a 23 year old man is brought into the ER wtih severe face and arm muscle…
a 23 year old man is brought into the ER wtih severe face and arm muscle spasms by his brother. The patient can hardly speak he is in so much pain. We learn from the brother that the patient has multiple tattoos including a fresh one he got done yesterday at a "shady" tattoo parlor. Lab tests are ordered, and when the test results return, we found out he has been infected by Clostidium Tetani, a bacterial infection that stems from dirt getting into an open wound. The brother wants to know why his brother is in so much pain.
Clostridium tetani is an anaerobic bacteria who's spores produce 2 distinct toxins- tetanolysin, which causes local tissue destruction, and tetanospasmin, which causes clinical tetanus.
if the nuerotoxin deposits itself into a wound, the nuerotoxin interferes with nerves that control muscle movement. The can cause severe muscle spasms, serious breathing difficulties and could ultimately be fatal.
Our patient could have gotten some dirt in any old or new wound he might of had, all we know is that the bacterial infection was brought on by dirt. Although the leading cause was the shady tattoo parlor our patient visited earlier.
This infection can be highly fatal considering that the bacteria confuses muscle contractions at the nueromuscular junction, causing difficulties breathing, pumping blood throughout the body and regulating life sustaining functions.
Other symptoms from this infection include: Jaw cramping, muscle spasms in the stomach, trouble swallowing, painful muscle stiffness, jerking or staring seizures, headache, fever and sweating, changes in blood pressure and increased heart rate.
The difference between twitch, summation and tetany.
Twitch summation or treppe is the addition of a second twitch, resulting in greater tension, and it results from stimulating the muscle before it has a chance to relax completely
Tetanus is prolonged contraction without relaxation and results from repeating stimulation before the muscle has a chance to relax at all.
Twitching can occur after physical activity because lactic acid accumulates in the muscles used during exercise. It most often affects the arms, legs, and back. Muscle twitches caused by stress and anxiety are often called “nervous ticks.” They can affect any muscle in the body
Major Systems involved with this case
The nervous system is obviously effected in this situation by the infection, blocking the neuromuscular junction and causing uncontrollable muscles throughout the body.
The heart and veins are also effected by this as well, causing stress and increased heart rate.
The gastrointestinal tract is effected as well, being the result of severe stomach muscle cramps and trouble swallowing.
Lastly the respiratory system is effected, causing slowed or almost completely stopped breathing.
Steps involved in exocytosis .
Exocytosis is important for chemical signal messaging and cell to cell communication.
Step 1. Vesicles containing molecules are transported from within the cell to the cell membrane.
Step 2. The vesicle membrane attaches to the cell membrane.
Step 3. The vesicle membrane attaches to the cell membrane.
Neuromuscular Junction Chain of events.
The action potential arrives at the axon terminal.
Voltage-gated calcium channels open, calcium enters motor nueron.
Calcium entry causes release of ACh neurotransmitter into synaptic cleft.
ACh diffuses across to ACh receptors (sodium chemical gates on sarcolemma)
ACh binding to receptors, opens gates, allowing sodium to enter resulting in an end plate potential.
Acetylcholinesterase degrades ACh.
Neurotransmitters involved in triggering muscle contraction.
Skeletal muscle tissue is composed of cells called muscle fibers. When the nervous system signal reaches the neuromuscular junction a chemical message is released by the motor neuron. The chemical message, a neurotransmitter called acetylcholine, binds to receptors on the outside of the muscle fiber
Calcium is released by the sarcoplasmicrecticulum into the t tubules causing chemical gated channels to open.