Anatomy Case Study

docx

School

Queens University *

*We aren’t endorsed by this school

Course

215

Subject

Anatomy

Date

Jan 9, 2024

Type

docx

Pages

Uploaded by DoctorCrownGoose10

Anatomy case study 1. 1. Explain the possible anatomical structures that were affected by the injury and how each relates to John’s presenting symptoms and test results (250 word maximum) . Based on the report given, the anatomical structures that were injured are the gastrocnemius, the soleus, the plantaris muscles, and the calcaneal tendon. The calcaneal tendon otherwise known as the Achilles tendon. The gastrocnemius and the soleus merge into one band of issue which ends up becoming the Achilles tendon. The reason the gastrocnemius is affected, it will cause flexion issues within the lower leg. This leads to limping and sharp pain when pressure is applied and when it is touched. If the soleus were to rupture, you would feel immense pain. This is because it would also affect the Achilles tendon because it would apply lots of pressure to it. This only applies to a grade 2-3 injuries. A grade 2 soleus injury would lead to sharp pain and lack of ability for certain activities, swelling, and bruising. A grade 3 however, the most severe would completely put you out. You would be left unable to walk, with significant bruising, and major swelling. This would leave you out of commission for a while. (Anonymous, 2017) The Achilles tendon rupture leads to a lot of symptoms. It feels like you get kicked in the calf, something John had experienced. When it occurs, you will hear a pop or snapping noise. Afterwards, you will experience swelling, an inability to bend your foot down or push off your foot, an inability to stand on your toes, and lots of pain. (239 words) 2. Identify and explain three differential diagnoses (diseases or conditions that present similar signs and symptoms that could possibly account for the patient's symptoms) with appropriate justifications. After describing your three differential diagnoses, indicate the most likely diagnosis based on your analysis and provide rationale and support for your selection. ( 250 word maximum ). There are 3 likely injuries injuries that can cause the same symptoms as John’s. The first is a calf tear. The symptoms of a calf tear include swelling, bruising, trouble walking, and the inability to do strenuous activity. (Avruskin, A., PT,DPT. (2019, December 13). Another injury which is similar is insertional Achilles’s tendinitis. The symptoms of this include severe pain and stiffness, swelling which is always there which gets worse throughout the day if doing activity, and bone spurs. ( Anonymous, June 2010) This could be a likely cause because John is not a professional athlete and may not have noticed some of the signs of this prior to playing his game. The third is an Achilles tendon rupture. This injury has symptoms that include: the feeling of getting kicked in the calf, a loud popping noise, severe pain, the inability to stand on toes, a severe decrease in plantarflexion, lots of swelling. (Anonymous, April 2008) The likely diagnosis for John Is an Achilles tendon rupture. This is because the symptoms he has are the exact same as the symptoms of an Achilles tendon rupture. He had the same “kicked in the calf” feeling, there was a popping sound, and his plantar flexion was severely disrupted.

Because John shares almost 100% of the symptoms as an Achilles tendon rupture, the diagnosis I make is that he is suffering from such. Word count (220) 3. From an anatomy point of view: a) Propose a management plan for the most likely diagnosis. This should include the treatment options you would implement given your patient's presenting symptoms. You should provide short- and long-term goals for the patient and a timeline on when you would implement each treatment. There may be several possible treatments you could prescribe your patient. Include support, justification, and evidence for your prescribed treatment(s) and management plan. ( 500 word maximum ) b) Explain the effects of your management plan for your patient's condition. From the management plan you've proposed, what effects will each treatment have on the patient's anatomy? Include any positive and negative effects this plan may have on the patient. ( 250 word maximum ) Within this treatment plan there are goals. In the week by week, you will find the short- term goals. The long-term goal and the primary one at that, is to get John playing sports again like he was before the injury. If you get surgery for this specific Injury the treatment plan is as follows; Within the first 2-3 weeks, no weight should be put on the leg. You should have your leg elevated a lot with the knee straight when resting and be icing the affected area multiple times a day. Doing this will help reduce pain and swelling in the calf. The goal for this small period is to prepare for the next 3-4 weeks prior where more is done for recovery. There are a few physios exercises you can do with your knee and hip to keep the upper leg strong and void atrophy. Exercises like slowly straightening the knee and abduction/adduction of the hips. The next phase can last anywhere from 2-6 weeks. Here it is focused on muscle strengthening. You will have a walking boot with heel extensions and crutches. The goal is to put 20-50% of the weight on your foot. You should continue with the icing constantly. The new exercises can be done with the boot off. Within this time, you should be doing inversion/eversion exercises on the foot only to neutral so nothing severe can happen. Another exercise is a slight dorsiflexion of the ankle. This will give a small stretch to the Achilles tendon. You should also massage the foot to decrease swelling. Each exercise 2-3 times per day. The next 6 weeks will consist of putting weight on the foot. Once you remove the heel lifts you should add weight to your own discretion in the boot. Exercises here change. John can now use a resistance band and start plantarflexion and dorsiflexion exercises in the ankle (N/a April 2008) . With the resistance band you should also do inversion/eversion exercises and pronation/supination exercises. These exercises will keep strengthening the calf and help john get his range of motion back so he may proceed to normal life. Some other exercises he can do are walking on his toes (with discretion), standing heel rises, one leg balancing, and calf stretches (with discretion). These will also help strengthen his calf muscles and put him on the path of sports again. The next 3-5 weeks will consist of the

