Reference no: EM133731407

Case Study

This discussion post will focus on a case study concerning the skeletal system.

Please read the History of the Presenting Patient and then answer the questions. Most of the questions can be answered in a few words or in one or two sentences. If the answer is longer than that then maybe you need to focus on the answer and improve the conciseness of the response.

You will submit your answers as a single Word document to this assignment folder. The answers need to be numbered and answered in order. DO NOT copy the questions or case study into the word document (this impacts Turnitin).

This is an individual assignment, your answers need to be in your own words (no sharing or discussing with other students, and NO use of AI platforms to create answers (any suspected use of AI will result in a referral to academic affairs). You are certainly welcome to use any references or source material to answer the question (please give the source credit). If you are using sources create a simple reference list at the bottom of the page (use an appropriate style).

The answers will be graded for completeness and logic (I am not expecting your answers to be from a medical professional), but you should base your answer on your basic understanding of these questions from the course at this point.

Grading assessment breakdown 10 pts total, Each Q is worth 2 pts (1pt accuracy, 1 pt logic/effort).

Chief Complaint: 84-year-old man who fell in bathroom.

History: Francis Marshall, an 84-year-old African-American male, was brought to the emergency room by his daughter after falling in his bathroom. He was previously in good health, despite leading a relatively sedentary lifestyle, his BMI is elevated at 31, and having a long history of cigarette smoking (approximately 2 packs per week for 30+ years). The only medications he currently takes are Inderal (propranolol) for mild hypertension and Simvastatin to manage cholesterol. He fell upon entering the bathtub when his left leg slipped out from under him; he landed on his right hip. There was no trauma to his head, nor did he complain of right or left wrist pain. However, he reports severe pain in the right hip and upper thigh and was unable to get up after the fall. An injection of oxymorphone hydrochloride (Numorphan) helped relieve his pain and he was taken to the radiology department for an X-ray of the leg and hip.

Physical Examination: The patient was alert, oriented to time, place, and date, and was responding appropriately to questions despite being in considerable pain. There were no signs of external trauma to the head, neck, torso, arms, or right leg. The right thigh and hip were extremely tender and were immobilized by a leg splint. Heart and lung sounds were normal, and abdominal sounds were reduced.

Radiology Report: The X-ray of the right hip revealed a complete, comminuted, intertrochanteric fracture of the right hip. No other fractures were noted in the right leg. There were also long-term osteoporotic changes in the femur, tibia, and fibula.

Question 1:

Describe the fracture. When describing, do not simply repeat the type of break. Name the bone that is broken, the location of the break, and the condition of the bone. How would you describe the break to the patient (not a medical practitioner).

Question 2: Why does the emergency room physician suspect osteoporosis (frame your answer in terms of risk factors that Francis has for osteoporosis)? What parts of the skeleton (i.e. what bones) are most vulnerable to the ravages of osteoporosis?

Question 3. The radiologist confirmed signs of osteoporosis. Describe the characteristics of an osteoporotic femur as seen on an X-ray. How would it differ in appearance from a normal femur?

Question 4. Imaging techniques such as X-ray, CT, and MRI are used to diagnose many bone disorders. Why do these tools play such an important role in diagnosing skeletal issues? Give a brief description of each technique and discuss why Francis needed an X-ray and not an MRI.

Question 5. During Francis' recovery, he is recommended physical therapy, which focuses on range of motion and weightbearing on the hip. Describe the changes a broken bone undergoes as it is healing and why it is important to have physical therapy as part of the recovery process.