Neurological & Genitalia

Neurological & Genitalia

The main risk factor for cerebrovascular accidents (CVA) is hypertension since it can lead to the degeneration of the patient’s blood vessels. Medical conditions which predispose the patient to hypertension, such as diabetes, high cholesterol, and obesity, have also been associated with increased risks of CVA (Lin et al., 2018). In the second paragraph, you mentioned Native Americans as the ethnic group with the highest risk of CVA. Additionally, studies show that most minority groups, like African Americans, are also at high risk of CVA des to inequality in the United States healthcare system. The deep tendon reflexes, on the other hand, just as you have mentioned, were scored from 0 to 4+, where 0 represents no response and is considered abnormal, and 4+ shows increased response, which is abnormal. The only normal score is 2+. As such, a patient with diabetic peripheral neuropathy will display a score of 0 due to the destruction of the reflex arc.

For the second part of the paper, other than the lithotomy position, you have mentioned the Sims position and the knee and chest position, which are rare but effective when used in the pelvic examination. The lateral decubitus position is also considered the best position for conducting pelvic examinations among obese patients (Wall, 2021). Consequently, other than the reasons you have provided, the main reason behind higher risks of UTI in females as compared to males is that women have a shorter urethra, which makes it easier for bacteria to invade the bladder. As such, they should be educated mainly on maintaining high genital hygiene to prevent UTIs, just as you have mentioned. The benefits of newborn circumcision are mainly associated with reducing the risk of infection, while its demerits are based on poor wound healing or surgical complications, as pointed out. Finally, for both Goodell’s sign and Chadwick’s sign, and direct inguinal and indirect inguinal hernias, you have clearly provided a brief definition of each, bringing out a clear difference. Generally, the paper has been well constructed, with adequate information answering each question in both parts of the assignment.

References

Lin, T. C., Zeng, B. Y., Chen, Y. W., Wu, M. N., Chen, T. Y., Lin, P. Y., … & Hsu, C. Y. (2018). Cerebrovascular accident risk in a population with periodic limb movements of sleep: a preliminary meta-analysis. Cerebrovascular Diseases, 46, 1-9. https://doi.org/10.1159/000490065

Wall, L. L. (2021). The Sims position and the Sims vaginal speculum were re-examined. International Urogynecology Journal, 32(10), 2595-2601. https://doi.org/10.1007/s00192-021-04966-w

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This discussion contains two parts:

 Part 1: Neurological 

List the risk factors for cerebrovascular accidents and why?

What cultures are at higher risk and why?

Describe the 0 to 4+ scale for scoring deep tendon reflexes.

What would you expect to find in a patient with diabetic peripheral neuropathy?

Share any experience you have encountered and elaborate.

Part 2: Genitalia 

Identify and explain positions other than the lithotomy in which a pelvic examination can be performed.

Why are women at a higher risk of UTI than males?

What would you educate to decrease the risk of UTI?

Summarize the pros and cons of newborn circumcision.

Describe the following signs on a female examination:

Chadwick

Goodell

Name the characteristics of the following type of hernias:

Indirect inguinal

Direct inguinal

500 words, formatted and cited in proper current APA style with support from at least 2 academic sources.