Tutor profile: Leon M.
Subject: Physical Therapy
D.J., a 39y/o male patient, complains to you of back pain of the lumbar region. Upon assessment, you noted muscle spasms on the area, as well as tightness of the hip extensors and hip flexors. Joint play on facet joints also revealed decreased movement upon palpation. Radiographic findings reveal arthritic changes in the facet joints. The patient asked if he will still be able to continue his hobby in cycling. What will you respond?
Since biking is a low impact sport on the joints, assuming that the client will bike on smooth terrain, then it can be done. However, the therapist should also inform the patient that the PT program shall focus on improving his condition so that he could still bike with ease in spite of the arthritic changes in his spinal joints.
Subject: Biomedical Science
A.D., a 45y/o female patient, had suffered a stroke around 1 month ago. She presents with orthostatic hypotension, difficulty in breathing in upright position, and flaccid paralysis on her left arm and leg. Right now, she asked what would be the prognosis of her being able to walk again. What would be your response to this matter?
As a clinician, you should first clarify with the patient that coming up with a prognosis involves extensive examination of the functions that are lost and preserved by the stroke syndrome. The clinician may answer only what is realistic of the patient's current situation, and not provide them with false hope. So they may tell the patient that ambulation may be possible only if the flaccidity on her arm gets resolved, and that she is able to tolerate upright position through compliance to her treatment program.
A.G., a 45y/o right-handed male patient, has suffered from a car accident four months ago. He had incurred loss of sensation on the lateral aspect of his arm and posterior wrist and forearm, weakness of elbow extension, and difficulty in lifting his wrist and fingers up. Radiographs taken today denotes a healed fracture of the distal end and proximal 1/3 of humerus. Why is the patient still feeling symptoms even up until now?
The radial nerve has a pathway which originates from the neck, through the brachial plexus, then runs through the medial side of the humerus just inferior to the humeral head. It then twists toward the lateral aspect of the distal humerus, down to the anterior lateral aspect of the elbow, and then crossing the midpoint of the radius and ulna. This would then terminate towards the posterior aspect of the hand. The radial nerve provides sensory function to the lateral and posterior aspect of the arm and elbow, posterior aspect of the forearm, wrist and hand. It also provides motor function to the extensors of the shoulder, elbow, forearm, wrist, and hand. Due to the patient's fracture on the sites mentioned, which are parts of the radial nerve pathway, neuronal damage would then occur due to lacerations caused by the fracture site, thereby causing impairment to the mentioned functions.
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