Physiologically, the symptoms associated with Parkinson’s diseas

Parkinsons case study instructions


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 Scenario: A 67-year-old man presents to the HCP with chief complaint of tremors in his arms. He also has noticed some tremors in his leg as well. The patient is accompanied by his son, who says that his father has become “stiff”, and it takes him much longer to perform simple tasks. The son also relates that his father needs help rising from his chair. Physical exam demonstrates tremors in the hands at rest and fingers exhibit “pill rolling” movement. The patient’s face is not mobile and exhibits a mask-like appearance. His gait is uneven, and he shuffles when he walks and his head/neck, hips, and knees are flexed forward. He exhibits jerky or cogwheeling movement. The patient states that he has episodes of extreme sweating and flushing not associated with activity. Laboratory data unremarkable and the HCP has diagnosed the patient with Parkinson’s Disease. 



Introduction with a well-developed purpose statement that encompasses all requirements of the paper


Section One answering the following: Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.


 Section Two that answers: Any racial/ethnic variables that may impact physiological functioning.


Section Three describing in detail: How these neurological and musculoskeletal pathophysiologic processes interact to affect the patient.


Summary that encompasses a brief recap of the how the pathology of Parkinson’s disease affects the patient in way of symptoms and adjustments to their life and surroundings are needed. Include a brief explanation of what evidence based treatment is recommended. 




The following section is a guide for you to understand what I would like to be the focus of the content. This MUST be rewritten as not to plagiarize. I have included 2 references that you will be able to find the content in for in-text citations. (In the McCance reference use chapters 15, 17, and 44). However, additional scholarly articles will be necessary to fully complete the paper. Please use articles written within the last five years. Thank you.




Parkinson’s disease affects the extrapyramidal system, which influences the initiation, modulation, and completion of movement. The extrapyramidal system includes the corpus striatum, globus pallidus, and substantia nigra.


 PD is a neurodegenerative disease. There is a loss of neurons (nerve cells) in certain areas of the brain, including a region called the substantia nigra. The neurons in this region produce a neurotransmitter called dopamine. Dopamine helps to regulate movement. As the number of cells in the substantia nigra decreases, there is less dopamine available in the brain. Dopamine is important to maintain normal movement patterns. This loss of dopamine is the reason that many treatments for PD are intended to increase dopamine levels in the brain.


 Physiologically, the symptoms associated with Parkinson’s disease are the result of the loss of several neurotransmitters, most notably dopamine.


In Parkinson’s disease, a dopamine deficiency occurs in the basal ganglia, the dopamine releasing pathway that connects the substantia nigra to the corpus striatum. Reduction of dopamine in the corpus striatum upsets the normal balance between the inhibitory dopamine and excitatory acetylcholine neurotransmitters. This prevents affected brain cells from performing their normal inhibitory function within the CNS and causes most parkinsonian symptoms. 


Degeneration of the dopaminergic neurons and loss of available dopamine lead to rigidity, tremors, and bradykinesia. 


The loss of dopaminergic cells in the substantia nigra affects the basal ganglia’s ability to coordinate inhibitory and excitatory neural motor signals. Rigidity is another common visible motor symptom associated with PD. It is a type of increased muscle tone generally defined as an increased resistance to passive movement of a joint. Rigidity tends to be more prominent in the flexor muscles of the trunk and limbs, causing a characteristic stooped posture. There are two types of rigidity: lead pipe and cogwheel. Lead pipe rigidity is defined as a constant resistance to motion throughout the entire range of movement. Cogwheel rigidity refers to resistance that stops and starts as the limb is moved through its range of motion 



McCance, K. L., & Huether, S. E. (2018). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby.

Raza, C., Anjum, R., & Shakeel, N. (2019). Parkinson’s disease: Mechanisms, translational models and management strategies. Life Sciences, 226, 77–90.



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