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Francine, 74 year old female, suffered a fall in the Nursing Home and was diagnosed with a neck of femur fracture.

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Francine, 74 year old female, suffered a fall in the Nursing Home and was diagnosed with a neck of femur fracture.

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1. Describe the process of calcification (3 marks) (75 words)

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1. Describe the process of calcification (3 marks) (75 words)

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Calcification is the process where calcium salts build up in body tissue, such as shells, bones, and carapaces. This accumulation of calcium results in hardened tissue and can disrupt the body’s normal processes. Calcium is a mineral that is found in almost every cell with 99% of it located in bones and teeth and 1% in the muscles, blood, extracellular fluid and other body tissues, thus, calcification can occur in most areas of the human body (Healthline, 2013).

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2. Choose one (1) principal effect of ageing on Francine’s bone tissue which may have contributed to herfracture. Describe the effect and identify a possible consequence /disease that may occur as a result. (3marks) (50 words)

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2. Choose one (1) principal effect of ageing on Francine’s bone tissue which may have contributed to herfracture. Describe the effect and identify a possible consequence /disease that may occur as a result. (3marks) (50 words)

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One principal effect of ageing on Francine’s bone tissue which may have contributed to her fracture is the loss of bone tissue that results from an increase in age. As an individual ages, the rate of bone resorption produced by osteoclast cells, is greater than the rate of bone formation. Consequently, mineral content is reduced and bones weaken (Physiopedia, 2019).

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3. Healing a fracture can sometimes take months. Provide a detailed rationale as to why this occurs. (3 marks)(75 words)

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3. Healing a fracture can sometimes take months. Provide a detailed rationale as to why this occurs. (3 marks)(75 words)

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The healing of a bone fracture is a slow process mainly due to the fact that the damaged vessels and cartridge take time to repair themselves. This healing process consists of multiple stages; phase 1: reactive inflammatory response, phase 2a: reparative soft callus formation, phase 2b: reparative hard callus formation and phase 3: bone remodelling. Bone remodelling begins 3-4 weeks after a bone fracture occurs and may last for 6-9 years (YUNYANG GU, 2019).

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4. Francine underwent a bone mineral density [BMD] test. She was diagnosed with osteoporosis. Outline three(3) factors that may contribute to porous bones. (3 marks) (75 words)

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4. Francine underwent a bone mineral density [BMD] test. She was diagnosed with osteoporosis. Outline three(3) factors that may contribute to porous bones. (3 marks) (75 words)

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Osteoporosis, also know as porous bone, is a bone disease where the body either makes too little and/or too much bone (National Osteoporosis Foundation, 2021). Factors that may contribute to porous bones are ageing as bone density is greatest in your early 20s then declines, low estrogen in women as this causes more bone resorption than formation, and low testosterone in men as this results in low bone mineral density.

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5. Diet plays an important role in the ongoing management of Francine’s condition. Choose three (3) nutrientsthat impact the skeletal system and describe how they contribute to bone metabolism and repair. (3 marks) (75 words)

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5. Diet plays an important role in the ongoing management of Francine’s condition. Choose three (3) nutrientsthat impact the skeletal system and describe how they contribute to bone metabolism and repair. (3 marks) (75 words)

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Three nutrients that impact the skeletal system are calcium, protein and magnesium. Bones are the main storage site for calcium and the body cannot make calcium on its own, meaning it needs to be consumed nutritionally so bones stay strong and don’t weaken. Dietary protein is a vital structural element of bone cells and increases serum levels of IGF-1 (20, 21), leading to increased bone mineralization and less fractures. Magnesium stimulates the hormone calcitonin, which preserves bone structure through pulling calcium from the blood and soft tissues back into bones.

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George, 59 years old, has suffered from chronic, refractory low back pain as a result of muscle spasms in the lumbar region, for the last ten years. It has been suggested that injections of Botulinum Neurotoxin A (Botox) might alleviate the condition.

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George, 59 years old, has suffered from chronic, refractory low back pain as a result of muscle spasms in the lumbar region, for the last ten years. It has been suggested that injections of Botulinum Neurotoxin A (Botox) might alleviate the condition.

