A phantom is a persistent image or memory of a body part, generally a limb, for a period of time after its loss that can last months, even years. Silas Weir Mitchell studied this phenomenon during the Civil War. For amputees, phantom limbs are essential to regaining use of limbs following prosthetic procedures, without this sensation the recovery and reanimation of limbs can be disastrous. Positional phantoms, a type of phantom that leads to proprioceptive illusions and ever changing distorted images, can bring about acute onset tabes that leads to the feeling of being on “a ship in heavy seas” (68). The jury is still out on whether or not phantoms can be termed good or bad, but it seems they allow those with prosthetics to keep the limb alive, active and well; a necessary part to recovery. Pain may accompany phantoms; generally these are dull or ‘ordinary’ types of pain, but they can be sharp and excruciating in some cases. Having a phantom can lead to severe sensory diabetic neuropathy, like it did for the sailor in the story. However, the experience of a pathological disorder can cure phantoms.
There are still questions as to exactly which pathways are involved with the experience of phantom limbs. Originally it was believed the peripheral nervous system was involved, but this theory including the concept of neuromas (nerves in stumps that fire the sensations of pain up the spinal cord to the brain) has since been widely disregarded. The central theory suggests that phantom limb pain is a result of central sensitization, or excessive activity in the spinal cord. This occurs as a result of the spinal cord losing the afferent input from the missing limb. The neurons in the dorsal horn thus get irritated and increase their excit...
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...similar to how prism is used in glasses for people who may not have eyes that set centrally. But this is pretty new and still needs to be studied some more, I just wanted to bring it up.
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His aim was to in-crease amputees’ confidence in the use of their prosthetics and their mental attitude. He recruited 100 volunteer amputees and put them through the programme. The results sug-gested that he achieved his aim he noted improvements in the physical and mental well-being of the volunteers. They also gained confidence in using their prosthetic which aided their recovery. Their mental well-being was particularly important as it was noted that a positive mental attitude and acceptance of the prosthetic resulted in a quicker recovery time (Dillingham, T.R., 1998).
The symptoms of a right-hemisphere stroke are very much similar like the symptoms Mr. Fix-it is experiencing. For example, both suggest that functions on the left side of the body are completely neglected; therefore, the left visual section of the body does not respond effectively to stimuli due to the neglect. Damage to the right occipital lobe is very likely. The patient may have experienced some damage to areas 18 and 19 of the occipital lobe. “Damage to these association areas resulted in the patient’s failure to recognize items even when they have been seen before”, such as Mr. Fix-it’s deficiency to recognize geometric shapes (Carlson, 2010). Moreover, the patient could have also experience damage in the frontal lobe, specifically on area 8, in which it could have r...
Resection was a process that “involved cutting open the limb, sawing out the damaged bone, and then closing the incision” (Jones, 1). Resection allows the patient to keep his limbs but it requires a great ordeal of time and skill. This also contributed to the common practice of amputation during the war. But there were cases where surgeons did use this method. Terry J. Jones said in his NY Times article, “resections were used more frequently after surgeons learned that amputations had a much higher mortality rate” (Jones, 1). In another article by Corydon Ireland, it describes Mitchell Adam’s, a Harvard lecturer, grandfather who served as a volunteer surgeon during the Civil War. In the article, “Adams was not a champion of hasty amputations, but argued for excision and other limb-saving measures. And he describes the everyday pressures of a country practice in Framingham, Mass” (Ireland, 1). This meant that not all surgeons at the time only wanted to amputate but strived for alternate methods. This new knowledge shows that some surgeons were more dedicated to thinking about the well-being of their patients than others and this opens up to other possibilities that may have occurred during the war. This allows an image to come to mind of a surgeon diligently operating on a soldier with care and compassion. However, even though there may be many possibilities, we can’t truly know every event that occurs during a
Scientists are on the brink of doing the unthinkable-replenishing the brains of people who have suffered strokes or head injuries to make them whole again. If that is not astonishing enough, they think they may be able to reverse paralysis. The door is at last open to lifting the terrifying sentence these disorders still decree-loss of physical function, cognitive skills, memory, and personality.
As an Occupational Therapist, it is crucial to consider the wellbeing of Martha as a whole person. She is not merely a stroke patient. She is a homemaker, wife, and game enthusiast. Two conditions hindering her accomplishment of these meaningful occupations are her motor planning deficit and the lack of functionality in her right upper extremity (RUE). Martha has difficulty following multi- step commands, and relies heavily on the assistance of others with mobility, transfers, and activities of daily living (ADLs). Despite these, two of her strengths are her abilities to consistently answer yes/no questions by moving her head, and the mobility of her left upper extremity (LUE). She is alert and oriented to herself, and the strength and sensation in her LUE are within functional limits. These factors shape a client’s Occupational Therapy experience.
