Reason for Visit: Recheck: Right Wrist Pain Vital Signs - B/P:130/86 Temp: 97.1 Pulse: 88 Resp: 18 O2 Sat: 98% S: TM completed 6 ESI visit. TM reports his wrist pain at 0, and at times 1-2/10 at rest; soreness at the right transverse carpal ligament area. TM reports intermittent soreness to right transverse carpal ligament area while working and rates his pain at 3-4/10. Reports sharp shooting pain going up to his mid-forearm at times; 5/10. TM reports some tingling sensation at times in in right pinky and ring finger. Denies his right arm pain interrupts his sleep. TM denies any numbness or loss of movements of right arm, wrist or hand. O:Right arm, wrist, and hand: no edema, discoloration noted, full ROM , tenderness with palpation
On History- The patient was a 49-year-old Caucasian male with a chief complaint of pain and weakness in R shoulder abduction and external rotation (dominant shoulder). He was a retired baseball player. He has been a baseball pitcher for 12 years before he retired 5 years
Type I and II classic EDS are identifiable by the smooth hyperextensible skin, anomalous wound healing, and joint hypermobility (Malfait F, Wenstrup R, De Paepe A, 2007) (see figure 1). Type III hypermobile EDS is the least drastic type of EDS, musculoskeletal complications may occur. The skin is smooth and slightly hyperextensible, bruising is also common. The hypermobile EDS patient suffers from chronic pain associated with dislocation from a slight amount of trauma (Levy, 2004). Type IV vascular EDS is recognizable by the translucent thin skin, easy bruising, facial manifestation (only present for some EDS patients), and finally by the fragility of the arterial, intestinal and (in some cases) the uterine (Pepin and Byers, 1999). Type VI kyphoscoloitic EDS can be identified at birth from severe muscular hypotonia. The skin is hyperextensible, thin scarring, bruising from minimal trauma, and joint laxity (Yeowell and Steinmann, 2000). Type VII A and B arthrochalasia can be identified by joint hypermobility, as well as fragile skin and tissue deformities. The hypermobile joints lead to severe dislocations and paralyzation...
There are approximately six types of EDS that have been distinguished but other types exist that are very uncommon. Classical, Hypermobile, Vascular, Kyphoscoliosis, Arthrochalasia, and Dermatosparaxis. Classical and Hypermobile make up over 90% of all reported cases of EDS. With the Classical type of EDS a person would have hyperextensible (stretchy) skin with widened atrophic scars and joint hypermobility. The skin is smooth and velvety with tissue fragility and easy brusability. Also evident are molluscoid pseudotumors (fleshy lesions associated with scars) frequently found over pressure points (e.g. elbows) and subcutaneous spheroids, which are commonly mobile and palpable on the forearms and shins. Complications of joint hypemobility include sprains, dislocation are common in the shoulder, patella and temporomandibular joints Muscle hypotonia and slower gross motor development also can occur It is inherited in an autosomal dominant manner (Clarke, D., Skrocki-Czerpak, K., Neumann-Potash, L.).
The etiology of calcaneal fracture is usually high energy trauma such as fall from a height or motor vehicle crash 1,2.
Chronic pain is a long term condition, which means it cannot be cured, but the symptoms may be controlled by therapies and medications (Saxon and Lillyman, 2011). When pain is considered chronic, it lasts longer than the expected healing period and there may not be a clear cause (Kraaimaat and Evers, 2003).
to the upper body and arms. These symptoms occur after four weeks and start by
On admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings. J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed several abnormal labs. A red blood cell count of 3.99, white blood cell count of 22.5, hemoglobin of 10.9, hematocrit of 33.7%, sodium level of 13, potassium level of 3.1, carbon dioxide level of 10, creatinine level of 3.24, glucose level of 200, and a BUN level of 33 were the abnormal labs.
A hypothesis that can be made from the patient’s report is that she is suffering from cervical radiculopathy, or a nerve root lesion. Symptoms that describe cervical radiculopathy include: arm pain in a dermatome distribution, pain increased by extension, rotation, and/or side flexion, possible relief of pain from arm positioned overhead, affected sensation, altered hand function, no spasticity, and no change to gait or bowel and bladder function (Magee, 2008, p. 142). These symptoms correlate to what the patient reported as a result of her injury. She stated that her pain is in the posterolateral upper and lower arm with aching and paresthesia in the thumb and index finger, which is in the dermatome pattern of cervical root 5 and 6 (C5, C6) (Magee, 2008, p. 25). She also reports lancinating pain with extension or rotation to the right of her head.
Pain is often overlooked and disregarded as an unimportant health issue by health care providers. However, according to the National Institutes of Health, pain affects more Americans than diabetes, heart disease, and cancer combined. It is the most common reason people seek health care, the leading cause of disability, and a major contributor to health care cost (National Institutes of Health [NIH], 2013). By managing pain, patient outcomes improve and health cost decreases because the patient is more likely to participate in activities such as mobilization and deep-breathing exercises, leading to fewer complications and earlier discharge. Organizations such as the American Society for Pain Management Nursing, the American Pain Society, and
Rehabilitation has been described as a secondary goal of incarceration. The concept of rehabilitation was not adapted until the 1870s as delegates in Cincinnati encouraged the reformation of prisoners. Rehabilitation remained a primary goal of incarceration for nearly one hundred years, until the 1970s. It was then that Americans began to reject the notion of rehabilitation. With a shift away from rehabilitation, Americans adopted punishment, deterrence, and incapacitation as the primary goals of imprisonment. It can be argued that there was a shift away from rehabilitation due to high recidivism rates; however, it becomes questionable whether or not offenders were continuing to commit crime because they were not given adequate support and
Definition of the condition: " Chronic pain is described as a long-lasting pain that people experience beyond a normal healing time (Hasenbring, Rusu & Turk, 2012). This time is usually up to three or six months prior to an incident (Hasenbring, Rusu & Turk, 2012). Chronic back pain can include a common diagnosis of muscle spasms, back strain, or myofascial syndrome (Weiner & Nordin, 2010). There are three different types of chronic back pain: simple musculoskeletal back pain, spinal nerve root pain and serious spinal pathology (Jackson & Simpson, 2006). Hasenbring, 2012.
1. What is the difference between a. and a. Introduction The main aim of this report is to present and analyse the disease called Cerebrovascular Accident, popularly known as stroke. This disease affects the cerebrovascular system, which is a part of the cardiovascular system.
This was his second episode since 10 days ago where he develop the same pain at his right flank. He suddenly experienced severe pain 8 hours before admission when the pain shifts to his right lower quadrant of his abdomen. The onset is at 6.30 am before worsening at 10 p.m to 2 p.m. He described the pain as continuous sharp pain and gradually increased in severity. There is no radiation of the pain. The pain was exaggerated on movement and touch. There were no relieving factor and he scale the severity as 7/10. He experienced fever for 1 day prior to admission. It was a mild grade continuous fever. He does not experienced chills and rigor. The patient does not experience any nausea or vomiting, no dysphagia, no pain during micturition and no alteration in bowel habit. He experienced loss of appetite but not notice any weight loss.