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A 23 year old male patient demonstrating severe face and arm muscle spasms
A 23 year old male patient demonstrating severe face and arm muscle spasms
Tattoo from potentially unsanitary needle
DX - Clostridium tetani,
patient is unvaccinated against Clostridium tetani,
Clostridium tetani produces a
toxin that affects neurons and their ability to release neurotransmitters
causes over stimulation of muscles
form of spastic paralysis
Clostridium tetani blocks release of inhibitory nuerotransmitter in spinal cord
results in over stimulation of muscles
progresses to lock jaw (flexed rigidity of the jaws
progresses to trunk/limb muscles spasms
Fever, sweating
Shortness of breath
Change in blood pressure
Difficulty swallowing
usually results in death due to respiratory failure
Background Information on Patient with Tetanus
Systems Affected
Nervous System
Muscular System
Integumentary System
Respiratory System
Events at the Nueromuscular Junction
AP arrives at axon terminal
voltage-gated calcium channels open, calcium enters motor neuron
Calcium entry causes release of ACh neurotransmitter into synaptic cleft
ACh diffuses across to ACh receptors (Na+ chemical gates) on sarcolemma
ACh binding to receptors , opens gates allowing Na+ to enter resulting in end plate potential
Acetylcholinesterase degrades ACh
Neurotransmitters involved in triggering muscle contraction
Acetylcholine
AP crosses from neuron to muscle cell
steps for muscle contraction
Events at Nueromuscular Junction
Muscle fiber excitation
Excitation-Contraction coupling
Cross Bridge cycling
Process of Exocytosis
The membrane bound vesicle migrates to the plasma membrane
Proteins at the vesicle surface bind with plasma membrane proteins
the vesicle and the plasma membrane fuse causing a pore to open
Vesicle contents are released to the cell exterior
Muscle Movements
Muscle Twitch
Simplest contraction simple action potential from motor neuron
3 phases
latent period: excitation/contraction coupling
Period of contraction - cross bridge formation
Period of relaxation - Ca2+ rentry into SR
Wave (Summation) - 2 muscle stimuli are are received by a muscle in rapid succession
smooth continuous contractions
Unfused (incomplete) tetanus
increased in stimulus frequency causes muscle to progress to sustained quivering contraction