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A 23-year old male is dealing with severe face and arm muscle spasms due…

- - - - Stimuli that are received by sensory structures are communicated to the nervous system where that information is processed
    - - Produces a response eon the basis of the stimuli perceived by sensory structures
    - - Reciving information about the environment to gain input about what is occurring on the inside and outside of the body
  - - - Peristalsis
      - Pump blood
      - Spincters
    - - Move Skin (facial muscles)
      - Move skeleton
  - - - Release of potassium causes depolarization
      - Action potential occurs as a wave of depolarization and depolarization down sarcolemma
      - Slower voltage-gated potassium channels also open, releasing potassium
      - Action potential travels through t-tubules and triggers voltage gated calcium channels
      - Voltage gated sodium channels allow sodium influx which open more voltage gated sodium channels
      - Sodium potassium pumps quickly restore sodium and potassium gradients
    - - Myosin binds to actin forming cross-bridge
      - ADP and Pi are released, myosin head bends
      - Tropomyosin exposes active sites on actin
      - Bending of myosin pulls actin toward M-line; power stroke
      - Troponin changes shape, moves topomyosin
      - ATP binds to myosin, causing it to release actin
      - Calcium released into sarcoplasm bind to troponin
      - Hydrolysis of ATP places myosin back in its ready position to repeat power stroke
    - - Influx of sodium depolarizes motor end plate
      - Adjacent voltage gated sodium channels open
      - Additional sodium crosses sarcolemma
    - - Many myosin heads pull on actin in ratcheting motions to draw actin toward the M-line
      - Once the actin is pulled toward the M-line, the sarcomere shortens
    - - Acetylcholine crosses synaptic cleft
      - Acetylcholine binds to chemically gated sodium channels and opens them
      - Influx of calcium triggers exocytosis of acetylcholine
      - Acetylcholinesterase breaks down acetylcholine for recycling
      - Action potential in axon opens calcium channels on terminal
  - - - Receives change in the membrane potential. Receives the chemical signal and in turn may generate an electrical signal
    - - Excitatory
        
        Push the neurons closer to threshold and make an action potential more likely
      - Inhibitory
        
        Push thee neuron further from the threshold, makes an action potential harder to achieve
    - - Electrical
        
        Least common, corresponds to gap junctions
      - Chemical
        
        Axon terminal, receptor region. More abundant, slower, more selective
    - - Acetycholin
        
        Neuromuscular junction
      - Dopamin
        
        Influences emotion and attention
      - Seratonin
        
        Mainly inhibitory, role in regulating mood, appetite, circadian rhythm, and sleep
      - Norepinephrine
        
        Triggers fight or flight
    - - Concerts an electrical signal (nerve impulse) into a chemical signal (released neurotransmitter)
    - - Temporal
        
        A single imput
        
        Response to stimuli that occur at the same location in the membrane of the postsynaptic cell but at different times
      - Spatial
        
        Multiple input
        
        Results from the buildup of neurotransmitters released by several presynaptic end bulbs
  - - - Immune cells help fight against anything foreign
    - - It returns excess fluid back to the blood to maintain fluid back to the blood to maintain fluid balance, blood pressure, and blood volume
  - - - Hematopoiesis occurs in red marrow cavities of certain bones
    - - Levers for muscles action
    - - Fat, used for an energy source is stored in bone cavities
    - - Protects the brain, spinal cord, and vital organs
    - - Osteocalcin secreted by bones helps to regulate insulin, secretion, glucose levels, and metabolism
    - - For body and soft organs
  - - - Central nervous system (CNS)
        
        Spinal cord
        
        Initiation of reflexes from ventral horn (somatic) and lateral horn (autonomic), pathway for sensory and motor functions between periphery and brain (somatic and autonomic)
        
        Brain
        
        Perception and processing of sensory stimuli (somatic and autonomic)
      - Peripheral nervous system PNS
        
        Spinal nerves
        
        Both sensory and motor
        
        Ganglia
        
        Reception of sensory stimuli by dorsal root and cranial ganglia (somatic and automatic), relay of visceral motor responses of autonomic ganglia (automatic )
        
        Cranial nerves
        
        Sensory and motor neurons (somatic and autonomic)
    - - Central nervous system (CNS)
        
        Integrative and control centers
      - Peripheral nervous system (PNS)
        
        Cranial and spinal nerves serve as communication lines between CSN and all the body
        
        Sensory (afferent) divison
        
        Somatic and visceral sensory nerve fibers, conducts impulses from receptors to the CNS
        
        Motor (efferent) division
        
        Somatic
        
        (Voluntary) Somatic motor, conducts impulses from the CNS to cardiac muscles, smooth muscles, and glands
        
        Autonomic
        
        Parasympathetic division
        
        Conserves energy, promotes house-keeping, functions during rest (wrist and digest)
        
        Sympathetic division
        
        mobilizes body for activity (fight or flight)
        
