A 23 y/o patient has come in to the emergency room with severe face and arm spasms. He is unable to speak so his brother explains that he has tattoos and a fresh one of his shoulder. His brother said the parlor was sketchy and they decided to run some blood tests. After the blood tests, the results showed that he has Clostridium Tetani a bacterium found in soil that can be transmitted through dirty needles. It produces a toxin that affects neurons and their ability to release neurotransmitters. the patient was never vaccinated from the bacterium.

Background Info

Upstream Effects

Downstream Effects

Systems Involved

Nervous System

Muscular System

Circulatory System

Integumentary System

Difference between Twitch, Summation, and Tetany

Summation: Produces smooth, continuous contractions that add up

Tetany: involuntary contraction of muscles

Twitch: simplistic contraction in response to a single action potential from motor neuron

Immune System

Steps to Exocytosis

Substance being ejected is enclosed in secretory vesicle

Some substances exocytosed: hormones, neurotransmitters, muscus, cellular wastes, etc.

Process where large substance is rejected from cell, usually activated by cell surface signals

Physiology

Neurotransmitters involved

Acetylcholine: a compound which occurs throughout the nervous system, in which it functions as a neurotransmitter.

Chain of events at the NMJ

  1. Calcium entry causes release of ACh neurotransmitter into synaptic cleft
  1. ACh diffuses across to ACh receptors (Na+ chemical gates) on sarcolemma
  1. Voltage-gated calcium channels open, calcium enters motor neuron
  1. ACh bindin receptors, opens gates, allowing Na+ to enter resulting in ending plate potential
  1. AP arrives at axon terminal
  1. Acetylcholinesterase degrades ACh

Clostridium Tetani

If toxin remains in the blood stream, you could experience:

Stiffness

Breathing difficulty

Facial weakness

nausea

Paralysis

botulism and tetany

If you leave this deadly condition untreated you could experience:

Problems with your respiratory system

Trouble breathing leading to death or suffocation

What could cause the patient to have spasms instead of tetany or flaccid paralysis?

Indirect Causes

1.Clostridium Tetani spreads the the central nervous system

  1. A toxin called tetanospasmin is produced
  1. Toxin blocks the nerve signals from your spinal cord to your muscles causing you to have spasms

Getting a tattoo with a dirty needle

Tetanospasmin can interfere with motor neurons causing tetanus