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1. Name the collective structure where Botox exerts its action and identity specific components (minimum of four) within the structure. (3 marks) (50 words)

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1. Name the collective structure where Botox exerts its action and identity specific components (minimum of four) within the structure. (3 marks) (50 words)

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Botox exerts its action at the neuromuscular junction. The junction is connected to the muscle tissue at the synaptic end bulb. It is through here that the synaptic vesicles containing acetylcholine can be transferred to the muscle cell. There is a small space called the synaptic cleft the separates the nerve from the motor end plate.

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2. Outline the role that calcium plays in the initiation of a muscle action potential. (3 marks) (75 words)

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2. Outline the role that calcium plays in the initiation of a muscle action potential. (3 marks) (75 words)

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As outlined in previous question, after the acetylcholine binds with the Ach receptor the calcium will flow into the muscle cell from the sarcoplasmic reticulum into the sarcoplasm. The calcium then binds to the troponin protein located on the thin filament causing the tropomyosin fibre to rotate around the actin. The Myosin heads then hydrolyse ATP in preparation for the contraction cycle. All of this cannot occur without the initial process of the release of calcium.

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3. How does Botulinum Neurotoxin A prevent the initiation of a muscle action potential at the structureidentified in Q. 1? (3 marks) (75 words)

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3. How does Botulinum Neurotoxin A prevent the initiation of a muscle action potential at the structureidentified in Q. 1? (3 marks) (75 words)

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It stops the release of acetylcholine from the synaptic vesicle. This means that there is no acetylcholine to bind with acetylcholine receptor and thus no muscle action potential is produced as no calcium is released into the muscle cell from the sarcoplasmic reticulum. More specifically, Botulinum Neurotoxin A inhibits the group of proteins named soluble NSF attachment protein receptor. This group is responsible for sending the acetylcholine to the muscle cell. Ultimately, with no muscle contractions, the muscle can rest and therefore reduce pain in the area.

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4. Outline the role that sodium plays in the production of a muscle action potential. (3 marks) (75 words)

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4. Outline the role that sodium plays in the production of a muscle action potential. (3 marks) (75 words)

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The inflow of sodium causes the inside of the fibre to become more positively charged. A muscular action potential is triggered as a result of this. Muscular action potential is produced due to the positive charge of the sodium being released into the cytoplasm of the muscle. This also triggers the release of calcium from the sarcoplasm reticulum and thus activating the cycle where the chains of proteins of the muscle cell change and lead to contractions.

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5. Botulinum Neurotoxin A can also be used for dystonic conditions. Define muscle tone and outline the mechanism by which muscles maintain it. Identify which tonic disorder can be treated by Botox. (3 marks) (75 words)

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5. Botulinum Neurotoxin A can also be used for dystonic conditions. Define muscle tone and outline the mechanism by which muscles maintain it. Identify which tonic disorder can be treated by Botox. (3 marks) (75 words)

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Muscle tone is the weak involuntary contractions of muscle tissue that aids in variety of areas such as posture, blood pressure and keeping muscles firm. Muscle tone is maintained through a reflex arc which is the neural pathway that sends signals to control the automatic reflex reactions. Dystonia is the involuntary contractions or spasms of the muscle. This can be caused by damage to any part of the nervous system. The botulinum neurotoxin serves to block the signals and prevent acetylcholine from being transmitted into the muscle cell.

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Multiple sclerosis (MS) is an abnormal immune response that causes inflammation and damage to the neurons in the central nervous system (CNS).

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Multiple sclerosis (MS) is an abnormal immune response that causes inflammation and damage to the neurons in the central nervous system (CNS).