        (Involuntary) Visceral motor, conducts impulses from the CNS to cardiac muscles, smooth muscle, and glands
        
        Motor nerve fibers, conducts impulses from the CNS to effectors (muscles and glands)
  - - - Spores are very common in the soil
    - - In tetanus is not the rod that cause the problem, it's the toxins it make
        
        The neurotoxin then block the release of neurotransmitter
        
        Therefore, it can't so there is too much muscle contraction
        
        Symptoms include:
        
        Rigor
        
        a sustained contraction
        
        Cramping
        
        Lockjaw
    - - Tonic muscular spasma usually at the site of infection, but it may be genealised involving whole of the somatic muscular system
        
        Toxin's produced
        
        Cause by 'us'
        
        Wond infection
        
        Septic abortion
        
        Unhygienic practices-application
        
        Toxins produced
        
        Hemolysin
        
        Tetanospasim
        
        powerful neurotoxin
        
        Responsible for tetanus
        
        The clostridium tetani affects the synapses of the brain which is part of the CNS
        
        If clostridium botulinum were to occur it can cause paralysis which happens in the neuromuscular junction when neurotoxin block synaptic vesicles therefore the skeletal muscle can't contract
        
        Paralysis can lead to respiratory arrest since the endospores can germinate
- - - - Whereas, if clostridium botulinum were to occur it can cause paralysis which happens in the neuromuscular junction when neurotoxin block synaptic vesicles therefore the skeletal muscle can't contract
        
        Paralysis can lead to respiratory arrest since the endospores can germinate
    - - Neuromuscular rigidity due to decrease in serum calcium levels
      - Other manifestations of hypocalcemia (mental status changes, CVs manic.)
      - Signs and symptoms
        
        Chvostek sign
        
        Tronssean sign
        
        Carpopedal spasm on occlusion of the coruscation to forearm and hand with BP cuff for several minutes
        
        Contraction of facial muscles on tapping facial
        
        Symptoms
        
        Numbness
        
        Laryngospasm
        
        Carpopedal spasm
        
        Paresthesias of distal extremities
        
        Generalized seizures
  - - - Not investigating enough about the tattoo parlor
      - Not understanding the importance of vaccinations
        
        For example: Tetanus vaccination
        
        Which contains part of the toxin so that we will make antibodies to the toxin
    - - Never getting vaccinated against the bateria
- - - - Causes
        
        Convulsive spasms of the muscles
      - Symtopms
        
        Lockjaw
        
        Stiffness of lower limbs
        
        Contraction of neck and sign into an arch these fuzzes are extremely painful
        
        Can cause bone structures
        
        Dislocations
        
        Tendon ruptures
    - - The toxin travels up the axon toward the neuron cell body which is found in the spinal cord
      - After 2 to 14 days the toxin reaches the motor neuron cell body in spinal cord
      - Comprehensive vaccination programs with adequate immunization tetanus is a preventable disease
    - - Respiratory system
        
        Causes respiratory failure
      - Cardiovascular system
        
        causes cardiac arrest
      - Nervous system
        
        Electrical message
        
        Send down and electrical message to the axon
        
        It arrives at the terminal bud
        
        Chemical neurotransmitters
        
        Bind to the muscle fibers causing muscles to contract
      - Skeletal systeem
        
        Movement enable by skeletal muscle
        
        Skeletal muscles are controlled by motor neurons
        
        Muscular system
        
        In a deep layer tetanus spores can be introduced into a wound
        
        Low oxygen causes spore to geerminate
        
        Germination can cause living tetanus bacteria
  - - - However, their is a moment in which the inter neuron can no longer control the motor neuron
        
        Causing motor neurons to fire constantly
        
        When many motor neuron have lots their inhibitory control and are constantly firing lead to
        
        Continual release of neurotransmitters from the motor neuron terminal bun which causes the muscle fiber to contract repeatedly until spasms occurs
        
        Spasms occurring resulting of severe muscle spasms
        
        If not treated on time it can lead to death
- - - - Organs
        
        Skeletal muscles
      - Allows manipulation of the environment, locomotion, and facial expression. Maintains posture, and produces heat
    - - Organs
        
        Nails
        
        Hair
        
        Skin
      - Forms the external body covering, and protects deeper tissues from injury
    - - Organs
        
        Spinal cord
        
        Nerves
        
        Brain
      - As the fast-acting control system of the body, it responds to internal and external changes by activating appropriate muscles and glands
    - - Organs
        
        Bones
        
        Joints
      - Protects and supports body organs, and provides a framework the muscle used to cause movement. Blood cells are formed within bones; bones store minerals
    - - Organs
        
        Heart
        
        Blood vessels
      - Blood vessels transport blood, which carries oxygen, carbon dioxide nutrients, wastes, etc. The heart pumps blood
    - - Organs
        
        Red bone marrow
        
        Lymphatic vessels
        
        Thoracic duct
        
        Thymus (in babies)
        
