Surgical Procedure

Dr. Ann Gina has a patient presenting with family complaints of cognitive dysfunction and left upper hemiparesis.

Dr. Gina gives the patient, Mrs. Ima Hart, a full physical examination and cognitive screening. She records the following notes in her chart:

The patient underwent a CABG in November, 2015. She falls asleep easily and sleeps through the night.

The increased difficulty remembering names, concentrating, and shortened attention span that she presented with following CABG surgery has not cleared; rather, the patient and the family have noticed an increase and persistence in the cognitive dysfunction.

The tingling and numbness in her left shoulder and hand also persist. Both the patient and her family noted that these symptoms were present following surgery and have remained.

Her family wants her license revoked due to the memory, concentration, and attention issues.

Vitals: Wt. 160 P56 BP 112/72 R 16 Temp. 97.3

Objective:

Chest: Clear to percussion and auscultation;

Slow but steady gait;

Sense: Normal vibratory sense in lower extremities; reduced sensation evident in left upper extremity;

Motor: Symmetric strength and tone with the exception of the left shoulder and hand. Pain in left shoulder and arm during ROM.

Cerebral: Mild confusion and decreased memory.

Your Challenge:

  1. What does Dr. Ann Gina attribute the aforementioned cognitive complaints to? Hint: Think about the surgical procedure and the bypass machine.
  2. What would have caused her left upper extremity weakness and sensation? Hint: Think about the surgical procedure and what neuropathy could occur.
  3. What further testing could be done?
  4. What treatment if any would be prescribed?

Be sure to include at least 2 links that support your findings. 

At the end of your initial post, select 10 medical terms related to this body system, dissect them into their component parts, and provide their meanings. 🙂

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