Respond to the 2 following posts separately with separate reference lists.

Respond to the 2 following posts separately with separate reference lists.
1. Migraines are considered a common primary headache, and primary headaches fall under three categories: migraine, tension-type and cluster headaches. Migraines can present with an aura or without it but in definition a migraine is the result of a wave of self propagating neuronal and glial depolarization that spreads across the cerebral cortex (Dlugasch & Story 2019). This cortical spreading depression causes the aura of migraine, activating the afferent trigeminal nerves, leading to inflammation around the meninges and the resulting headache. Prodrome manifestations can occur 1-2 days before the migraine starts and are often symptoms like irritability, euphoria, depression, yawning, food cravings and constipation. Following the prodrome, the aura presents with vision or sensory sensitivity.
Tension headache is another common primary headache most commonly in females usually related to stress and or dehydration and lasting 30 mins to a 1 week. Also called stress headaches, tension headaches occur as a result of hypersensitivity of nerve fibers and are usually infrequent (once a month) but if frequent or episodic, they can lead to migraines. On the other hand, cluster headaches are most common in males, and are thought to occur due to activation of the hypothalamus and triggering of the trigeminal nerve thus causing excruciating unilateral orbital pain ( Dlugasch & Story 2019). Although the overall reason for cluster headaches is not well understood, smoking and alcohol are considered risk factors.
Once again, migraine headaches is the most common type of headache for which affected individuals seek medical care, its cortical spreading depression causes the aura of the migraine although migraines without an aura are the most common. There is also trigeminal nerve stimulation with the release of several vasoactive peptides such as substance P, and neurokinin A, leading to neurogenic inflammation and neuronal sensitization. Tension headaches just like migraines consist of hypersensitivity of nerve fibers but do not come with prodrome symptoms or auras (Dlugasch & Story. 2019).
References:
Dlugasch, L., & Story, L. (2019). Applied pathophysiology for the advanced practice nurse (1st ed.). Jones & Bartlett Learning.
2. Parkinson’s disease (PD) is a neurodegenerative illness resulting in the loss of neurons in
the substantia nigra and depletion of the neurotransmitter dopamine in the brain. Dlugasch &
Story (2021) mentioned that according to the NIH, about 50,000 people in the United States are
diagnosed with Parkinson’s disease each year. Parkinson’s disease occurs in people 45 to 70
years of age with a peak at 60, as in the case presented.
Bradykinesia is a generalized slowness of body motion resulting in difficulty initiating or
continuing a movement. Examples are difficulties in getting out of a chair, walking, and standing
from a sitting position. Also, a loss of dexterity is noted, such as difficulty in buttoning clothes,
tying shoelaces, and typing. Thus, a person with PD manifests with a shuffling gait (quick short
steps) as an impulse compensating for a gait freeze.
The postural instability of this patient results from the involvement of the basal ganglia of
the brain or extrapyramidal system responsible for body posture, voluntary motor movement, and
cognitive and emotional functions. The extrapyramidal tract originates in the brain stem and
carries motor fibers to the spinal cord. This postural instability leads to an easy loss of balance in
PD patients leading to falls. In contrast, the pyramidal tract starts in the cerebral cortex, carries
motor fibers to the brain stem and spinal cord, and is responsible for the voluntary control of the
face and body muscles.
Transmission of signals in the nervous system uses myelinated (with myelin sheath)
nerve fibers that allow impulses to “jump” from node to node, thus greatly accelerating the signal
transmission rate. In contrast, unmyelinated nerve fibers do not contain myelin sheath; therefore,
the conduction of signals is slower. Myelinization is critical in neurodegenerative diseases, like
Parkinson’s disease, as manifestations are due to alteration of the myelin composition.
Reference:
Dlugasch, L., & Story, L. (2021). Applied Pathophysiology for the Advanced Practice Nurse.
Jones & Bartlett Learning. Kindle Edition.

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