        Spleen
        
        Lymph nodes
      - Picks up fluid leaked form blood vessels and returns in to blood. Also houses white blood cells (lymphocytes) involved in immunity. The immune response mounts the attack against foreign substances within the body.
  - - - Motor. Innervate one extrinsic eye muscle (latera rectus) to move the eye. Located in potion (abducens nucleus of the pons)
    - - Mixed (Bothe sensory & motor). Conducts taste sensations from anterior two- thirds of tongue; relays motor output to muscles of facial expressions; tear glands and most salivary glands.
    - - Mixd (both sensory & motor). Mixed nerve that consists of three divisions: ophlamic, maxillae, and mandibular. Located in the nuclei of pons
    - - Sensory. Spinal ganglion (hearing), vestibular ganglion (balance)
    - - Motor. Contracts one extrinsic eye muscle (superior oblique) to move eye inferior
    - - Motor. Terminal ganglia serving thoracic and upper abdominal organs (heart and small) intestines
    - - Motor. Oculomotor and Edinger Westphal nuclei within the midbrain
    - - Motor. Pharyngeal muscles, geniculate ganglion, otic ganglion
    - - Sensory, (vision). Retina of the eye
    - - Motor. Neck muscles, controls movement of the head
    - - Sensory, (smell). Recptors in olfactory epithelium of nasal cavity
    - - Motor: Muscles of the larynx and lower pharynx, promotes speech and swallowing
  - - - Dura mater and arachnoid mater
      - Pia mater
      - Anterior root of spinal nerve
      - Epidualr space
      - Denticulate ligameent
      - Anterior rams of spinal nerve
      - Posterior root of spinal nerve
      - Posterior ramps of spinal nerve
      - Subarachnoid space
    - - Dorsal Root Ganglion
        
        Contains cell bodies of sensory neurons
      - Ventral Root
        
        Including rootlets contain axons of motor neurons, which conduct nerve impulses form the CNS to effectors (muscles and glands)
    - - Central canal
      - Anterior median fissure
      - Posterior median sulcus
      - Pia Matter (inner)
      - Subdural space
      - Arachnoid mater (middle)
      - Subarachnoid space
      - Dura Mater (outer)
      - Denticulate ligament
    - - Brachial Plexus
        
        Musculocutaneous nerve, Axillary nerve, Median nerve, Radial nerve, Ulnar nerve, Intrcoastal nerve, Subcostal nerve,
      - Lumbar Plexus
        
        Iliohypogastric nerve, lateral nerve, femoral nerv, obturator nerve
      - Cervical Plexus
        
        Lesser occipital nerve, greater auricular, Ansa Cervicalis, transverse cervical nerves, supraclavicular nerve , phrenic nerve
      - Sacral Plexus
        
        Superior gluteal nerve, inferior gluteal nerve, tibia nerve, posterior cutaneous nerve of thigh
      - Spinal Nerves
        
        Paths of communication between the spinal cord and specific regions of the body
        
        There are 8 pairs of cervical nerves, 12 pairs of thoracic nerves, 5 pairs of lumbar nerves, 5 pairs of sacral nerves, and q pair of coccygeal nerves
    - - Gray Matter
        
        Site for integration of EPSP's and IPSP's
        
        Mostly neuron cell bodies and unmyelinated fibers
      - White Matter
        
        Contains sensory and motor tracts
        
        Dense collections of myelinated fibers (axons)
  - - - Electrical stimuli produce twitch responses
        
        Contraction-cross bridges develop, tension increases
        
        Relaxation-cross bridges reduced, calcium pumped back into SR
        
        Latent period- excitation contraction occurring
        
        Total time for one twitch can range from a few milliseconds to a few hundred milliseconds
    - - Tension
        
        Force a muscle exerts against a load (opposing force)
      - Contraction types
        
        Isometric contraction
        
        Muscle tension exerted against an immovable load; muscle does not change length
        
        Ex: trying to push against a wall or lift a car
        
        Isotonic contraction
        
        Concentric
        
        Ex: curling a dumbell involves a concentric contraction of the biceps brachii
        
        Muscle shortens: tension exceeds load
        
        Eccentric
        
        Muscle tension exerted against an immovable load; muscle does not change length
        
        Ex: trying to post against a wall or lift a car
    - - Recruitment: increases the strength of contraction
      - Motor units are recruited from small to large as greater contractile force is needed
      - One muscle may have feet or many motor units
      - Motor units range from a few muscle fibers per neuron
      - One motor neuron and the muscle fibers it stimulates
      - Muscles requiring fine motor control have smaller motor units for increasing dexterity
    - - Combining twitches
        
        Summation-if frequency of stimulation causes twitches to start before relaxations complete
        
        Unfused tetanus
        
        Higher stimulation frequency results in unfused tetanus
    - - Fused teetanus
        
        The max frequency is reached causing stimulation to fused together and not having a relaxation between stimuli