BSC2346 All Week Cases Studies Latest 2018 December Question # 00596745 Subject: General Questions Due on: 01/11/2019 Posted On: 01/11/2019 05:29 AM Tutorials: 1 Rating: 4.8/5

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Human Anatomy and Physiology

Module 01 Case
Study

Question 1

Ben is a 6-month old infant who has a history of respiratory
infections. His parents are concerned that his symptoms are worsening and bring
him to his pediatrician, Dr. Johnson. They explain that he has a persistent
cough and sometimes coughs up phlegm. He also experiences periodic wheezing and
shortness of breath. Dr. Johnson notes that his weight and height have not
increased as much as predicted since his last visit. He is concerned that Ben
may have a genetic condition called Cystic Fibrosis.

There are several ways to test for Cystic Fibrosis. In your
own words, briefly describe 2 diagnostic tests that Dr. Johnson could use to
determine if Ben has Cystic Fibrosis.

Question 2

Cystic Fibrosis is an inherited condition. Which of the
following describes the inheritance pattern?

Answers:

X-linked recessive

Autosomal recessive

X-linked dominant

Autosomal dominant

Question 3

List at least 3 other symptoms of Cystic Fibrosis that are
not mentioned in the case study about Ben.

Question 4

Which of Ben’s parents carried the defective gene which
causes Cystic Fibrosis?

Both Parents

Neither parent- this was passed on from a prior generation

His mother

His father

Question 5

If both of Ben’s parents are Cystic Fibrosis carriers and
plan to have another child, what are the chances that their next child would
NOT be a carrier and would NOT be affected by Cystic Fibrosis?

Answers:

0%

50%

75%

25%

Question 6

In your own words, briefly describe how the Cystic Fibrosis
gene affects the cell membrane.

Question 7

Which of the following is not a common treatment for Cystic
Fibrosis?

Frequent blood transfusions

Prescription medications, such as mucolytics, inhaled
through a nebulizer

Pancreatic enzyme supplementation

Using an inflatable vest that vibrates to loosen mucus in
the chest

Question 8

In your own words, briefly describe why Ben’s skin may taste
salty.

Question 9

Which of the following statements is true of Cystic
Fibrosis?

Answers:

Cystic Fibrosis is generally diagnosed between 20-40 years
of age.

Cystic Fibrosis involved multiple mutations of more than one
gene.

A carrier of Cystic Fibrosis has a 100% chance of having a
child with Cystic Fibrosis.

Cystic Fibrosis affects the ability of chloride ions to pass
through the cell membrane.

Question 10

Which tissue type is most affected by the excess mucus
produced in Cystic Fibrosis?

Answers:

Connective tissue

Epithelial tissue

Nervous tissue

Muscle tissue

Question 11

Taylor, a 6-month-old infant, has recently been very fussy
and appears to be in pain when his parents touch or squeeze his hands and feet.
Both extremities have shown swelling that appears to be increasing slowly over
time. He had a condition known as jaundice when he was born and his parents are
noticing that his skin is starting to have that same yellowish color that it
did when he was a newborn. Taylor’s parents are very concerned and take him to
his pediatrician.

Taylor’s pediatrician decides to perform blood tests because
he is concerned that Taylor may have sickle cell disease. If he is, which of
the following tests would be abnormal?

Answers:

Platelets

WBC

Hemoglobin

HIV antibodies

Question 12

Taylor’s test results provide a definitive diagnosis of
sickle cell disease. Which other symptom would be common for his disease?

Answers:

Increased energy

Weight gain

Fatigue

Bleeding

Question 13

Why would the physician be interested in Taylor’s parents’
ethnicity? In your own words, provide a brief explanation of why ethnicity may
be related to Taylor’s diagnosis.

Question 14

Taylor’s parents have never been tested for sickle cell
disease because they have never had any of the common signs or symptoms.
Knowing that Taylor has sickle cell disease, which of the following statements
is true?

Answers:

This disease trait skips generations and neither of his
parents is a carrier for the SCD gene.

Taylor’s father carries the gene for SCD and his mother does
not.

Both of Taylor’s parents carry the gene for SCD.

Taylor’s mother carries the gene for SCD and his father does
not.

Question 15

If Taylor’s parents have another child, what is the
likelihood that the second child will be a CARRIER of the sickle cell trait?

