Nervous System Case Study 6*


A 42-year-old male complained of severe, lower (lumbosacral) back pain which radiated to his left buttock, leg, and foot. This dull pain was intensified during coughing, sneezing, and bending. The patient was able to walk but sitting for extended periods exacerbated the pain down the leg.  He also experienced muscle spasms in the left leg. There was mild sensory and motor loss in the left buttock and leg as well. The patient had taken over-the-counter pain medications but with little effect. 


1.) Describe how nerve impulses are transmitted from neuron to neuron.


2.) What is myelin?  What is its function?  Explain.


3.) What is the disorder of this individual?  How did you determine your diagnosis?


4.) What major nerve is involved? From what spinal cord levels does this nerve emerge?


5.) Define dermatome and described the dermatomes involved for this individual.


6.) Why did coughing, sneezing, and bending intensify the dull pain?


7.) Why was there both mild sensory and motor loss in the left buttock and leg?


8.) Could useful information be obtained from an x-ray?  Explain.


9.) What treatments may be of benefit to this individual?


*adapted from “Case Studies in Human Physiology” Donna Van Wynsberghe and Gregory M. Cooley  3rd edition McGraw-Hill Publ.