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1. Name the specific neuronal component that is affected in the disease and describe its associated structure (including the neuroglia involved). (3 marks) (50 words)

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1. Name the specific neuronal component that is affected in the disease and describe its associated structure (including the neuroglia involved). (3 marks) (50 words)

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Multiple sclerosis is a chronic, inflammatory disease affecting the central nervous system (CNS) (Sciencedaily, 2016). The CNS, consisting of the brain and spinal cord, is made up of the nucleus, nissl bodies, mitochondria, neurofibrils, and microtubules. The Neuroglia, half the volume of the CNS, is a protective, supporting cell and the main target of multiple sclerosis.

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2. Outline how damage to the above component affects the functioning of the neuron and why axons in the CNS display minimal regeneration after injury. (3 marks) (50 words)

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2. Outline how damage to the above component affects the functioning of the neuron and why axons in the CNS display minimal regeneration after injury. (3 marks) (50 words)

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Damage to the neuroglia and neurons cause disruptions of communication between the body and brain. Patches of inflammation appear in the myelin that surround axons in the brain and other areas of the nervous system. This inflammation can damage the myelin causing myelin around axons to deteriorate and become lost.

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3. Compare and contrast continuous and saltatory conduction of the nerve impulse. Answer must include at least one similarity. (3 marks) (100 words)

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3. Compare and contrast continuous and saltatory conduction of the nerve impulse. Answer must include at least one similarity. (3 marks) (100 words)

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Continuous conduction is the second way of nerve impulse transmission, occuring in unmyelinated axons ("The Somatosensory System | Boundless Anatomy and Physiology", 2021). Action potential is generated along the entire length of the axon with saltatory conduction being the fastest form of nerve impulse transmission. In between myelinated sheaths, there are uninsulated spaces called nodes of Ranvier. The key difference between them is that saltatory conduction is the propagation of action potential along myelinated axons while continuous conduction is the propagation of action potential along unmyelinated axons. Similarly, the conductions are two ways of transmission of an action potential along the neurons, the action potential is generated in both ways and ion channels participate in both methods.

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4. Many individuals with MS experience impairment of proprioception and vibrational sensation. Name and describe the function of each of the components of the somatosensory pathways. (3 marks) (75 words)

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4. Many individuals with MS experience impairment of proprioception and vibrational sensation. Name and describe the function of each of the components of the somatosensory pathways. (3 marks) (75 words)

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The somatosensory pathway contains three neurons, primary, secondary, and tertiary (lumenlearning, n.d). In the periphery, the receptor is the primary neuron that discerns the sensory stimuli of temperature and touch. The secondary neuron, located in the spinal cord, has the role of carrying signals from the spinal cord to the thalamus (Heidelberg, 2013). Tertiary neurons form a sensory homunculus through projecting cell bodies in the thalamus to the parietal lobes post central gyrus, producing touch.

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5. Which specific somatosensory pathway is affected when an individual with MS experiences the loss of the sensations identified in Q. 4? Name two (2) specific areas in the cerebral cortex that may be affected when experiencing loss of vibrational sensation and proprioception and provide rationale for answer. (3 marks) (75 words)

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5. Which specific somatosensory pathway is affected when an individual with MS experiences the loss of the sensations identified in Q. 4? Name two (2) specific areas in the cerebral cortex that may be affected when experiencing loss of vibrational sensation and proprioception and provide rationale for answer. (3 marks) (75 words)

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Individuals who experience MS have loss of sensations by periphery somatosensory being the targeted pathway. The parietal lobe receives impulses for perception of tactile sensations, temperature, pain and proprioception. Heat tolerance is a symptom amongst MS individuals as the parietal lobe is responsible for impulses of temperature. The occipital lobe is also an affected cerebral cortex area as it receives information for sound and auditory reception, causing discomfort in the back of the eyes and blurred vision.

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Georgina, 45 years old, has been recently diagnosed with Hashimoto’s disease, an autoimmune disease that reduces the thyroid’s ability to produce hormones, and has been commenced on hormone replacement therapy with synthetic thyroid hormone.

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Georgina, 45 years old, has been recently diagnosed with Hashimoto’s disease, an autoimmune disease that reduces the thyroid’s ability to produce hormones, and has been commenced on hormone replacement therapy with synthetic thyroid hormone.

