Sarah Mitchell is a 68-year-old female who is normally healthy. However, about five days ago she began to feel very fatigued and started to experience a burning and tingling sensation on her right thigh.
You ask to see the area and upon visual inspection you notice 3â4 small, red, swollen areas with vesicles on the posterior aspect of her right thigh. She describes the pain to you, saying âit feels like the back of my leg is on fire and it hurts so bad.â She denies being exposed to any excessive heat sources, any changes in her diet, and any changes in the type of body soap, lotion, or laundry detergent she is using. All other physical findings are within normal limits, but her oral temperature is 100.6ËF. She complains about being under a lot of stress for the past three months because she has been helping take care of her husband, who is in the end stages of Alzheimerâs disease. She has no known drug allergies, is a non-smoker, and attends a water aerobics class twice a week. You suspect she may be suffering from a particular viral infection, so you ask if she had chicken pox as a child. Sarah confirms that she had chicken pox and measles during childhood. Her answer confirms your suspicions that she is likely suffering from shingles (herpes zoster) due to varicella-zoster virus infection.
Short answer questions
1.Define the following terms, used in the case and also in associated questions.
a.paresthesia
b.skin vesicle
c.dorsal
d.ventral
e.dormant
2.The list below classifies sensory receptors by the stimulus that activates them. Using your textbook or other resource, name the receptor for each stimulus type.
a.activated by touch, pressure, vibration, and stretch.
b.activated by changes in temperature
c.activated by light or changes in light wavelengths
d.activated by changes in chemical concentrations in a solution
e.activated by tissue injury or situations that may lead to tissue injury
3.Based on what you know about their stimuli, which type of sensory receptor is activated and causing Sarahâs symptoms of pain and paresthesia?
4.The virus infecting Sarah lies dormant in the dorsal root ganglion. What part of a neuron is located in the dorsal root ganglion? Does the dorsal root and its ganglion carry sensory input, motor output, or both?
5.Based on the pattern of skin vesicles and pain, which of Sarahâs peripheral nerves is infected? To which peripheral nerve plexus does this nerve belong?
6.If Sarah had skin vesicles on the anterolateral region of her neck, which peripheral nerve is infected by the virus? To which peripheral nerve plexus does this nerve belong?
7.If Sarah had a viral infection that affected neuron function in the ventral root of the same spinal nerve, how would the signs and symptoms be different than those she has now?
8.If we traced the sensory pathways that carry Sarahâs thigh pain up to her brain, which cerebral lobe AND which part of the cortex would be active when she feels this sensation?
Sample Solution
Illumination is an idea and a word that is normally utilized and connected with intercession, the act of Buddhism and its advantages. More often than not, it is utilized regarding the idea of Nirvana. In most Buddhist writings and written works, illumination can be perused to have begun with the Buddha himself, along these lines the term samma-sambodhi is utilized to apply to the accomplishment of edification of bodhis or meditators going for it. This is the objective of the ways of contemplation dependent on most Buddhist conventions. In the first setting, the word bodhi is a Pali and Sanskrit term that is utilized to allude to an individual who has allegorically woken up and gotten things. It is likewise used to indicate out a particular degree of comprehension or information that the Buddha has picked up when he encountered his very own enlivening. This comprehension gave him learning on to the common reasons for things that adds to how human and other aware creatures come into their particular presence and furthermore the functions of the mind that adds to keeping human and other conscious creatures caught into ideas, for example, enduring, resurrection and yearnings. In this sense, the word bodhi would then be able to be associated with picking up a more profound degree of comprehension on how an individual can free oneself from the things that makes the person in question be detained on the three ideas referenced previously. Edification in the Buddhist Traditions The Buddha Siddharta Gautama, is the principal recorded being to have achieved a degree of full illumination. This level he has effectively accomplished is composed as sammasambuddha in the Pali language (samyaksambuddha in Sanskrit), or what is called as the ideal structure off Buddhahood. In the Theravada custom of Buddhism’s narratives or the sutta pitaka, there are various writings and portrayals about how the Buddha has encountered arousing or illumination himself. This can be found in the seventeeth part of the Vanapattha Sutta, the Majjhima. In this particular section, it is portrayed how the Buddha has carried on with his life in the wilderness and how from that point, he had the option to achieve a condition of enlivening or edification. This, the writings appear, was done after the Buddha has effectively crushed the aggravations that happened in his psyche, enabling him to accomplish centralization of the brain. This has come about into him achieving the Vidhyas or the familiarities. This incorporates the nearness of understanding into his previous existences, accomplishing knowledge into the functions of resurrection and karma and understanding to the nearness of the Four Noble Truths. In the writings, the fulfillment of understanding into the Four Noble Truths is the thing that gave illumination the other term arousing. This implies any meditator rehearsing it has just accomplished a degree of achieving a security from servitude on a preeminent nature. Besides, arousing is likewise identified