Human Anatomy-a stroke case study

I undertook a 6 week Massive Online Open Course called ‘Human Anatomy’, by the Hong Kong Polytechnic University, where I learnt about the human anatomy from the perspectives of multiple healthcare professionals, through a case-based study of a stroke.

A stroke is a life-threatening medical condition, which occurs when the blood supply to part of the brain is cut off.

In most cases, the cause is ischaemic (blood supply is stopped by a clot). It can also be haemorrhagic (a weak blood vessel supplying the brain bursts.) in the case study, the patient suffered a transient ischaemic attack, where the blood supply to the brain is temporarily interrupted, and it lasts for only a few minutes. The TIA can be a warning sign of a full stroke in the future, which this patient had days later. The patient was a heavy smoker and drinker, with a diet consisting of many fatty foods. He also had a very stressful job, and all these factors increased the risk of him having a stroke.

Throughout the course, I learnt about the different organ systems in the human body, and how a stroke can affect each of them.

Skeletal system:
A stroke can affect the skeletal system in many ways, and some affects include:

  • Bone loss- more severe in upper body (because it usually functions more)
  • Increased risk of fractures, most commonly on the hemiplegic side
  • Post-stroke osteoporosis (weakening of the bones), contributing to bone loss and increased risk of fractures
  • Vitamin D insufficiency
  • Bone resorption (loss of bone minerals like calcium to the blood) which can lead to hypercalcemia

Treatments for the effects on the skeletal system involve the administration of bisphosphonate drugs for osteoporosis, vitamin D supplements, and more.

Muscular system:
Because of contralateral control of the body by the brain, if the left side of the brain is damaged in the stroke, the right side of the body will be effected, and vice versa. A stroke can cause:

  • Muscle weakness- leading to difficulty in mobility
  • Paralysis
  • Hypoesthesia or hyperesthesia (change in sensitivity) for example to temperature
  • Contracture-. Muscles around the joint can change shape, and become shorter/longer. Sometimes this can become permanent, fixing the joints and muscles in a position. For example, your arm may be stuck in a bent position.
  • Spasticity-changes in muscle tone which can cause tight, stiff muscles
  • Drop foot- the dorsiflexor muscles (which lift up the toes) are weak, so your toes catch on the ground when you step forward

Treatments: exercising the muscles you find difficult to control, which can be helped by a physiotherapist. Occupational therapists will help the patient to find ways to carry out everyday activities. For drop-foot, an ankle-foot orthosis can be worn (a brace.) to treat spasticity, Botox can be injected into the muscle to reduce the muscle’s ability to contract. Medication can also help with the muscle stiffness.

In the case study, the treatments included antithrombotic therapy, which is administered in the hope that the blood clot will dissolve. Physiotherapy and occupational therapy was given to improve the strength of the patient’s limbs, and help walking. Speech therapy was given to the patient as he acquired mixed dysphasia. Optometrists helped his vision, as the stroke can cause the patient’s gaze to drift to one side.

Overall, the course ‘Human Anatomy’ was very interesting, and it allowed me to develop my basic knowledge of the anatomy of the human body further, whilst learning more about the causes and effects of a stroke.

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