Answers:

100%

0%

50%

25%

Question 16

Sickle cell disease is a dominant disease, which means both
parents of an affected individual must carry the sickle cell trait.

Answers:

True

False

Question 17

If a red blood cell is affected by sickle cell disease,
which of the following is true?

Answers:

The plasma membrane of the red blood cell allows too much
fluid into the cell because of a hypotonic environment.

The plasma membrane of the red blood cell allows too much
fluid into the cell because of a hypertonic environment.

The nucleus of the red blood cell has genetic defects.

Abnormal hemoglobin causes abnormal structure of the red
blood cell.

Question 18

Sickle cell disease can be detected by prenatal screening.
In your own words, briefly describe this process.

Question 19

Which of the following is NOT a possible treatment for
sickle cell disease?

Answers:

Hematopoietic stem cell transplantation

Liver transplant

Red blood cell transfusions

Preventative antibiotics

Question 20

In your own words, briefly describe how sickle cell disorder
affects homeostasis in the human body.

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Human Anatomy and Physiology

Module 02 Case
Study

Question 1

Since childhood, Linda has always enjoyed the outdoors. She
tries to spend as much time outside in the summer as she can because she lives
in the Pacific Northwest, where summers are short. Now, Linda is 62 years old
and is taking her grandchildren to the same lake house where she spent long
days boating, swimming, and playing sports as a child.

Linda has noticed an itchy skin lesion on the superior
portion of her right ear within the past two weeks. She is beginning to worry
because it doesn’t seem to be healing. She packed a large-brimmed hat for her
lake trip to keep her face and ears out of the sun. She wants to make sure she
is helping protect her grandchildren from any potential skin damage, too.

If Linda’s lesion is a sign of cancer, which types of skin
cancer do you think it could be? What other information would you need to know
to make a more educated diagnosis?

Question 2

Which of the following is the most deadly type of skin
cancer?

Question 3

Linda asks her son, who is a nurse, to look at the lesion.
He notices that the lesion has an asymmetric border, is black and brown, and
measures less than 3 mm. Which of these factors is NOT a warning sign of
cancer?

Question 4

Linda’s son thinks a biopsy might be necessary and urges her
to follow-up with a dermatologist. In your own words, briefly describe the
process of a skin biopsy.

Question 5

Humans have a natural protection against UV light called
melanin, produced by melanocytes. Which layer of skin contains melanocytes?

Question 6

In your own words, what is the difference between a benign
and a malignant tumor?

Question 7

Linda had a grandfather who was diagnosed with melanoma. She
is now wondering if she inherited a gene that has caused her to have melanoma,
too. Could this be true? Why or why not?

Question 8

If Linda’s biopsy is positive for melanoma, which of the
following would NOT be a treatment option?

Question 9

How has Linda’s exposure to sun throughout her life
contributed to her possible melanoma? (Hint: think about what happens to the
DNA of skin cells.)

Question 10

How can Linda help protect her grandchildren when they are
spending time outdoors? Be specific, use your own words, and include at least 3
ideas.

Question 11

Craig works in a factory and is often exposed to extremely
corrosive chemicals. He always follows the proper safety precautions when
necessary. One day, his coworker tripped on a staircase and Craig rushed to see
if he was okay. As he tried to help his coworker stand up, Craig’s hands and
arms began to tingle and burn intensely.

He looked around and realized that the box his coworker was
carrying had been filled with a corrosive material and had spilled on his bare
hands and arms. Craig immediately ran to the sink and began running water over
his skin, while his coworkers called 911. He was rushed to the hospital. While
riding in the ambulance, he was in excruciating pain. He observed large
blisters forming over his right arm, while his left hand seemed to hurt less
than the right, but appeared to be more damaged.

The blisters forming on Craig’s right arm indicate that his
burns are at LEAST which type?

Question 12

Craig’s left hand is more damaged and the EMTs believe it is
a third degree burn. If they are , which layers are damaged?

Question 13

Craig’s left arm has sustained damaged on the anterior and
posterior aspects from fingers to shoulder. His right arm and hand have
sustained damage on the anterior surface only. How much of his body has been
experienced burn damage?

Question 14

Did Craig do the right thing by rushing to the sink to rinse
his skin with running water? Why or why not?

