Sannu’s Story

Unit 8. Case Study 1. Sannus Story Sannu has contracted Leprosy. As a sixteen year old teenager, it is hard to pin point when he was infected since Leprosy has a long incubation period. As a sm every(prenominal) boy traveling b arfoot along trails in his village, Sannus be has already adapted to his living conditions. Sannus feet are tough and c bothoused. As Sannu ages, so does his Leprosy infection progress. The infection willing cause neuropathy in his extremities which will lead to many injuries to his feet and hands. The wounds acquired will be infected for weeks or even months without treatment.The neuropathy caused by the Leprosy infection is characterized by causing a decrease in sensation in the extremities, muscle weakness, and numbness. Sannus feet that have been toughened by his environment and life name have been further injured due to drop of sensation and medical treatment. In an attempt to abide by his feet clean to aide the healing of his infections, Sannu is m ore than likely maintaining a sedentary life course. This life style along with the progression of the Leprosy infection will weaken Sannus muscles. A feature common to all forms of Leprosy is nerve infection.Nerve damage appears to result from the multiplication of bacilli indoors Schwann cells and damage to the perineurium. Most of the deformities occurring from Leprosy are in incident due to trauma or a secondary infection. In a Leprosy infection one of the first gear symptoms are anesthesia to heat and cold. Leprosy affects the computer peripheral nervous ashes by attacking the myelin pillow slip surrounding the axons which affects the reliability and speed of nerve impulses. In other words, the nerve fibers are no long insulated and nerve impulses cannot be conducted efficiently.There are different types of sensorial receptors located throughout the body and are designed based on a selective stimulus response. The appropriate receptive field is stimulated within a sens ory receptor producing a response. In Sannus condition this action is delayed or absent due to the damage of his free nerve endings. Free nerve endings detect torment, temperature, and signature as well as tickle and itch. Sannus encapsulated nerve endings are in any case damaged. Encapsulated nerve endings detect pressure, vibration, and touch sensations.When Dianna performed the tests to check Sannus Achilles tendon and Babinskis reflex, she was evaluating his somatic senses. Somatic senses involve sensations such as touch, pressure, and pain as well as temperature perception. These are all touch in Leprosy infection. In Sannus subject area he has similarly lost the sensations of touch, pressure, and pain in his feet and hands due to the affects of leprosy on his nociceptors, mechanoreceptors, proprioceptors, and exteroceptors. These sensations are also present in the sensory receptors free nerve endings and encapsulated nerve endings.Sannus interoceptors would not be affect ed in a Leprosy infection because interoceptors pertain to the bodys internal environment. Mycobacterium leprae grow best(p) in relatively cool areas of the body such as the skin, peripheral nerves, the mucosa of the upper respiratory tract as well as the chamber of the eye and in severe untreated cases the testes and last other vital organs. Leprosy affects the exteroceptors of the external surface of the body. Nociceptors are the receptors of pain and are located in all tissues of the body with an exception of the forefront.Proprioceptors do no adapt very much, this is why Sannu still feels pain in his leg that has been amputated. Sannus pain is slow pain. Slow pain is referring to pain that is chronic, burning, aching, or throbbing. The peripheral receptors mad during a stimulus are the nociceptors. Like other cutaneous and subcutaneous receptors, Nociceptors transduce a transmutation of stimuli into receptor potentials. Also, like other somatic sensory receptors, Nociceptor s arise from cell bodies in dorsal settle ganglia that send one axonal process to the periphery and the other into the spinal cord or brain stem.Peripheral Nociceptors terminate at the site of free nerve endings. Nociceptors are located in the entire body except for the brain. The loss of myelination causes impulses to misfire. Without the myelin sheath the impulses are slower and misdirected. Sannu had little sensation to his extremities because of the process colligate to his Leprosy infection. Phantom limb pain is a result of neuroplasticity (new neural links can be made), or the brain region that once was responsible for controlling the amputated limb is taken over by an side by side(predicate) area of the brain.The phantom limb pain is enhanced by referred sensations, so that stimuli applied to other body parts can be sensed from the phantom limb. In patients with Leprosy, phantom limb pain will not occur with unaccompanied the amputation of fingers, toes, hands, or feet. P hantom limbs and phantom limb pain will only occur when the amputation is taken up to the stump of that limb. The representation of Sannus amputated leg on the somatosensory sub class will involve referred sensations because of remapping of somatosensory areas in the brain. The activity of the somatosensory map in the brain leads to certain experience of body image and somatic sensations.After Sannus amputation it is possible for him to initially experience some personal effects on his balance and equilibrium. This is because after amputation Sannu may still have confused senses of his missing leg. With the introduction of a prosthesis, Sannus brain will connect to the prosthetic device causing his brain to remember how to bureau as if the original leg were still there. The initial sensory loss that Sannu experienced was due to hoo-ha of the sensory pathway transmission. Leprosy affects the skin and peripheral nerves which are closest to the exterior of the body where the senso ry receptors are located.Leprosy infection is caused by mycobacterium leprae and mycobacterium lepromatosis. Both forms affect the peripheral nervous system by attacking the Schwann cells, destroying the myelin. At the site of the Schwann cell, the bacteria multiply and cause damage of the nerve architecture and cause secondary inflammation. This disease process results in desensitizing sensory receptors. This is why when Sannu cut his foot, he did not feel the pain, nor the infection that followed. Due to his location in a remote village and lack of medical care, his infection resulted in an amputation.The receptors that should have sensed the initial injury to Sannus foot are the exteroceptors. Exteroceptors are responsible for responding to stimulus from outside the body such as touch, pressure, pain, and temperature. After Sannus amputation he began experiencing phantom limb sensations. This is considered as a form of neuropathic pain. It is presumed to be a response by the per ipheral nervous system and the central nervous system of an injury. The process of reorganizing occurs from retained nerves from the amputated limb, spinal cord, thalamus, and rational cortex.After an amputation the area of the brain that is responsible for processing the sensations from the missing limb are taken over by areas that neighbored the missing limb. It is believed that around 95% of people are naturally immune to Leprosy. Recent research suggests that there is a defect in cell-mediated immunity that causes susceptibility to Leprosy. The area of DNA responsible for that variable is also found in Parkinsons disease. It is speculated the two disorders are linked somehow at the biochemical level. question has shown that susceptibility to the disease was linked to region q25 on the long arm of chromosome 6.Further study indicated that the Leprosy susceptibility gene lies within a region shared by two genes for Parkinsons disease. Resources The Merk Manual of Diagnosis and Therapy septic Diseases caused by Mycobacteria 2004 International Journal of Leprosy and other Mycobacterial Diseases Linkage of Leprosy Susceptibility to Parkinsons Disease Genes June 2004 www. who. ch/program emailprotected nl www. encyclopedia. com www. ncbi. nlm. nih. gov/pubmed/15372437 en. wikipedia. org/wiki/proprioception rarediseases. about. com. lepercolonies. thalidomide May 16 2009 pubmed. gov Muscle Nerve October 30 2004