23 male pt. brought into the ER by brother. Pt is demonstrating severe face and arm muscle spasms. Pt can hardly talk, trying to get info from the brother. I noted that Pt has many tattoos, including a fresh one on his shoulder. Brother says he got it done yesterday and the tattoo parlor was "sketchy." Ordered blood test, came back positive for Clostridium tetani. Pt has never been vaccinated against this bacteria.
Downstream
Respiratory
Lungs
Lung infection
Breathing in foreign materials
Aspiration
Pneumonia
Difficulty breathing
Death
Blockage of main artery of lung
Blood clot
Pulmonary embolism
Restricted blood flow
Decrease oxygen level
Difficulty breathing
Death
Spasms due to vocal cords
laryngospasms
Struggling to inhale
Airway is blocked
Difficulty breathing & talking& swallowing
Spasms in muscles that control breathing
Bronchospasms
Constriction of muscles in bronchioles
Decreased airflow
Difficulty breathing
Death
Cardiovascular
Heart
Increase blood pressure
Death
Increase heart rate
Bradyarrhythias
Cardiac arrest
Death
Lymphatic
Lymphatic vessels
Enters the lymphatic vessels through deep wounds or contaminated needles.
Nervous
Muscular system
Skeletal System
Central Nervous System
Brain
Spinal Cord
Seizures
Blocks nerve signal
Spinal cord spasms
Causing infection in the blood
Death
Masseter muscle
Severe muscle spasms
"Lockjaw"
Skeletal muscle
Severe muscle spasms
Tear muscles
Opisthotonos
Difficulty talking
Humerous, radius, and ulna
Muscle Spasm
Swelling
Death
Fracture
Upstream
Direct: Tetanus neurotoxin binds to the presynaptic membrane of the neuromuscular junction. This toxin is a poison that blocks neurotransmitter release from spinal cord to muscles, which can lead to severe muscle spasms.
Indirect: Pt got tattoo at a "sketchy" tattoo parlor.
Indirect: Pt was not vaccinated against the bacterium.
Background
Organ systems
Respiratory system
Lungs
Pleural cavity
Thoracic cavity
Cardiovascular system
Heart
Pericardium
Lymphatic system
Lymphatic vessels
Nervous system
Central Nervous System
Brain
Spinal cord
Skull
Posterior Region of body
Cervical Spine
Thoracic Spine
Lumbar spine
Spaces between cells throughout the body
Muscular system
Masseter muscles
Skeletal muscles
Posterior region
Jaw muscle
Jaw
Paralysis
Lumbar spine
Thoracic spine
Neurons
Unipolar nervous
Bipolar neurons
Multipolar neurons
Single process
Divides two branches
One branch to CNS
Periphery branch
end of Spinal cord
Skin
Joints
Muscles
internal organs
Two process
Single axons
Single dendrites
Sense organs
Retina of the eye
Olfactory cells
Multi process
One axon
Many dendrites
In CNS
Brain
Spinal card
Face
Thoracic cavity
Physiology
Organ system
Respiratory system
Lungs
Breathing
Cardiovascular
Heart
Blood circulation
Lymphatic system
Lymphatic vessels
Blood production, maintenance of fluid balance, and defense against disease
Nervous system
Spinal cord
Brain
Provide structural support and balance
Communication between and coordination of all the body systems
Muscular system
Skeletal muscle
Masseter muscle
Spine
Spine
Supports body, facilitates movement, & protects internal organs.
Jaw
Muscle that helps to pull the lower jaw upward, which causes the jaws to close while chewing.
Skeletal system
Humerous, Radius, Ulna
Movement
Support
Chewing
Neurons
Unipolar
Bipolar
Multipolar
Sensory neuron
Afferent neuron
Collects information from receptors
Sends info to CNS
Sends info Periphery branch
Sensory neuron
Interneurons
Process the information & predict the right response.
CNS
Help react to external stimuli.
Motor neuron
Efferent neuron
Send directions for the right response.
Involuntary & voluntary movement
Presynaptic neuron
Postsynaptic neuron
Presynaptic neuron
Presynaptic neuron
Excitatory postsynaptic potentials
Inhibitory postsynaptic potentials
Depolarization of postsynaptic membrane potential
Neurotransmitters opens chemically gated ion channels
Na+ enters cell & K+ outside cell
Positively charged ions into the postsynaptic cell
Allows to send message
Fire action potential
Hyperpolarize of postsynaptic membrane potential
Negatively charged ion into the postsynaptic cell
Neurotransmitter GABA opens chemically gated ion channels
Cl- ion inside the cell or K+ ion outside the cell
Don't Fire
No action potential
ESPSs brings neuron closer to threshold s
IPSPs drive neuron away from threshold (goes down)
Clostridium Tetani
Tetanospasmin
Binds to presynaptic terminal
Retrograde axonal transport to CNS inhibitory interneurons
Transcytosis from axon to inhibitory interneurons
Blockage of neurotransmitters GABA ( inhibit motor neurons)
Blocking GABA causes violent spams
Excitatory transmitters are consistently being released.
Excitation- Contraction Coupling
An action potential arrives at the axon terminal and voltage-gated Ca2+ channels open causing an influx of Ca2+ into the axon terminal.
The influx of Ca2+ into axon terminal causes the exocytosis of ACh into the synaptic cleft.
ACh then binds to receptors on the motor end plate (of muscle cell). If the end plate reaches threshold, an action potential is propagated on the sarcolemma and down the T tubules
Causes depolarization of the T tubules and causes the release of Ca2+ from the terminal cisternae of the sarcoplasmic reticulum.
Movement of Ca2+ into the muscle cell causes Ca2+ to bind to troponin, which moves tropomyosin, exposing the myosin-binding active sites on G actin.
Myosin heads then form cross bridges to the G actin and immediately pivot toward the M line causing chemically activated muscle contraction.
ATP binds to myosin heads, causing them to release muscle contraction and recock.
Summation
Temporal summation
Spatial summation
One presynaptic neurone releases neurotransmitter many times over a period of time.
Higher the frequency of the action potential the more quickly the threshold may be exceeded.
Multiple presynaptic neurones together release enough neurotransmitter (ACh) to exceed the threshold of the postsynaptic neuron.
Threshold may be exceeded and an action potential generated.
Summation brings the axon's initial segment to threshold and AP fires.
Pain
Paralysis
Humerous, radius and ulna
Upper arm
Lower arm
Spine
The temporal summation occurs when the presynaptic action potentials occur in quick succession.
The time frame is dependent upon the passive properties of the membrane, specifically the time constant.
A single action potential in sensory neuron 1 produces a 1-mV EPSP in the motor neuron
Spatial summation in nerve cells occurs because of the space constant, the ability of a charge produced in one region of the cell to spread to other regions of the cell.