Question 15

Craig noticed that his left hand appeared to be the most
damaged portion of his skin, but it didn’t hurt as intensely as the less
damaged skin. In your own words, explain how this is possible

Question 16

All of the following are potential complications of Craig’s
injuries EXCEPT:

Question 17

Assuming Craig has sustained third degree burns, which of
the following treatment options is most likely and most effective?

Question 18

Explain, in your own words, why a full-thickness skin graft
may be a better choice for Craig’s wounds when compared to a split-thickness
skin graft

Question 19

Craig’s injuries were caused by chemical burns. Which of the
following factors can also cause third degree burns?

Question 20

Research new types of burn care/treatment. Briefly describe
a new burn treatment technique that has been developed in the past 5 years.
(Rasmussen’s Library and journal databases are a great place to start your
research.)

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Human Anatomy and Physiology

Module 03 Case
Study

Question 1

Alyssa is a 74-year-old female patient who presents to her
primary care provider for a routine physical. She states that she feels “quite
healthy” and has no complaints other than mild back pain. She has a family
history of various cancers, diabetes, and osteoporosis, so she knows that it is
important to stay active and keep up with screenings and annual physical exams.
Alyssa’s provider finds that she has lost 10 pounds since last year’s exam. She
is almost a full inch shorter, as well.

Alyssa’s provider suspects that she may have osteoporosis.
Which other two factors would support that other diagnosis?

Answers:

Family history of cancer and obesity

A history of smoking and being post-menopausal

Taking calcium supplements and intense daily exercise

Weight loss and history of surgery

Question 2

Explain, in your own words, how Alyssa’s loss of height
could be related to her possible osteoporosis diagnosis.

Question 3

Alyssa’s provider orders a DEXA scan. Which of the following
T-score outcomes would indicate a diagnosis of osteoporosis?

Answers:

-2.6

-1.4

+1.2

0

Question 4

Why might Alyssa’s provider ask her about her diet? Provide
two reasons and explain how they are related to osteoporosis.

Question 5

Explain how the body controls calcium levels in the bones
and blood. Be sure to describe the roles of parathyroid hormone (PTH) and
calcitonin in detail.

Question 6

Alyssa has been prescribed several medications over the past
two decades for various reasons. Which of the following may have had an impact
on developing osteoporosis?

Answers:

Steroid medication

Antibiotics

Cholesterol-lowering statins

Over-the-counter antacid medication

Question 7

Alyssa’s doctor recommends that she increase her calcium
intake. List at least five foods that have high calcium content.

Question 8

Alyssa does some research on risk factors for osteoporosis
and comes across the term “peak bone mass.” In your own words, explain what
peak bone mass means and at which age it typically occurs.

Question 9

Which of the following choices has NOT been shown to cause a
decrease in blood calcium levels?

Answers:

Caffeine

Alcohol

Cannabis

Sodium

Question 10

If Alyssa does have osteoporosis, can she reverse its
effects on her bone density? Explain why or why not. What is the best course of
action she can take to keep her bones as healthy as possible?

Question 11

Kaysee is a 14-year-old athlete who was injured during a
basketball game. Another player fell on the lateral aspect of her right leg as
her foot was pinned in place. She was taken by ambulance to the hospital after
having her lower leg splinted on the court. She is in extreme pain and every
bump in the road makes the pain worse. When the ambulance arrived at the
hospital, the ER physician ordered x-rays.

Based on the limited information you are given, which of the
following bones is most likely injured?

Answers:

Tibia

Humerus

Metatarsals

Femur

Question 12

The x-ray shows that both lower leg bones have been
fractured. There is no break in the skin tissue. Which of the following terms
describes the type of fracture that has occurred?

Answers:

Colles

Simple

Compound

Greenstick

Question 13

Kaysee has always been a fairly healthy child. She has no
history of any major illness. However, her physician is surprised that she has
sustained two fractured bones from a relatively mild trauma. List and describe
three possible underlying conditions that would increase Kaysee’s risk of
fracture. (Keep her age in mind.)

Question 14

The time required for healing a fracture depends on all of
the following except:

Answers:

Casting

Patient’s age

Nutrition

Type of fracture

Question 15

During bone healing, osteoclasts are by far the most active
bone cells.

Answers:

True

False

Question 16

Which of the following may diminish Kaysee’s body’s ability
to heal her fracture?