with having achieved the phase of Nirvana, where sufferings are finished and the way toward being reawakened never again happens. In the writings, the Buddha has guaranteed that the freedom he got from this is sure in light of the fact that the nearness of learning transpiring has enabled him to create knowledge. This have then given him certain opportunity, rendering him to be free from resurrections. In showing this idea to a meditator, the educator must pressure that the nearness of enlivening methods picking up knowledge into the ideas of resurrection and karma, into the nearness of the Four Noble Truths and the end of everything which add to accomplishing the province of Nirvana. Just in encountering this would freedom be surely experienced by the understudy. Accomplishing Awakening or Enlightenment The fulfillment of edification or arousing at its fullest limit can be accomplished by a meditator by turning into a Buddha and going into Buddhahood. At the point when looked with this idea, the instructor should initially disclose to the meditator the different implications and setting of the word Buddha in the Buddhist customs. In addition, another term Tathagata ought to likewise be disclosed to the understudy. This term signifies “the along these lines gone” and is utilized as a comparable to the word Buddha. Achieving full arousing or illumination is considered in the Theravada Buddhist convention to be compared in achieving the phase of Nirvana. This implies when a meditator begins rehearsing, the educator should set his or her way to have a definitive objective of achieving Nirvana. This is valid in other Buddhist customs too. This way includes the meditator relinquishing the then shackles of his reality and progressing in the direction of the stopping of misery or dukkha. This full arousing or edification is accomplished by the meditator in four phases. Besides, Budhaghosa, another specialist in the Theravada Buddhist convention has portrayed another way to achieving edification. In the Visuddhimagga or the Path to Purification, he has depicted what he calls the Seven Stages to Purification which depends on the Noble Eightfold Path initially portrayed by the Buddha. The distinction, nonetheless, lies on the way that Buddhaghosa has accentuated on understanding dependent on the three attributes of life which are dukkha, anatta and anicca. These ideas are what separates it separated from the four phases of edification where the ten shackles or human presence are surrendered in a progressive way. The Four Stages of Enlightenment In Buddhism, there are four phases of a progessing nature that is identified with the four phases of edification. These stages are significant in coming about into the full edification of a meditator as an Arahat. The general population who are into both of the four phases of illumination are alluded to by the Buddha as the ariya-puggala or the honorable individuals. On the other hand, the general population inside the network of the bikkhu-sangha are called as the ariya-sangha or the respectable sanghas. The four phases of illumination are the Sotappana, Sakadagami, Anagami and the Arahat. These four phases of edification and their educating to meditators are focal components in the Buddhist schools, for example, Theravada convention. This was chronicled in the sutta pitaka, and how each level are accomplished were depicted too. Aside from the four phases referenced over, the instructor would need to tell his or her understudies that there are additionally different sorts which portrays different stages also. In any case, the focal point of this module is on the four phases of edification so these four would be the ones that are to be depicted in detail here. As referenced in the past segments, the four phases of illumination are the final result or aftereffect of the seven refinements that a meditator experiences. This was examined at extraordinary lengths in the Visuddhimagga. The instructor can empower his or her understudy meditators to peruse on passages from the Visuddhimagga about the seven refinements, their successions and how each of these are identified with four ways and organic products. Additionally, in the Visuddhimagga, prajna and its significance is likewise depicted in detail, just as picking up understanding into anatta and how these are identified with freedom and can be accomplished in the act of Insight reflection or Vipassana. The four phases of fulfillment or edification are likewise connected with happening two by two of way and natural product. Coming up next are the way and organic product sets of the four phases of achievement: The way to stream passage and the realization of stream section The way to once returning and the realization on once returning The way to non returning and the realization of non returning The way to turning into an arahant and the realization of turning into an arahant Each of these are depicted beneath in their connection to the accomplishing of illumination: The Sotapanna. This is the primary phase of edification and is gotten from the Pali language (composed as Srotapanna in Sanskrit). This term implies or is meant mean the individual or the person who enters the streams (apadyate sota). The stream being portrayed here is the overly everyday portrayal of the Noble Eightfold Path and is viewed as the most noteworthy type of Dhamma also. The individual who is this stage is likewise viewed as one who had the option to open the eye of the Dhamma (or dhammacakkhu in Pali and dharmacaksus in Sanskrit). The meditator who enters the stream is said to be capable achieve the condition of being an arahant in a range or seven resurrections after the person in question has accomplished opening the eye of the Dhamma. Another viewpoint that the instructor needs to worry in encouraging this is the meditator can achieve a grip of the Buddhist precepts on an instinctive level or what is known as the correct view (samyagdrsti