Please enable JavaScript.
Coggle requires JavaScript to display documents.
23 year old patient is demonstrating severe face and muscle spasms.…
23 year old patient is demonstrating severe face and muscle spasms. Patient has fresh tattoo obtained from a "sketchy" tattoo parlor. Blood results show he is infected with Clostridium Tetani, a bacterium that is transmitted by dirty needles. Patient was never vaccinated against this bacterium.
Upstream Causes
Direct Cause - The direct cause is due to the tattoo parlors dirty needles used when given the tattoo, which was contaminated with Clostridium Tetani.
Indirect Cause - Possible indirect cause is lack of choosing a sterile tattoo parlor and not being vaccinated against the bacterium.
Background Information
-
The Nervous system receives, integrates, and responds to information.
Sensory Input - Nervous system uses sensory receptors to monitor changes occurring both inside and outside the body. Gathered information is called sensory input.
-
Motor output - the nervous system activates effector organs, the muscles and glands, to cause a response.
CNS PNS SNS ANS
CNS - includes brain and spinal cord, integrative and control centers.
PNS - Cranial nerves and spinal nerves, communication lines between the CNS and the rest of the body.
SNS - Somatic (voluntary) motor nerve fibers, Conducts impulses from CNS to skeletal muscles
ANS - visceral (involuntary) motor nerve fibers, Conducts impulses from the CNS to effectors (muscles and glands)
-
-
-
Temporal or wave, summation
two identical stimuli are delivered to a muscle in rapid succession, the second twitch will be stronger
contributes to contractile force, creates smooth muscle, and continuous muscle contractions by rapidly stimulating specific number of muscle cells
Incomplete tetanus
the degree of wave summation becoming greater and greater , progressing to sustain a quivering contraction
complete tetanus
Evidence of muscle relaxation disappears and contractions fuse into smooth, sustained contraction plateau
Clostridum Tetani
is an obligate anaerobic bacteria whose spores produce two distinct toxins, tetanolysin, which causes local tissue destruction, and tetanospasmin, which causes clinical tetanus.
Tetanus neurotoxin binds to the presynaptic membrane of the neuromuscular junction, is internalized and transported to the spinal cord.
The spastic paralysis induced by the toxin is due to the blockade of neurotransmitter release from spinal inhibitory interneurons.
Widespread intoxication through the systemic circulation results in continuous involuntary muscle contraction of clinical generalized tetanus, whereas local internalization and transport of toxin can result in a localized state of muscle hyperexcitability.
-
-
-
Downstream effects
Effect 1
tetanus toxin is transferred to inhibitory presynaptic terminals surrounding motor neurons. The toxin then destroys a vesicular synaptic membrane protein
This will result in inactivation of inhibitory neurotransmission that normally suppresses motor neuron and muscle activity
Effect 2
Because inhibitory neurotransmission is inactivated. suppression of motor neuron and muscle activity will not occur
This will cause the patients muscles to experience enhanced excitability and activation of the affected motor neurons.
Effect 3
Patient is now experiencing a widespread of the toxin. Leading to enhanced excitability and activation of the affected motor neurons
Patient possibly received the bacterium via needle onto is arm, the toxin is considered to be in a localized state which has resulted in muscle hyperexcitabillity.
Effect 4
Because the toxin is starting to cause muscle spasms in the arm this will result to a widespread intoxication through the circulatory system.
Patient will then begin to experience continuous involuntary muscle contractions such as muscle spasms of the face leading to inability to speak.