Question

Mr. Banks, a 63 year old male, was admitted to the local hospital for symptoms that included fluid-filled vesicles on one side of his chest and waist. They are all painful and very itchy. What is his likely diagnosis? What other clinical findings may suggest this diagnosis? Why is Mr. Banks experiencing this disease? Describe what a dermatome and dermatome map is and how they can be useful for Mr. Banks. Name 3 other clinical findings or procedures that a dermatome map can be useful for. Lastly, name and describe what pathways and dermatomes may be activated with Mr. Banks' clinical condition.,

Answer 1

1. diagnosis: herpes zoster( shingles)
2. clinical findings suggest the diagnosis include:

• Pain, burning, numbness or tingling,itching
• Sensitivity to touch
• A red rash that begins a few days after the pain
• Fluid-filled blisters that break open and crust over

3. herpes zoster occurs in person who had chicken pox several years earlier . the virus remaining latent in the sensory ganglia , may leak out at times but is usually held at check by immunity. in this case Mr banks immunity has waned, the virus get reactivated and travel along the sensory nerve to producelesons. the rash is unilateral and confined to areas supplied by the specific sensory ganglion. the most common sites are areas innervated by spinal cord segments D3 to L2 and the trigeminal nerve.

4. dermatome is an area of skin supplied by nerves from a single spinal root

dermatome map helps to identify which nerve root is affected by Symptoms that follow a dermatome (e.g. like pain or a rash)

People with herpes zoster most commonly have a rash in one or two adjacent dermatomes (localized zoster). The rash most commonly appears on the trunk along a thoracic dermatome. The rash does not usually cross the body’s midline.

5.Dermatomes maps helps the medical professionals to assess and diagnosis the exact level of spinal cord or nerve injury in a patient with spinal cord trauma.

They also are used by medical professionals in anesthesiology when epidural blocks are given to patients for pain.

6. in Mr banks condition the most common dermatomes invloved are those innervated by spinal cord segments D3 to L2 and the trigeminal nerve.