from compromised internal tissues. The patients presentation of symptoms are indicative to that of a potential medial verificatory ligament and medial meniscus tear. (Healthline, 2014, 5). The medial meniscus articulates with the medial condyles of the tibia and femur.Part III The Mile soaring ClinicAn X-ray, of which the primary diagnostic foc us is jampack structure and density (SWOG, 2013, 1), was ordered for the patient. X-ray results although forbid for break were positive for swelling further indicating the possibility of tendon or ligament damage. A Lachman Test was performed on the patient to test the unity of the anterior cruciate ligament within the patients right knee. To determine integrity the knee is flexed at a 20-30 angle, the tibia is displaced anteriorly relative to the femur a soft final result or greater than 4 mm of displacement is positive. (Free Dictionary- medical examination Dictionary, 2014, 1).(The clinical Advisor, 2014)Upon the positive results of the Lachman test, further examination substantiate injury to the medial collateral ligament as well. Patient was instructed to see an orthopedist, given crutches, a brace, and instructed to keep the outgrowth elevated and workout ice to further aid in the reduction of swelling and pain. Furthermore patient was instructed not to use heat, such( prenominal) as a heat pad or hot tub, as heat crapper result in vasodilatation leading to increased pain and swelling.Part IV perceive the Orthopedic Surgeon 1Upon arriving home the patient was seen by a local orthopedic surgeon. Although the patient previously had an x-ray, an MRI was ordered to obtain a clear and concise understanding of the impact of the ski accident on the internal soft tissue structures of the patients right knee. An MRI or magnetized resonance imaging, combines a powerful magnet with radio waves and a computer to manipulate these magnetic elements and create highly detailed images of structures in the body. (SWOG, 2013, 4) In comparison to an MRI, an X-ray is typically used to refer and assess bone degeneration or disease, fractures and dislocation. (SWOG, 2013, 1)Age often plays a rolein the heal process, as does the patients natural health. Typically younger patients have an increased regenerative capacity for heal as opposed to older patients who m ay present with osteoarthritis. Osteoarthritis is the degeneration of cartilage and its underlying bone within a reefer as well as bony overgrowth. (CDC, 2011, 1) Patients with poor physical health and other complications may not always be a good candidate for reconstructive surgery. Although the patient in this case is 55, she presents as a good candidate for reconstructive surgery as a result of leading a fairly active life style and was referred to an orthopedic surgeon who performs such surgical procedures on a routine basis.Part V Seeing the Orthopedic Surgeon 2Patient presents in good health and as an ideal candidate for surgery. Referred to pre-hab to have the knee and oarlock in the best possible shape prior to surgery. The knee is a synovial joint and can be further classified as a hinge joint as it allows movement in only one direction. Synovial joints are lined by a synovial membrane fill with fluid to support the joint and reduce friction. (Buzzle, 2014), 3). Tendons and ligaments composed of dense regular junction tissues hold the structures of the knee together.(eHealth Ideas, 2013)The hamstring, sartorious, gracilis, and popliteus assist in producing flexion, whereas the Quads rectus femoris, vastus medialis, vastus lateralis, and vastus intermedius contribute to producing extension. (Healthline, 2013, 4-5). With regard for the surgical even off of the patients ACL the synovial membrane would need to cut in order to operate on both the meniscus and ACL. In addition, the use of a tendon to replace the ligament is possible, as both are composed of collagenous connective tissues. (University of Michigan, (n.d.), 2). preceding to surgical intervention it is especially important that the patients knee is in the best physical shape as post-operatively the patient can expect to experience some degree of atrophy and loss of bone mass as a result of restricted and limited use of the surgically repaired joint and limb. (Healthline, 2014, 1). During post-operative healing the patella is likely to heal fasterthan the ACL, MCI and menisci, as it has access to the arterial blood supply. (KneeHipPain, n.d., 14). The cartilage and the ligaments will take longer to heal as they are avascular and contain little to no blood supply. abrasion tissue is a normal occurrence of the healing process, and is composed of fibrous connective tissue. This tissue contains a fibrous protein called collagen, as well as long carbohydrate molecules called polysaccharides, water and cells called fibroblasts. Scar tissue also known as adhesion, plays an important role in the healing process as its collagenous fibers bind to damaged tissues in an effort to reconnect the damaged fibers.Part VI ResolutionThe body is an incredible mechanism, through homeostasis and feedback loops the body is often able to regulate and return itself to a state of equilibrium. This can be evidenced in the case of the patient, as when subjected to the extreme cold thermo-rece ptors in the skin activated signaling the hypothalamus, resulting in vasoconstriction and shivering as a method to create and conserve body heat. However, in some cases such as that of a torn ACL, the body is not always able to repair itself and surgical intervention may be deemed necessary. Still, throughout the post-operative healing process the body employs various methods of negative feedback to once again return to a state of equilibrium.ReferencesBuzzle. (2014). Synovial membrane. Retrieved from http//www.buzzle.com/articles/synovial-membrane.html The Centers for Disease Control and Prevention. (2011). Osteoarthritis. Retrieved from http//www.cdc.gov/arthritis/basics/osteoarthritis.htm The Clinical Advisor. (2014). Photo of Lachman Test. Retrieved from http//www.clinicaladvisor.com/tests-to-assess-acl-rupture/slideshow/394/0 eHealth Ideas. (2013). Photo of Knee Anatomy Design. Retrieved from http//www.ehealthideas.com/2013/12/knee-anatomy-diagram.html The EMT Spot. (2014). The ultimate emt guide to vital signs. Retrieved from http//theemtspot.com/2010/05/22/the-ultimate-emt-guide-to-vital-signs/ TheFree Dictionary. (2014). Medical dictionary. Retrieved from http//medical-dictionary.thefreedictionary.com/Lachman+test Healthline. (2013). Knee muscle anatomy. Retrieved from http//www.healthline.com/human-body-maps/knee-muscles4/4294967045 Healthline. (2014). Muscle atrophy. Retrieved from http//www.healthline.com/symptom/muscle-wasting Knee Hip Pain. (n.d.). The anatomy of the patella. Retrieved from http//www.kneehippain.com/patient_pain_anatomy.php Minerva Union. (2011). Homeostasis basics. Retrieved from http//minerva.union.edu/linthicw/homeo.htm Minerva Union. (2011). Photo of Homeostasis Temperature Control. Retrieved from http//minerva.union.edu/linthicw/homeo.htm References southwest Orthopedic Group. (2013). What is the difference between x-rays, mri, and ct scans. Retrieved from http//www.sworthogroup.com/general-orthopedic-faq/25-what-is-the-diffe rence-between-x-rays-mri-and-ct-scan University of Michigan. (n.d.). Section 9 Ligament tendon structure. Retrieved from http//www.umich.edu/bme332/ch10ligten/bme332ligamenttendon.htm
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