in Sanskrit or sammaditthi in Sanskrit). In addition, the meditator can likewise have a total certainty, or Sadha on what is viewed as the three gems of training specifically the sangha, dharma and Buddha. This implies when the meditator passes away, the individual in question won’t experience resurrection in any plane that is completely lower than the human plane, for example, the creature or in damnation. The Sakadagami. This is the second phase of illumination which is likewise called the phase of the once returner. The cause of this word is Pali (Sakrdagamin in Sanskrit), which when interprets implies the once who once comes (sakrt and agacchati, separately). When clarifying what this implies, the educator should tell the understudy that individuals who have a place in this stage will return yet again to the human plane or world once again in many occurrences. An individual who advances in this phase in the wake of experiencing the first is said to have relinquished the initial three of the ten chains. Meditators who are in this stage are likewise observed to show a more fragile feeling of desire for things, milder sentiments of detest, and even debilitated daydreams. This implies any individual who is viewed as a once-returner would encounter resurrections less than multiple times and that these resurrections more often than not happen in the higher planes in spite of the fact that there would happen a resurrection in the human plane at any rate once again. >
Illumination is an idea and a word that is normally utilized and connected with intercession, the act of Buddhism and its advantages. More often than not, it is utilized regarding the idea of Nirvana. In most Buddhist writings and written works, illumination can be perused to have begun with the Buddha himself, along these lines the term samma-sambodhi is utilized to apply to the accomplishment of edification of bodhis or meditators going for it. This is the objective of the ways of contemplation dependent on most Buddhist conventions. In the first setting, the word bodhi is a Pali and Sanskrit term that is utilized to allude to an individual who has allegorically woken up and gotten things. It is likewise used to indicate out a particular degree of comprehension or information that the Buddha has picked up when he encountered his very own enlivening. This comprehension gave him learning on to the common reasons for things that adds to how human and other aware creatures come into their particular presence and furthermore the functions of the mind that adds to keeping human and other conscious creatures caught into ideas, for example, enduring, resurrection and yearnings. In this sense, the word bodhi would then be able to be associated with picking up a more profound degree of comprehension on how an individual can free oneself from the things that makes the person in question be detained on the three ideas referenced previously. Edification in the Buddhist Traditions The Buddha Siddharta Gautama, is the principal recorded being to have achieved a degree of full illumination. This level he has effectively accomplished is composed as sammasambuddha in the Pali language (samyaksambuddha in Sanskrit), or what is called as the ideal structure off Buddhahood. In the Theravada custom of Buddhism’s narratives or the sutta pitaka, there are various writings and portrayals about how the Buddha has encountered arousing or illumination himself. This can be found in the seventeeth part of the Vanapattha Sutta, the Majjhima. In this particular section, it is portrayed how the Buddha has carried on with his life in the wilderness and how from that point, he had the option to achieve a condition of enlivening or edification. This, the writings appear, was done after the Buddha has effectively crushed the aggravations that happened in his psyche, enabling him to accomplish centralization of the brain. This has come about into him achieving the Vidhyas or the familiarities. This incorporates the nearness of understanding into his previous existences, accomplishing knowledge into the functions of resurrection and karma and understanding to the nearness of the Four Noble Truths. In the writings, the fulfillment of understanding into the Four Noble Truths is the thing that gave illumination the other term arousing. This implies any meditator rehearsing it has just accomplished a degree of achieving a security from servitude on a preeminent nature. Besides, arousing is likewise identified with having achieved the phase of Nirvana, where sufferings are finished and the way toward being reawakened never again happens. In the writings, the Buddha has guaranteed that the freedom he got from this is sure in light of the fact that the nearness of learning transpiring has enabled him to create knowledge. This have then given him certain opportunity, rendering him to be free from resurrections. In showing this idea to a meditator, the educator must pressure that the nearness of enlivening methods picking up knowledge into the ideas of resurrection and karma, into the nearness of the Four Noble Truths and the end of everything which add to accomplishing the province of Nirvana. Just in encountering this would freedom be surely experienced by the understudy. Accomplishing Awakening or Enlightenment The fulfillment of edification or arousing at its fullest limit can be accomplished by a meditator by turning into a Buddha and going into Buddhahood. At the point when looked with this idea, the instructor should initially disclose to the meditator the different implications and setting of the word Buddha in the Buddhist customs. In addition, another term Tathagata ought to likewise be disclosed to the understudy. This term signifies “the along these lines gone” and is utilized as a comparable to the word Buddha. Achieving full arousing or illumination is considered in the Theravada Buddhist convention to be compared in achieving the phase of Nirvana. This implies