Molly Moony Case Study

Marcy is a 34-year-old female here today with her daughter for a followup regarding her chest pain and GERD. The patient tells me following her last evaluation on July 1st, she did take the Nexium as was recommended. She was taking 40 mg for about a month. She said that worked very well. Her symptoms lessened and ultimately resolved. However, when she ran out of the Nexium, the symptoms are back again. She feels a pain in the lower sternum area, as well as in the upper epigastric area and was relieved when it went away with the Nexium. She has not continued to take it and wonders what she should do next. She is eating and drinking normally. She did try to cut back on dairy as she initially thought that might be related, but found that was not the case and now has that back in her diet. She is up three pounds since I last saw her and is at her highest weight that I have in the office. She is having no nausea, no vomiting. No early satiety. There is no diarrhea. No constipation. No blood in the stool. No melena. She wonders what the next step should be. She does tell me that when she was talking with her family, her mother has had an ulcer and her sister has been diagnosed with "stress ulcers" in the past.

The human body is made up of 206 bones that we rely on everyday. They are extremely vital! Also bones are responsible for producing red blood cells in the bone marrow. With that being said bones are a huge contributor to the overall health of each individual. Unfortunately bones also get diseases just like any other body system. The diseases of the bones can range from osteoporosis, bone cancer and many other diseases.

Bones serve five main purposes: to form a sturdy framework for the body, to protect delicate structures, to work as levers with attached muscles to produce movement, to store calcium salts, and to produce blood cells. Long bones are hard and dense, which provides strength and structure. Long bones contain both yellow and red bone marrow, both of which are vital for blood cell production. They also allow muscles to work to their maximum potential. Their size enables them to protect delicate structures. Its size enables it to assist the body. With age, the human body experiences a loss of calcium salts. The bones become weaker and it becomes more difficult to move. Humans can also experience a loss of balance.

Periosteum is a dense layer of connective tissue. It is very thin and is on the outside of the bone. It plays a vital role in growth and repair. It is divided into two sections, an outer layer and inner layer. The inner layer contains osteoblasts which helps with the increase of the width and length of other bone types. [13]

Another function of bones is the storage of certain minerals. Calcium and phosphorus are among the main minerals being stored. The importance of this storage "device" helps to regulate mineral balance in the bloodstream. When the fluctuation of minerals is high, these minerals are stored in bone; when it is low it will be withdrawn from the bone

The function of the skeletal system is spilt into three different sections: Mechanical, protective and metabolic. Mechanical is basically support and movement; protective is protection of the bonds; tissue and metabolic is mineral storage, which is where bones work as a reservoir for calcium and phosphorus, which are essential minerals for numerous cellular activities throughout the body. It is also energy storage; fats stored in adipose cells of the yellow marrow serve as an energy reservoir. The whole package of bones, cartilage, ligaments and tendons that make up the human skeletal system account for about 20 percent of our body weight. Muscles are vital because they hold parts of the skeleton together: these parts are joints. The muscle will grow around the joint, holding it in place and making it

Bones are the organs that hold the framework of the human body. Not only do they keep our bodies erect, they also house and protect organs, provide mineral and triglyceride storage, allow movement, produce hormones and blood cell formation (hematopoiesis). Cells of bone tissue contains major cells that build bone from matrix secretion (osteoblast) and breaks down bone (osteoclast). Both cells are a vital factor in bone growth, healing, and remodeling. Other important cells include osteogenic cells, osteocytes, and bone lining cells. Osteogenic cells mitotically divide and later form into osteoblasts. Osteocytes are aged bone cells that no longer divide, but do perform as stress receptors and respond to mechanical weight and impact by communicating with osteoclasts and osteoblasts to promote bone remolding. Finally, bone-lining cells work cohesively with osteocytes to maintain bone matrix.

There are two types of bone tissue: cancellous bone and cortical bone, whereas there are four main types of bone cells (Table 1). Bones serve multiple functions; mainly protecting various organs within the body and assisting mobility. Due to their rigidity, they support and maintain the shape of the body. Also, bones are essential in hematopoiesis and for physiological processes. Their calcium and phosphate containing crystals regulate mineral homeostasis and metabolic processes (Webb and Tricker, 2000).

It had density of 1.1 kg/m3 and shore A hardness of 12, the same properties as the artificial flesh used in previous hip protector testing (Derler et al., 2005). Its thickness of 20 mm corresponds to the typical thickness of soft tissue found over the most prominent part of the greater trochanter in female hip fracture patients (Lauritzen and Askegaard, 1992). The artificial flesh (and the fabric specimen size) was 5 cm × 5 cm, derived from the 5 cm diameter of the average female femur head (Derler et al., 2005, Mall et al., 2000) and the vulnerable area that projects over the femur (Choi et al., 2010).

Hyaline cartilage: covers the end of the bone, smooth surface stops the bones and absorbs shock.

Bones are dynamic organs, growing and continually remodeling throughout life. The responsible for the make-up of the skeleton are bone cells which are found within the bone tissue. Each cell type has a unique function and is found in different locations in bones, They are called osteoblast,osteocytes,and osteoclast.

The human skeleton has 6 main functions that provide the body with good health. They are as follows:

Bones function in our body by providing structural support, protection, attachment sites for muscles, mineral storage, fat storage, and even involved in the formation of blood cells. The two types of bone in our body are compact bone (which is found forming the outer layer of bones for protection and support) and spongy bone (which is composed of an unusual lattice of slender columns of bone termed trabeculae and in the spaces of the trabeculae red bone marrow can be found). Bones of made of three cells, osteoclasts which breaks down bone tissue, osteoblasts which secrete the matrix for bone creation osteocytes which are mature osteoblasts that have become stuck in the bone matrix. An important cycle that bone goes through, Bone Remodeling, is the process of old bone tissue being replaced by new bone tissue. This process involves 5 steps Activation, Resorption, Reversal, Formation, and Quiescence. The activation step involves the activation of stimulating of pre-osteoclasts and mature into active osteoclasts, the resorption phase in which the osteoclasts begin to digest old bone, the reversal stage involves the ending of resorption, formation then begins with osteoblasts forming a new bone matrix, and finally quiescence is when the osteoblasts become resting bone which line the cells on the freshly constructed bone surface.

Bone serves the organism at multiple levels: As a system, bones permit the organism to locomote effectively and to maintain posture by bearing loads without deformation, by providing rigid attachment sites for muscles and acting as a system of levers to amplify small movements. As an organ, bones protect the viscera and house the hemopoietic tissue (red marrow). As a tissue, bones serve as a reservoir of readily mobilizable calcium, an

Bones support, move, and protect the body; they also give us our features. But without bone cells we would have no bones. Bone cells are the living units that make up your bones and keep them functioning. Bone cells have two major roles, which are the production of new bones and resorption or destruction of old bone. They also carry out other small roles. There are four main types of bone cells: Osteogenic, which are bone cells that respond to traumas, osteoblasts, which form bone matrix around themselves by laying down collagen fibers and depositing the hard mineral material, osteocytes, which respond to the bodies need for lower or higher circulating level of minerals contained in the bone and osteoclasts, which break down bone tissue.