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1. Name the two (2) thyroid hormones affected by the above disease and identify the cells that produce them. (2 marks) (25 words)

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1. Name the two (2) thyroid hormones affected by the above disease and identify the cells that produce them. (2 marks) (25 words)

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The two hormones affected by Hashimoto’s disease are thyroxine (T4) and tri-iodothyronine (T3). They are produced by follicular cells of the thyroid gland (ThyroidClinic, 2014).

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2. Describe the mechanism of action of thyroid hormones from release into the blood stream through to the response of the target cell. (4 marks) (125 words)

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2. Describe the mechanism of action of thyroid hormones from release into the blood stream through to the response of the target cell. (4 marks) (125 words)

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Two glands in the brain, the hypothalamus and pituitary, control the release and production of T3 and T4. When the bodies bloodstream decreases in T3 and T4 levels, thyrotropin releasing hormone (TRH) is secreted from the hypothalamus and into a vein transporting it to the pituitary gland. Thyroid-stimulating hormone (TSH) is then released from the pituitary gland and travels via the bloodstream to the thyroid gland. This causes the thyroid gland to release T3 and T4 into the blood where proteins carry the hormones to their target tissues, such as the brain, heart, muscles and bone. Once inside the target cell, T4 is converted to T3 which controls the bodies metabolic rate, breakdowns the main sources of fuel (carbohydrates, fats and protein) and promotes heat  production (ThyroidClinic, 2014).

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3. The synthetic thyroid hormone replaces the deficient production of the endogenous thyroid hormone. Discuss two (2) actions of thyroid hormone within the body. (2 marks) (50 words)

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3. The synthetic thyroid hormone replaces the deficient production of the endogenous thyroid hormone. Discuss two (2) actions of thyroid hormone within the body. (2 marks) (50 words)

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The thyroid hormones have a growth-promoting effect within the body that is intimately linked  with the growth hormone and ensures that normal growth is achieved. They also effect the cardiovascular system and increase heart rate, cardiac output, cardiac contractility and enhance blood flow to organs (VIVO Pathophysiology, n.d).

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4. Hormonal axes are pathways that direct neuroendocrine function. Identify the relevant axis, in this case, and describe the associated control and regulation of thyroid hormones. Include the relevant organs, hormones and cells from which they are released/produced (7 marks) (150 words)

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4. Hormonal axes are pathways that direct neuroendocrine function. Identify the relevant axis, in this case, and describe the associated control and regulation of thyroid hormones. Include the relevant organs, hormones and cells from which they are released/produced (7 marks) (150 words)

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Individuals with Hashimoto’s disease have a negative feedback control mechanism within the hypothalamus-pituitary-thyroid (HPT) axis. The HPT axis is a hormone regulatory system from the hypothalamus to the pituitary and peripheral target organs (NCBI, 2013). The HPT axis’ primary function is to maintain normal, circulating levels of thyroid hormone which is vital for the biological function that occurs in the bodies tissues, such as brain development, cardiovascular regulation, liver and bone function as well as food intake. The hypothalamus, located in the brain, senses when there are low circulating levels of thyroid hormone thyroxine (T4) and triiodothyronine (T3), and reacts through releasing thyrotropin-releasing hormone (TRH). TRH is then used to stimulate the anterior pituitary and this creates thyroid-stimulating hormone (TSH) which restores thyroid hormone levels in the blood to a normal level. In Hashimoto’s disease, the thyroid-infiltrating lymphocytes attack the autoantigens found in follicle cells, which consequently eventually destroys them.

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Communicate with each other in a respectful and clear manner

Make sure everyone is on the same page and has a strong understanding of what is required of them throughout the assessment

Don’t be afraid to ask questions

Respect each others privacy

Review and edit all work before submitting

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Multiple Sclerosis_ Pathogenesis, Symptoms, Diagnoses and Cell-Based Therapy

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Efficacy of Botulinum Toxin Type A for Treating Chronic Low Back Pain

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Note: Unfortunately we couldn't get a hold of our other assigned group members Megan Ray, Guy Thorpe and Ashley Hanak.