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The patient has contracted Clostridium tetani from a dirty tattoo needle…
The patient has contracted Clostridium tetani from a dirty tattoo needle
direct cause
what happens in the neuromuscular junction
initially bound to the presynaptic terminals
transported by motor neurons to spinal cord
toxin is then transferred to inhibitory presynaptic terminals surrounding those motor neurons
The toxin destroys a vesicular synaptic membrane protein (VAMP, or synaptobrevin)
inactivation of inhibitory neurotransmission that normally suppresses motor neuron and muscle activity
how does this affect the neuromuscular junction
enhances the excitability and activation of affected motor neurons.
continuous involuntary muscle contraction
Indirect casue
the patient got tattooed with a dirty needle
the patient did not receive a vaccine against clostridium tetani
Background Anatomy and Physiology
Anatomy
Organ systems affected
nervous system
brain
spinal cord
nerves
cardiovascular system
heart
blood vessels
blood
muscular system
skeletal muscles
smooth muscles
cardiac muscles
immune/lymphatic system
lymphatic vessels
lymph nodes
spleen
skeletal system
bones
respiratory system
diaphragm
lungs
structure of a neuron
types of summation
temporal summation
spatial summation
postsynaptic potentials
excitatory postsynaptic potential (EPSPs)
includes sodium ion channels
inhibitory postsynaptic potential (IPSPs)
includes potassium ion channels
includes chloride ion channels
Clostridium tetani and what it affects in the neuromuscular junction
presynaptic terminals
motor neurons
spinal cord
inhibitory presynaptic terminals
vesicular synaptic membrane protein (VAMP)
muscles
Physiology
organ systems affected
immune/lymphatic system
lymph nodes
filter lymph
builds immune response
lymphatic vessels
transports lymp
circulates plasma
spleen
filters blood
cardiovascular system
heart
pumps blood
blood
transports oxygen to body
blood vessels
transports blood throughout body
muscular system
skeletal muscle
moves the body
pulls on tendons
smooth muscle
lines organs and helps them function in different ways
cardiac muscle
helps the heart pump blood
nervous system
brain
controls the body
spinal cord
relays messages to the brain
coordination
nerves
send impulses to the brain and spinal cord from the rest of the body
skeletal system
bones
maintain structure of the body
protect the organs
respiratory system
lungs
gas exchange
diaphragm
contracts and relaxes for inhalation/exhalation
function of neuron
axon
carries impulses away from the cell body
axon hillock
cone-shaped area where the axon leaves the cell body
axon terminals
contain synaptic vesicles; send signals out and to other neurons
cell body
contains and protects most of organelles in neuron
dendrites
receives incoming signals and conveys them to the cell body
nissl bodies
rough endoplasmic reticulum in the cytoplasm of neurons
nodes of ranvier
gaps between schwann cells on a neurons axon
myelin sheath
fatty layers that surround and electrically insulate the axon, speeding up nerve impulses
oligodendrocytes
cells that form myelin sheaths in the central nervous system
Schwann cells
cells that form myelin sheaths in the peripheral nervous system
Excitation-contraction coupling
step one: a neuron releases acetylcholine
step two: chemically gated sodium (Na+) channels open
step three: the membrane of a muscle fiber depolarizes
step four: the voltage-gated calcium (Ca2+) channels open
step five: calcium binds to troponin
step six: tropomyosin unblocks the myosin-binding sites on actin
step seven: myosin attaches to (and slides past) actin
step three and a half: a neurotransmitter is released
summation
neurons add messages together to push past the resting membrane potential
temporal summation
rapidly firing presynaptic neuron causes excitatory postsynaptic potentials (EPSPs) that are in close in time
spatial summation
more than one presynaptic neurons firing at the same time
EPSPs are generated at different locations on the neuron
postsynaptic potentials
excitatory postsynaptic potential
changes that depolarize the membrane
uses sodium ion channels to make the cell more positive
inhibitory postsynaptic potential
changes that hyper-polarize the membrane
uses potassium and chloride ion channels to make the cell more negative
Clostridium tetani and how it affects the neuromuscular junction
the tetanus toxin attaches to the presynaptic terminals
motor neurons then transport the toxin to the spinal cord
tetanus toxin is then transferred to inhibitory presynaptic terminals surrounding those motor neurons.
The toxin then destroys a vesicular synaptic membrane protein
the results of the toxin
enhanced excitability and activation of affected motor neurons
widespread intoxication causes continuous involuntary muscle contraction
local internalization can result in a localized state of muscle hyperexcitability.
inactivation of inhibitory neurotransmission that normally suppresses motor neuron and muscle activity
effects of tetanus on the body
uncontrolled/involuntary tightening of the vocal cords (laryngospasm)
muscular system
skeletal and smooth muscle
spasms of the vocal cord muscles
broken bones
muscular system
skeletal muscles
weaken over time
skeletal system
bones
prone to break because of lack of muscular strength
hospital-acquired infections
lymphatic system
lymph nodes
the lymph nodes can have a hard time fighting thee toxin and weaken the immune system
pulmonary embolism
cardiovascular system
blood vessels
the blood vessels can carry a blood clot from another part of the body and block the main artery in the lung
breathing problems
muscular system
muscles
weaken or spasm causing issues with breathing
respiratory system
diaphragm
can be paralyzed by the toxin and can not contract/relax for breathing
lungs
cannot gain oxygen from lack of contraction from the diaphragm
lockjaw
muscular system
muscles in the jaw
spasms of the jaw muscles that cause the jaw to remain tightly closed
general involuntary muscle spasms
muscular system
muscles
sudden, involuntary muscle contraction
painful muscle stiffness
nervous system
brain/nerves
the toxin affects the neurons making them send out faulty messages to the muscular system
muscular system
muscles
stiffen due to messages being sent
changes in blood pressure and heart rate
cardiovascular system
heart
the cardiac muscles help pump blood through the heart, so if there are spasms/stiffness that can become difficult
muscular system
cardiac muscle
spasms or weakens the cardiac muscle affecting the heart
fever and sweating
lymphatic system
lymph nodes
weakened; therefore infection is more common which cause fevers
NERVOUS SYSTEM
brain, spinal cord, and nerves
major system that is effected by the toxin and is/should be included in all complications because it is where the toxin originates
