A patient developed a malignant skin tumor on the dorsum of his left foot and was found days later to have metastasis of his left inguinal nodes on the side and into his right frontal lobe. Trace the tumor to explain this occurrence.

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Nestor RutherfordLv2

12 Jan 2019

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A 62 year old man sudden developed an ataxic gait, and he tended to fall to the right. His right arm and leg became clumsy and he became hoarse. When he was asked to stand with his feet together, he tended to fall to the right, whether his eyes were open or closed. The right eyelid drooped, and the right pupil was distinctly smaller than the left. He did not sweat on the right side of his face. Pain and temperature sensations were decreased on the right side of the face and over the left side of the body and left limbs.

A) where in the central nervous system was the lesion? What was the cause of the somatic sensory deficits?

B) what was the cause of the autonomic changed in the right eye and face?

C) what was the mother disorder affecting gait? Why did he become hoarse?

How many times had Javier told his kids not to leave their toys lying around on the floor? While walking down a dark hallway in the middle of the night, Javier stepped on a tiny race car with his right foot. He immediately withdrew his foot from the painful stimulus, but then stepped on a second car with his left foot. Fortunately, he was able to shift his weight back to his other foot not to fall down. After reading this chapter, explain the spinal reflexes that kept Javier on his feet. Describing those reflexes will require your knowledge of nervous system organization from chapter 11.

Answer the questions based on the following Medical Record:

History of present Illness: This 77 year old gentleman washospitalized with chest pain, and a diagnosis of myocardialinfarction was made. The patient had CPK elevation to 800 with 10%MB fraction. He subsequently developed heart failure and cardiacarrhythmia. He underwent cardiac catheterization and coronaryangiography. His ejection fraction was 30%. He has severe left maincoronary artery stenosis and right coronary artery occlusion. Thepatient has had carcinoid tumor of bowel resected 4-5 years ago andin a recent laparotomy he was found to have diffuse carcinoidinvolvement of the liver and mesentery. The patient did have smallbowel resection and currently has a colostomy. He is expected tolive 2-3 years.

Past Medical History: Long standing hypertension, colostomysecondary to bowel carcinoma, transurethral resection of theprostate, previous transient ischemic attacks, and bilateralcarotid disease with 60-70% stenosis.

Impression:
Severe coronary artery disease with recent with recent myocardialinfarction, high grade left main coronary artery stenosis andocclusion of right coronary artery, ischemic cardiomyopathy,ventricular and supraventricular arrhythmias
History of carcinomatosis, status post recent bowel obstruction,previous colostomy
Carotid occlusive disease with history of transient ischemicattacks.

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The patient and his family are fully aware of recent cardiaccatheterization findings. The patient is in agreement withproceeding with coronary artery bypass graft surgery, knowing thathe is expected to live 2-3 years. Informed consent has beenobtained.

1) What medical problems does the patient have? Explain these inlay terms, as if you were talking with the patient and hisfamily.
2) What does it mean to have a "30% ejection fraction?" Is thisgood or bad?
3) Describe the coronary artery bypass graft surgical procedure inlay terms.
4) What is carotid endartarectomy, and is this patient a good riskfor it? Why or why not?

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A patient developed a malignant skin tumor on the dorsum of his left foot and was found days later to have metastasis of his left inguinal nodes on the side and into his right frontal lobe. Trace the tumor to explain this occurrence.

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