The Case of the Terrible Tooth Essay Sample

1. List the symptoms experienced by Mr. Gower.
Mr. Grower experiences symptoms such as experiencing hot. and light headedness. and unawareness. He felt hot and warm prior to the root canal remotion. Therefore this symptom is most likely hinting at some jobs he got before the remotion. His symptoms of dizziness could be due to the effects of the surgery or anaesthetic. Necessitate more information to be certain.

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2. Procaine hydrochloride blocks action possible production at the site of injection. How do you believe Novocain plants on the axon membrane. and how does it barricade the esthesis of hurting? Novocain serves to barricade receptors on nervus cells that sense hurting. Therefore forestalling neurotransmitter from adhering to the receptors and exciting centripetal nerve cells to fire. More specifically Novocain blocks the Na channel and prevents depolarisation from happening in the nerve cells of the site of injection. Because of this an action potency is non possible and neurotransmitter can non be release.

Questions
3. What new symptoms does Mr. Gower exhibit?
Mr. Grower now experience a stiff jaw with utmost oral cavity hurting. a lower than normal blood force per unit area of 100 over 60. failing. and musculus weariness.

4. Which of these symptoms could be due to the old day’s process? The stiff jaw and utmost oral cavity hurting could most probably be due to the old twenty-four hours operation. This is because the oral cavity was operated on and the after effects of a root canal remotion is get downing to kick in. However the lowered blood force per unit area. musculus failing. and weariness could be due to an initial job before the root canal.

5. Why can’t Mr. Gower open his oral cavity?
Mr. Gower can non open his oral cavity because his jaw is in a lock province. This is most likely caused by abnormally high frequence of excitant postsynaptic potency or EPSP in his jaw musculuss. This well cause nonvoluntary contraction of those musculuss basically locking up his jaw.

6. What are the possible diagnosings for Mr. Gower’s status at this clip? For each diagnosing that you come up with. depict the symptoms that relate to that diagnosing One possible diagnosing is that Mr. Grower has temporal inframaxillary upset. The symptoms for this includes hurting in jaw country. lock jaw. and experiencing weariness or dizzy. Another possible diagnosing is the Mr. Grower has Tetanus disease. The symptoms for this includes nonvoluntary musculus contraction in country of infection. restlessness. lock jaw. and troubles take a breathing.

Questions
7. What new symptoms does Mr. Gower exhibit?
Mr. Grower now experiences sudating from a febrility. stiff cervix. dry oral cavity. and locked lips. These symptoms are nearer associated with Tetanus disease.

8. Is there a common factor between his jaw being locked shut. his stiff cervix. and his lips being drawn across his oral cavity in a changeless smile? The common factor is that all these symptoms occurs near his oral cavity country. Deducing from this and his febrility it is really possible there is a Tetanus infection near his oral cavity country perchance from the root canal remotion. This infection is presently distributing and inflammatory responses are doing his febrility.

9. Look at the diagram of three nervus cells on the right. At the underside. there is a postsynaptic cell. which receives chemical synapses from two presynaptic cells. which are shown at the top of the diagram. One of the presynaptic cells is labelled excitatory and the other is labeled inhibitory. Assume that a individual action potency in a presynaptic cell does non bring forth an action potency in the postsynaptic cell. Show ( by pulling a graph of membrane potency against clip ) how the membrane potency of the postsynaptic cell alterations if there is one action potency in: a. Merely the excitant presynaptic cell.

On dorsum of instance survey
B. Merely the repressive presynaptic cell.
On dorsum of instance survey
c. Both the inhibitory and the excitant presynaptic cells. On dorsum of instance survey

10. Now think about how the two presynaptic cells could bring forth an action potency in the postsynaptic cell. a. Which presynaptic cell must hold action potencies to bring forth one or more action potencies in the postsynaptic cell? Excitatory presynaptic cell must hold action potencies to bring forth one or more action potencies in the postsynaptic cell because they promote depolarisation of membrane which is needed to do an action potency. On the other manus Inhibitory presynaptic cell promote hyperpolarization which goes against bring forthing an action potency. B. What phenomena must take topographic point for the little postsynaptic potencies to make threshold and bring forth action potencies? Summation of Excitatory postsynaptic potency and Inhibitory postsynaptic potency must take topographic point. More specifically spacial summing up. which means that all the types of possible must add up to be greater ( less negative ) than the threshold potency of -55mv for an action potency to happen in the postsynaptic nerve cell.

c. If the frequence of action potencies in this presynaptic cell ( # 10a ) additions. what happens to the figure of action potencies in the postsynaptic cell? If the frequence of action potencies in the excitant presynaptic cell additions than the figure of action potencies in the postsynaptic cell will increase every bit good. This is due to temporal summing up of EPSP at really frequent times. This causes the postsynaptic cell to bring forth many action potency in sequence. d. What happens to the figure of action potencies in the postsynaptic cell if the other presynaptic cell ( # 10a ) besides produces action potencies? If the frequence of action potencies in the repressive presynaptic cell additions than the figure of action potencies in the postsynaptic cell will diminish. This is due to spacial summing up of both EPSP and IPSP. Mostly it is because IPSP promote hyperpolarization which will do it a batch harder to depolarise the membrane to be greater ( less negative ) than the threshold potency. and doing action potency less possible.

11. Assume that the postsynaptic cell in the diagram is a motor nerve cell. If Mr. Gower’s jobs are associated with kept up musculus contraction. what must take topographic point in the motor nerve cell to bring forth a kept up musculus contraction? The inhibitory synaptic cell must hold more action potency that can impact the postsynaptic cell to make more IPSP to decrease the musculus contraction. With a higher figure of EPSP than IPSP. Mr. Grower experiences an irregular sum of contraction of the motor nerve cells because action potencies are often fire off. IPSP is needed to chant down or loosen up the musculus by decreasing the action potencies created in postsynaptic cell. His nonvoluntary contractions are the cause of his locked jaw. stiff lips. and stiff cervix.

