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)

how does this affect the neuromuscular junction

enhances the excitability and activation of affected motor neurons.

continuous involuntary muscle contraction

inactivation of inhibitory neurotransmission that normally suppresses motor neuron and muscle activity

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

cardiovascular system

muscular system

immune/lymphatic system

lymphatic vessels

lymph nodes

heart

blood vessels

blood

skeletal muscles

smooth muscles

cardiac muscles

brain

spinal cord

nerves

Physiology

organ systems affected

immune/lymphatic system

cardiovascular system

muscular system

nervous system

lymph nodes

filter lymph

builds immune response

lymphatic vessels

transports lymp

circulates plasma

heart

pumps blood

blood

transports oxygen to body

blood vessels

transports blood throughout body

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

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

structure of a neuron

fullsizeoutput_107b

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

cell body

contains and protects most of organelles in neuron

contain synaptic vesicles; send signals out and to other neurons

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

types of summation

temporal summation

spatial summation

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 (EPSPs)

inhibitory postsynaptic potential (IPSPs)

includes sodium ion channels

includes potassium ion channels

includes chloride ion channels

postsynaptic potentials

excitatory postsynaptic potential

changes that depolarize the membrane

inhibitory postsynaptic potential

changes that hyper-polarize the membrane

uses sodium ion channels to make the cell more positive

uses potassium and chloride ion channels to make the cell more negative

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

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

inactivation of inhibitory neurotransmission that normally suppresses motor neuron and muscle activity

widespread intoxication causes continuous involuntary muscle contraction

local internalization can result in a localized state of muscle hyperexcitability.

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 system

skeletal muscles

weaken over time

bones

prone to break because of lack of muscular strength

skeletal system

bones

skeletal system

bones

maintain structure of the body

protect the organs

hospital-acquired infections

lymphatic system

lymph nodes

spleen

spleen

filters blood

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

respiratory system

diaphragm

lungs

respiratory system

lungs

diaphragm

gas exchange

contracts and relaxes for inhalation/exhalation

breathing problems

muscular system

respiratory system

muscles

weaken or spasm causing issues with breathing

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

muscular system

brain/nerves

muscles

the toxin affects the neurons making them send out faulty messages to the muscular system

stiffen due to messages being sent

changes in blood pressure and heart rate

cardiovascular system

heart

muscular system

cardiac muscle

the cardiac muscles help pump blood through the heart, so if there are spasms/stiffness that can become difficult

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