This type of neurological disorder then follows suit into other stories such as “The Man Who Fell Out of Bed” and the “Hands” Story. These two stories are similar with the patient in “The Man Who Fell Out of Bed” believed his leg did not belong to him and calls it a “foreign leg”. Whilst in the “Hands” story Madeleine age 60 is blind with cerebral palsy and found her hands useless lumps of dough. However, in Madeline’s case all her sensory capacities where intact and she was able to restore full sensation in her hands by tricking her into grabbing food when she was
Research illustrated connection between aphasia and depression (Robinson, Murata & Shimoda, 1999), social isolation (Sarno Taylor, 1997) and low self-esteem (Herrmann & Wallesch, 1989). Kauhanen and colleague (2000) conducted a research to investigate the prevalence and cause of post-stroke aphasia and to study the mental, neurological, and cognitive correlates with 106 patient who suffer from first ischemic stroke. The prevalence of major depression increased from 11 to 33% within the first year.
The control center of the human body is none other than the mighty brain. Due to its incredible importance in basic human functioning, both voluntary and involuntary, any injury or trauma to this organ will have a great influence on the body and it's capabilities (Burrus, 2013). Exploring how the brain deals with various injuries and damage proves that the functionality of the brain is fitting to make the brain the power house of the body. But before exploring this with the help of case studies, it is important to first make sense of the the anatomy and functioning of the nervous system as a whole in order to understand how it is affected during injury, the functioning of the body that is lost, the intervention implemented for treatment or rehabilitation and the changes experienced.
Circumcision, the removal of the foreskin over the penis, was long thought to be a painless experience for an infant and was treated accordingly with little or no anesthesia. Most of the times during the surgical procedure, the babies cry very forcefully. This was for a long time thought to be normal and healthy. Other times, they lie still without making a sound from either shock or the act of passing out from the pain (1). This unresponsiveness was always thought to be from undeveloped pain receptors, or Nociceptors in the Somatosensory system (2) . These pain receptors send information to the spinal cord, then to the brain stem, thalamus, and somatosensory cortex. Modulation can occur through these pathways by way of suppression using large mechanosensitive fibers that enter the spinal cord or by endorphine release. This modulation involves changing the information about the pain to lessen the perception of its magnitude.
There are many psychological and physical changes after an amputation. Body and mind have suffered changes and must adapt to the unexpected challenges. Some of the psychological effects that can be observed on an amputee are denial of the situation, anger, depression, factors like this can affect anyone without a prosthetic, nonetheless an amputee. Furthermore, this patient was active prior to the first failed surgery of TKA, which leaded to the amputation. The physical condition of the patient might have been compromised after two surgeries. Additionally, it can be assumed the patient is deconditioned and lacks endurance. The patient might know of his physical limitations and this creates a safe point of self awareness when ambulating and
Peripheral and central mechanisms involving nerve lesions and their input are substantial when perceiving phantom pain. Due to the impairment of peripheral nerves in the process of amputation, regenerative sprouting of damaged axons occurs and the activity rate of inflamed C-fibres and demyelinated A-fibres spontaneously increases (Flor, 2002). As a consequence of this nerve injury, a neuroma, which is a mass of pruned and tangled axons, may form in the residual limb producing abnormal (ectopic) activity (Katz, 1992). Flor, Nikolajsen and Jenson (2006) proposed that ectopic discharge from a neuroma in the stump illustrates abnormal afferent input to the spinal cord, which is a possible mechanism for unpro...
Now for our eyes we use them for vision, their like our own personal camera’s,
Sperry, R. W. (1982, September 24). Some Effects of Disconnecting the Cerebral Hemispheres. Science Megazine, 217, 1223-1226.
M.M. Merzenich, R. N. (1984). Somatosensory cortical map changes following digit amputations in adult monkeys. Journal of Comparative Neurology, 224(4): 591-605.
Pain is defined by the International Association for the Study of Pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage" (1). When pain is described in these terms we can see that pain is a perception, sort of like seeing and hearing. When pain is processed there are a number of brain structures activated, commonly referred to as the "central pain matrix" (2). It may seem irrelevant to delve into pain signal activation in the brain since it is seemi...