A 35-year-old male is admitted to a hospital following a minor car accident. He was driving home and fell asleep at the wheel. This is the third accident he has had in the past year. He also falls asleep regularly at work, at the dinner table, at church, and, in fact, anywhere. When he becomes excited or enraged, he suddenly becomes weak and falls. At night, he often has bizarre, terrifying dreams. During these dreams, he feels as if he were paralyzed.
Based on the scenario given above, answer the following questions:
- Describe how a nerve impulse is transmitted from one neuron to the next.
- Compare the structure and functions of the CNS and PNS.
- What is the probable diagnosis for this man’s condition?
- What parts of the person’s brain could have been affected?
- What sleep state do these symptoms resemble?
- How would an electroencephalogram (EEG) look like during the sleep condition of this patient?
- What type of treatments (physical or chemical) would you prescribe for the patient?
must have reference and citation with page number mcCance and Huether 2014 pathopsyology Pathophysiology: The Biologic Basis for Disease in Adults and Children,
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Introduction: The following questions are based on a scenario of a 35-year-old male who has been admitted to a hospital following a minor car accident. The aim is to test your understanding of nerve impulse transmission, the structure and functions of the CNS and PNS, diagnosis of the condition, the parts of the brain that could have been affected, the sleep state of the patient’s symptoms, how an EEG would look during the sleep condition of the patient, and the type of treatments (physical or chemical) that would be prescribed for the patient.
1. Describe how a nerve impulse is transmitted from one neuron to the next.
Nerve impulses are transmitted from one neuron to another through a synapse, a small gap between the terminal of the presynaptic neuron and the dendrites of the postsynaptic neuron. The presynaptic neuron releases neurotransmitters that bind to the receptors on the postsynaptic neuron, thereby causing depolarization or hyperpolarization, leading to either the generation or inhibition of an action potential, respectively. The neurotransmitters that have been released are then either taken back up by the presynaptic neuron or broken down by enzymes in the synapse.
Reference: McCance, K. L., & Huether, S. E. (2014). Pathophysiology: The Biologic Basis for Disease in Adults and Children (7th ed.). Mosby. p. 239-240.
2. Compare the structure and functions of the CNS and PNS.
The central nervous system (CNS) consists of the brain and the spinal cord. It is responsible for integrating and interpreting sensory information and for controlling all motor functions. The CNS also has roles in memory, learning, and emotion. The peripheral nervous system (PNS) consists of cranial and spinal nerves that extend from the brain and spinal cord, respectively. The PNS is further divided into the somatic nervous system (SNS), which controls voluntary movement and sensory perception, and the autonomic nervous system (ANS), which controls involuntary activities such as heart rate and digestion.
Reference: McCance, K. L., & Huether, S. E. (2014). Pathophysiology: The Biologic Basis for Disease in Adults and Children (7th ed.). Mosby. p. 109-110.
3. What is the probable diagnosis for this man’s condition?
The probable diagnosis for this man’s condition is narcolepsy. Narcolepsy is a neurological disorder that causes excessive daytime sleepiness, cataplexy (sudden loss of muscle tone), hypnagogic hallucinations (vivid dream-like experiences), and sleep paralysis (temporary inability to move or speak during sleep onset or awakening).
Reference: McCance, K. L., & Huether, S. E. (2014). Pathophysiology: The Biologic Basis for Disease in Adults and Children (7th ed.). Mosby. p. 384.
4. What parts of the person’s brain could have been affected?
The parts of the brain that could have been affected in this condition include the hypothalamus, which regulates sleep-wake cycles and controls the release of hypocretin (a neurotransmitter involved in wakefulness), and the brainstem, which is responsible for controlling the autonomic functions such as breathing and heart rate.
Reference: McCance, K. L., & Huether, S. E. (2014). Pathophysiology: The Biologic Basis for Disease in Adults and Children (7th ed.). Mosby. p. 384-387.
5. What sleep state do these symptoms resemble?
The symptoms in the scenario resemble the rapid eye movement (REM) stage of sleep. During this stage, the body is deep in sleep, but the brain is active, and it is the stage where dreams are most vivid and bizarre. REM sleep is also associated with muscle atonia (temporary paralysis of muscles) to prevent acting out the dreams.
Reference: McCance, K. L., & Huether, S. E. (2014). Pathophysiology: The Biologic Basis for Disease in Adults and Children (7th ed.). Mosby. p. 394-395.
6. How would an electroencephalogram (EEG) look like during the sleep condition of this patient?
During the sleep condition of this patient, an EEG would show signs of REM sleep, which is characterized by low-amplitude, mixed-frequency waves resembling an awake but relaxed state. The EEG patterns would resemble those observed during wakefulness, with some additional patterns, such as sawtooth waves, that are indicative of the REM stage.
Reference: McCance, K. L., & Huether, S. E. (2014). Pathophysiology: The Biologic Basis for Disease in Adults and Children (7th ed.). Mosby. p. 395.
7. What type of treatments (physical or chemical) would you prescribe for the patient?
The treatments for narcolepsy include physical and chemical interventions. Physical interventions involve improving the sleep hygiene, such as ensuring a regular sleep-wake cycle and avoiding daytime naps. Chemical interventions include administering stimulant medications, such as modafinil or methylphenidate, to improve wakefulness during the daytime and reducing the frequency of cataplexy and hypnagogic hallucinations.
Reference: McCance, K. L., & Huether, S. E. (2014). Pathophysiology: The Biologic Basis for Disease in Adults and Children (7th ed.). Mosby. p. 385-386.