Answers:

Her history of athletic activity

Vitamin D supplements

An increase in calcium intake

Over-the-counter pain medications

Question 17

In your own words, describe the term “neoangiogenesis” and
explain how it relates to fracture healing.

Question 18

The first step in bone healing involves the formation of a:

Answers:

Soft callus

Hemotoma

Fibrous tissue

Hard callous

Question 19

Considering Kaysee’s age, could this injury impact bone
growth at her epiphyseal plates? Why or why not?

Question 20

Which of the following statements is true?

Answers:

A fibrocartilaginous callus is converted to bone tissue over
time.

The soft callus is composed of elastic tissue and collagen
fibers.

Formation of a soft callus is the first step in bone repair.

Vascularization never returns to an injured bone site.

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Human Anatomy and Physiology

Module 04 Case
Study

Question 1

Jordan is now 19-years old. As an infant, Jordan reached
many gross motor skill milestones, such as holding his head up, rolling over,
sitting, and standing, at normal times. However, he was considered a “late
walker” because he took his first steps at 17 months. By 2 years old, his
parents noticed a hyperlordotic posture while he was standing. A Gower’s sign
and Trendelenberg gait were noted by age four. Throughout his childhood, he
suffered progressive muscle weakness, especially in the proximal musculature of
the arms, pelvis, and legs. He required orthotic braces to assist his walking
and was confined to wheelchair ambulation by age 13.

At 16, he was hospitalized with bronchitis requiring
antibiotic treatment, but recovered. Jordan has a history of progressive muscle
weakness, but no history of muscle pain or spasm, chest pain, or irregular
heartbeat. The only medications that he normally takes are calcium and fluoride
supplements. Jordan has three siblings. His older and younger sisters have never
had any major medical issues. Jordan’s older brother is also to a wheelchair
with problems similar to Jordan’s. No other immediate or distant family members
have musculoskeletal issues.

Jordan’s history aligns most closely with which diagnosis?

Question 2

Jordan had a biopsy of the left gastrocnemius muscle when he
was 5 years old. Based on your answer for his diagnosis, describe the
microscopic pathological changes that the pathologist would have noted in her
report.

Question 3

Explain, in your own words, why Jordan’s brother appears to
have the same disease and why his sisters are unaffected.

Question 4

Jordan’s calves appear enlarged. Which of the following
statements explains this phenomenon?

Question 5

Jordan displayed Gower’s sign at a young age. Which of the
following statements explains why this this true?

Question 6

Weakness in his erector spinae muscles forces Jordan to
assume which exaggerated position when standing?

Question 7

In your own words, please explain why Jordan must take
calcium supplements for the rest of his life. (Hint: Think about your prior
material and Wolff’s law.)

Question 8

Jordan is prone to respiratory infections, in part because
of the weakness of which muscles?

Question 9

Genetic testing would reveal that Jordan has a y-linked
disorder.

Question 10

In your own words, briefly describe the role of dystrophin
within the motor unit.

Question 11

Colette has been experiencing some muscle pain and soreness
after workouts this last week. She decides to research how muscles work because
she wants to find ways to help alleviate her pain. She is hoping to find out
the names of the muscles that are aching and find ways to stretch and
strengthen them. Answer the following questions to help her find the answers
she is looking for.

Colette has been sore “all over,” but her primary area of
concern is the posterior right thigh. Which of the following muscles could be
causing the soreness in this region?

Question 12

Colette has played softball for over 20 years and has been
told in the past that she may have a rotator cuff injury. Which of the
following rotator cuff muscles is on the anterior aspect of the scapula?

Question 13

Colette is trying to understand what causes her occasional
calf muscle cramps. Which of the following statements is true regarding cramps?

Question 14

According to the sliding filament theory, myosin filaments
slide past actin filaments during contraction of a muscle because the myosin
heads bind to the sarcolemma.

Question 15

Which of the following statements is true regarding muscle
contraction?

Question 16

Colette is having trouble understanding the role of fascia
within the musculoskeletal system. Explain, in your own words, how fascia is
related to the muscles of the human body.

Question 17

Colette is finding that studies about the benefits of
stretching have mixed results. However, stretching can improve flexibility,
which is a priority for her. Which of the following statements is true?

Question 18

In your own words, describe how acetylcholine, calcium, and
ATP are involved in the process of muscle contraction.