when a meditator begins rehearsing, the educator should set his or her way to have a definitive objective of achieving Nirvana. This is valid in other Buddhist customs too. This way includes the meditator relinquishing the then shackles of his reality and progressing in the direction of the stopping of misery or dukkha. This full arousing or edification is accomplished by the meditator in four phases. Besides, Budhaghosa, another specialist in the Theravada Buddhist convention has portrayed another way to achieving edification. In the Visuddhimagga or the Path to Purification, he has depicted what he calls the Seven Stages to Purification which depends on the Noble Eightfold Path initially portrayed by the Buddha. The distinction, nonetheless, lies on the way that Buddhaghosa has accentuated on understanding dependent on the three attributes of life which are dukkha, anatta and anicca. These ideas are what separates it separated from the four phases of edification where the ten shackles or human presence are surrendered in a progressive way. The Four Stages of Enlightenment In Buddhism, there are four phases of a progessing nature that is identified with the four phases of edification. These stages are significant in coming about into the full edification of a meditator as an Arahat. The general population who are into both of the four phases of illumination are alluded to by the Buddha as the ariya-puggala or the honorable individuals. On the other hand, the general population inside the network of the bikkhu-sangha are called as the ariya-sangha or the respectable sanghas. The four phases of illumination are the Sotappana, Sakadagami, Anagami and the Arahat. These four phases of edification and their educating to meditators are focal components in the Buddhist schools, for example, Theravada convention. This was chronicled in the sutta pitaka, and how each level are accomplished were depicted too. Aside from the four phases referenced over, the instructor would need to tell his or her understudies that there are additionally different sorts which portrays different stages also. In any case, the focal point of this module is on the four phases of edification so these four would be the ones that are to be depicted in detail here. As referenced in the past segments, the four phases of illumination are the final result or aftereffect of the seven refinements that a meditator experiences. This was examined at extraordinary lengths in the Visuddhimagga. The instructor can empower his or her understudy meditators to peruse on passages from the Visuddhimagga about the seven refinements, their successions and how each of these are identified with four ways and organic products. Additionally, in the Visuddhimagga, prajna and its significance is likewise depicted in detail, just as picking up understanding into anatta and how these are identified with freedom and can be accomplished in the act of Insight reflection or Vipassana. The four phases of fulfillment or edification are likewise connected with happening two by two of way and natural product. Coming up next are the way and organic product sets of the four phases of achievement: The way to stream passage and the realization of stream section The way to once returning and the realization on once returning The way to non returning and the realization of non returning The way to turning into an arahant and the realization of turning into an arahant Each of these are depicted beneath in their connection to the accomplishing of illumination: The Sotapanna. This is the primary phase of edification and is gotten from the Pali language (composed as Srotapanna in Sanskrit). This term implies or is meant mean the individual or the person who enters the streams (apadyate sota). The stream being portrayed here is the overly everyday portrayal of the Noble Eightfold Path and is viewed as the most noteworthy type of Dhamma also. The individual who is this stage is likewise viewed as one who had the option to open the eye of the Dhamma (or dhammacakkhu in Pali and dharmacaksus in Sanskrit). The meditator who enters the stream is said to be capable achieve the condition of being an arahant in a range or seven resurrections after the person in question has accomplished opening the eye of the Dhamma. Another viewpoint that the instructor needs to worry in encouraging this is the meditator can achieve a grip of the Buddhist precepts on an instinctive level or what is known as the correct view (samyagdrsti in Sanskrit or sammaditthi in Sanskrit). In addition, the meditator can likewise have a total certainty, or Sadha on what is viewed as the three gems of training specifically the sangha, dharma and Buddha. This implies when the meditator passes away, the individual in question won’t experience resurrection in any plane that is completely lower than the human plane, for example, the creature or in damnation. The Sakadagami. This is the second phase of illumination which is likewise called the phase of the once returner. The cause of this word is Pali (Sakrdagamin in Sanskrit), which when interprets implies the once who once comes (sakrt and agacchati, separately). When clarifying what this implies, the educator should tell the understudy that individuals who have a place in this stage will return yet again to the human plane or world once again in many occurrences. An individual who advances in this phase in the wake of experiencing the first is said to have relinquished the initial three of the ten chains. Meditators who are in this stage are likewise observed to show a more fragile feeling of desire for things, milder sentiments of detest, and even debilitated daydreams. This implies any individual who is viewed as a once-returner would encounter resurrections less than multiple times and that these resurrections more often than not happen in the higher planes in spite of the fact that there would happen a resurrection in the human plane at any rate once again. >