same exercises with weights attached. The short-term goal is still strengthening the area and gaining mobility. Another goal is to have a normal walking pattern by the end of this stretch. Increasing weight is justified because it will make the muscles work more thereby strengthening them. Finally, you will have arrived at the 12 weeks + period. This will last for up to 3 months. The goals here are to be able to jog and run preparing you for sports again. (N/a April 2008) The exercises are running on even ground, jogging on stairs, and trying to put 100% of weight on the injured heel. After the last 10-12 weeks of running, jogging, and having the foot bear weight, re-examine the heel. After approval, you can gradually make your way back into sports. Avoid contact sports for another 2-4 months to avoid risk of re-injury. (Word Count 500) 3 b) The patient John will benefit from everything here because they are recovery- based treatments. Using physiotherapy is the fastest way to help heal and injury. Taking no action will result in no leg function, whilst being on the other end of the spectrum and jumping in full force will result in injury . (Gilbert, B., PT. (2015, October 20). Physiotherapeutic techniques gradually strengthen and heal the injured calf/heel area and get you back to the way you were. Inversion/eversion exercises in the first 4-6 weeks will help range of motion and will start using the injured area again. Doing hip, knee, and slight leg movements will help those areas stay stronger whilst you are not using them much, preventing atrophy. As you get into the weeks after that, you start doing more with the exercises, you build upon them. You started going to neutral and slightly past, now you will push that angle and go farther than that. This will have the same effects and you will start to notice progress. When you start using the resistance bands to do exercises without your walking boot on, this lets you be the judge of how far you can push the process. The same thing occurs with weights etc. The only adverse effects that may arise are slightly less mobility than before injury after the full healing process, and the patient pushing too hard and causing re-injury. The positives are safe recovery and guaranteed use of leg/foot again. (Word count 236) Citations: N/a, N. (n.d.). Achilles rupture. Retrieved April 06, 2021, from https://www.physio-pedia.com/Achilles_Rupture Achilles Tendon Therapy PDF. (n.d.). https://banffsportmed.com/wp-content/uploads/2018/01/Achilles-Tendon-Rupture_0.pdf

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

Achilles tendinitis - OrthoInfo - AAOS. (2010, June). Retrieved April 06, 2021, from https://orthoinfo.aaos.org/en/diseases--conditions/achilles-tendinitis/ Achilles tendon rupture. (2020, July 31). Retrieved April 06, 2021, from https://www.mayoclinic.org/diseases-conditions/achilles-tendon-rupture/symptoms- causes/syc-20353234 Maughan KL. Achilles tendinopathy and tendon rupture. Accessed April 6 th 2021 https://www.uptodate.com/contents/search Achilles tendon rupture. American Academy of Orthopaedic Surgeons. Accessed April 6 th 2021 http://orthoinfo.aaos.org/topic.cfm?topic=av0003 . Gilbert, B., PT. (2015, October 20). 10 reasons why physical therapy is beneficial. Retrieved April 06, 2021, from https://www.burke.org/blog/2015/10/10-reasons-why-physical- therapy-is-beneficial/58 Avruskin, A., PT,DPT. (2019, December 13). Physical therapy guide to calf strain. Retrieved April 06, 2021, from https://www.choosept.com/symptomsconditionsdetail/physical- therapy-guide-to-calf-strain N/a, N. (2021, March 31). Achilles tendon injuries. Retrieved April 06, 2021, from https://gophysiotherapy.co.uk/achilles-tendon-injuries/#:~:text=The%20more%20severe %20the%20strain,bear%20weight%20through%20your%20foot .

Anatomy Case Study

Related Documents