Question 19

While Colette is researching weight lifting techniques, she
finds contradictory information about the “best” way to build muscle. Which of
the following statements is true of skeletal muscle?

Question 20

Muscle relaxation occurs when acetylcholine is cleaved from
its receptors, calcium is pulled back inot the sarcoplasmic reticulum, the
myosin is released from its binding site, and the muscle fiber returns to its
resting length.

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Human Anatomy and Physiology

Module 06 Case
Study

Question 1

Donna, a 42-year-old mother of two, has been experiencing
intermittent tingling and numbness in both of her feet. She has also had
trouble holding a pen while writing. In the past few months, the tingling and
numbness in her extremities seemed to subside on its own, so she was not very
concerned. Recently, though, the symptoms have spread to her knees and thighs
and are persisting.

Yesterday, she stumbled when getting out of bed in the
morning. When she tried to stand, her right leg was too weak to hold her weight
and she fell again. She noticed that she scraped her right knee during the
fall, but does not feel any pain from the wound. Donna notices that she has
blurry vision and thinks that might be the reason she fell.

All of the following indicate sensory deficits EXCEPT:

Question 2

Donna does not feel the wound on her knee. In a normal
situation, describe how this sensory input of a scraped knee would result in
the feeling of pain.

Question 3

Donna has weakness in her right leg, but her left leg is
functioning normally. Which components of the nervous system are involved with
skeletal muscle movement? Be specific about how the motor impulse moves through
the body.

Question 4

Which of the following ly defines a motor unit?

Question 5

Which of the following statements is true?

Question 6

List and describe any and all symptoms in Donna’s history
that could be related to a pathology of her motor neurons.

Question 7

Donna’s primary care physician wants to screen her for
Multiple Sclerosis. Which of the following tests would provide the most
definitive diagnosis for MS?

Question 8

If Donna does have MS, the disease is affecting her myelin
sheath. Briefly describe what happens to the myelin sheath and how it disrupts
nerve function in patients with Multiple Sclerosis.

Question 9

Donna later sees a specialist who wants to perform a spinal
tap, which is an analysis of cerebrospinal fluid. Where is cerebrospinal fluid
(CSF) found?

Question 10

After extensive testing, Donna’s care team concluded that
she does have Multiple Sclerosis and have prescribed steroid treatment. How
will steroids help alleviate her symptoms?

Question 11

Andre is a 68-year-old grandfather who has been struggling
with his memory lately. At first, he was simply forgetting an appointment from
time to time or forgetting to take his morning vitamins. However, now his
spouse and children have noticed that his forgetfulness is progressing. There
have been moments where he forgot how to get home, couldn’t remember his own
phone number, or the names of his grandchildren. His family is worried he may
have Alzheimer’s disease and they are not sure what to do.

Andre’s family decides to do some research about dementia
and

Alzheimer’s disease. Which of the following statements is
true?

Question 12

Which of the following is NOT a typical symptom of
Alzheimer’s disease?

Question 13

Which of the following scenarios is considered a normal
age-related change in memory?

Question 14

What are the risk factors in Andre’s history that would
support a diagnosis of Alzheimer’s disease?

Question 15

What other Alzheimer’s disease risk factors might exist that
are not given in Andre’s history? List and describe at least 5 risk factors.

Question 16

As Alzheimer’s disease progresses, the brain produces less
and less of which neurotransmitter?

Question 17

Alzheimer’s disease is diagnosed using all of the following
tools EXCEPT:

Question 18

Describe how the plaques found in Alzheimer’s disease
disrupt nerve impulses.

Question 19

There is no cure for Alzheimer’s disease, but cholinesterase
inhibitors can be used to treat symptoms like memory loss or language issues.
Briefly discuss how this type of medication affects the physiology of neurons
and nerve impulses.

Question 20

Andre’s primary care physician will likely refer him to a
specialist. Which type of specialist treats Alzheimer’s disease? With the
information you are given about Andre, how do you think his specialist will
proceed? List and describe at least 3 treatments, tests, or other options that
would make sense for Andre’s stage of memory loss.

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Human Anatomy and Physiology

Module 07 Case
Study

Question 1

Scott, a 37-year-old elementary teacher, is seeing his
general practitioner for complaints of general weakness, especially in his
lower extremities. He has also been feeling very fatigued lately and has
trouble keeping up with his students throughout his work day. His physician
notes that he has lost a significant amount of weight in the last 6 months.
Scott reports that even simple tasks, such as brushing his hair and getting
dressed, can seem like a chore. He has trouble climbing stairs because of his
weakness and notices that his speech is slurred, especially at the end of the
day.

Scott’s physician uses a tongue depressor during his
physical examination and Scott begins to gag and has difficulty swallowing. His
physician notes muscle wasting and abnormal spasticity in upper and lower
extremities bilaterally. All reflexes are normal except the Babinski reflex. Scott’s
toes fan out when the sole of his feet are stroked with the reflex hammer.

Scott’s symptoms are primarily related to problems with:

Question 2

Because Scott’s symptoms are progressively getting worse
over a period of several months, we can rule out which of the following
diagnoses?

Question 3

Scott’s physician believes he may have ALS. Briefly describe
this condition in your own words.

Question 4

Which of the following is NOT an early symptom of ALS?

Question 5

What are the major differences between ALS and MS,
physiologically? Describe any pathological differences you find in your
research.

Question 6

Scott has a positive Babinski reflex. What is the
significance of this? What does a positive Babinski reflex mean in adult
patients?

Question 7

ALS stands for Amyotrophic Lateral Sclerosis. What does
“amyotrophic” mean? What is happening to the body (physiologically) if it is
experience “amyotrophic” changes?

Question 8

ALS stands for Amyotrophic Lateral Sclerosis. What is the
word “lateral” referring to in this case?

Question 9

The motor neurons affected by ALS are found in the spinal
nerves and peripheral branches of those spinal nerves only.

Question 10

Which of the following statements regarding ALS is true?

Question 11

Russell is 72 years old and is still working part-time as a
professor. He has noticed some arm and hand shaking in the past year, but
assumed it must be related to low or high blood sugar levels because he has had
some issues with that in the past. However, the shaking/twitching has become
more consistent lately and does not seem to be correlated with his diet.
Russell’s doctor said that the stress of his job could be the problem, so he
took the entire summer off from teaching.

When he returned to work in the fall, Russell and his
students noticed that his handwriting has become nearly illegible. Drinking a
cup of coffee without spilling had also become a challenge. Russell returned to
his doctor, who performed a physical exam and a few tests. Here are the notable
results: shuffling gait, mild bradykinesia, mild voice tremor, intermittent
rigidity of the limbs, and normal EEG.

If Russell is having symptoms in his upper extremities,
lower extremities, and his speech is slurred, which of the following body
regions is most likely experiencing a pathology?

Question 12

Russell’s physician suspects that he may have Parkinson’s
disease. List at least two other diagnoses that could fit Russell’s history and
test results.

Question 13

Which of Russell’s physical exam findings could be related
to a brain condition?

Question 14

Shuffling gait is often associated with Parkinson’s disease.
Which of these symptoms is NOT another common sign of Parkinson’s disease?

Question 15

Russell’s physician decides to follow-up with an MRI. If he
does have Parkinson’s disease, his MRI may show degeneration in which part of
the brain?

Question 16

Parkinson’s disease involves the loss of a particular
neurotransmitter. Which neurotransmitter is involved and how is it associated
with the motor symptoms of Parkinson’s disease?

Question 17

Which of the following is NOT a treatment option for
Parkinson’s disease?

Question 18

If Russell is diagnosed with Parkinson’s disease and chooses
not to pursue treatment, what is his prognosis?

Question 19

What does the term “neurodegenerative” mean? Briefly
describe this term in your own words. (Do not copy a definition.)

Question 20

Which of the following statements is true regarding
Parkinson’s disease?

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Human Anatomy and Physiology

Module 08 Case
Study

Question 1

Joanne just celebrated her 50th birthday and knows that she
should probably see her physician for a physical. She’s generally in good
health, but has been experiencing some odd symptoms lately. Joanne has been
experiencing mild to moderate headaches once or twice a week, usually in the
morning hours. She feels that her mental acuity “isn’t what it used to be” and
forgets the day of the week occasionally. Her husband often complains that she
has the TV too loud, but Joanne thinks it’s a normal volume. She has noticed that
her feet and toes are colder and she has to wear socks and slippers around the
house to be comfortable.

A few nights a week, she wakes up in the middle of the night
with tingling and numbness in her right hand. Joanne works at a desk all day
and she notices a sharp, an