12. Assume that both presynaptic nerve cells have action potencies. What two conditions in these presynaptic cells would bring forth an addition in the figure of action potencies in the postsynaptic ( motor ) nerve cell? A greater frequence of action potency in the excitant presynaptic cell and a lesser frequence of action potency in the repressive presynaptic cell would bring forth an addition figure of action potency in the postsynaptic nerve cell. These two conditions are presently go oning to Mr. Gower’s neurons around his mouth country.

13. Make you wish to alter or modify your diagnosing of Mr. Gower’s job? I believe that Mr. Gower is confronting a Tetanus infection near his oral cavity. This is because the stiff cervix. and stiff lips suggests that he is sing unnatural musculus contraction in that country. Therefore an infection in this country that is easy turning can merely be responsible for this. It is besides really possible he contracted this infection during his root canal operation. In add-on. it is more logical than Mr. Grower all of a sudden holding temporal inframaxillary disease.

The Emergency Room

Questions
14. What is the normal response to person puting a lingua depressor on the dorsum of your pharynx? The normal response to person puting a lingua depressor on the dorsum of your pharynx would be that they regurgitate or gag because of joke physiological reactions which something is forced down our pharynx. 15. Why didn’t Mr. Gower open his oral cavity with the lingua depressor trial? Mr. Grower could non open his oral cavity because his jaws are locked up due to the musculuss around his cervix and jaw country undertaking excessively much. 16. What does this Tell you about the action possible activity in Mr. Gower’s motor nerve cells to his jaw ( and cervix ) musculuss?

This tells me that there is a really high activity or frequence of action potencies in Mr. Gower’s motor nerve cells in his jaw and cervix musculuss. Specifically. his organic structure is either directing highly high degree of EPSP or something is suppressing IPSP from making his motor nerve cells. 17. Travel back to your reply to Question 12 in the last portion of the instance. Make the consequences of the lingua depressor trial support one of the two replies? Yes it does back up one of the reply. The reply it support is that there seem to be a lesser frequence of IPSP or action potency in the repressive presynaptic cell. Mr. Grower seems to be sing a Tetanus infection that is forestalling IPSP from making his motor nerve cells around his mouth country. 18. What does the antibody titre tell the doctor?

The antibody titre basically tells the physician how much antibody is produced in Mr. Gower’s mouth country by taking a blood sample. This is for Dr. Umphasea to prove how strong Mr. Gower’s immune system is every bit good as trial her initial intuition that Mr. Gower has non taken his Tetanus shooting. He does this to do certain that his diagnosing is right. 19. Make this explicate his febrility?

Yes. this does explicate his febrility. This is because if Mr. Gower has a Tetanus bacterial infection than that means that his organic structure is directing a batch of assistance to battle the infection doing an redness in his mouth country. Naturally his organic structure heats up to seek to kill off the bacterium and hence do his febrility. 20. Why is penicillin prescribed for Mr. Gower’s status? Penicillin is prescribed for Mr. Gower’s status because it is an antibiotics that can destruct the bacterial growing that is presently taking topographic point in his oral cavity. This will hopefully decrease or work out his current symptoms. In add-on. Dr. Umphasea mentioned culturing the lesion in his oral cavity to see the current province of the bacterial growing from the infection. 21. How did Mr. Gower ab initio go septic?

Mr. Gower most likely become infected after his root canal remotion. The initial mulch exposure into the surgery was the ground why the bacterium semen to happen its manner into his oral cavity. That along with the remotion of his root canal which exposes a vulnerable topographic point for the bacteriums to assail caducous visible radiation into how he became septic. 22. Make you wish to alter or modify your diagnosing of Mr. Gower’s job? My current diagnosing is that Mr. Grower became infected with the Tetanus bacteriums after undergoing his root canal remotion. The lockjaw bacterium was introduced into the surgery when mulch came winging in through the window. Finally the growing and development of the Tetanus bacterium is what caused stiffness and hurting in his mouth country every bit good as his febrility.

End of the Day

Questions
An action potency in a motor nerve cell produces a contraction of the musculus ?bers it supplies. Tetanus toxin is thought to diminish repressive synaptic effectivity. particularly onto the motor nerve cells to the face and cervix. As a consequence. the motor nerve cells produce more action potencies than usual and the musculuss remain contracted over a long clip period. One consequence of lockjaw infection is called tetanus.

23. Fill in the ?ow diagram ( see following page ) for repressive chemical transmittal. On dorsum of Case survey.

24. Look at each phase in the diagram and propose how tetanus toxin could diminish the postsynaptic response. i. e. . the response of the motor nerve cell. The Tetanus toxin produced by the bacteriums attack the inhibitory neurotransmitter GABA tract. Thereby. diminishing the sums of IPSP signals to make the motor nerve cell in Mr. Gower’s mouth country and this causes over contraction of the musculuss in that country because of higher sums of EPSP. More specifically the toxin stops the release of GABA by aiming the synaptobrevin protein in the tract. Synaptobrevin is responsible for stabilising snare proteins and without snare proteins hooking SNAP25 and Synapsin together it is non possible for the neurotransmitter GABA to be release from the presynaptic membrane.

25. Think about the release of synaptic sender and its reaction with the postsynaptic receptor to open a channel. How could benzodiazepines. like Valium. work to antagonize the e?ect of lockjaw toxin? Benzodiazepines. like Valium. work to antagonize the consequence of Tetanus toxin by increasing the efficiency of GABA sender. GABA is an repressive neurotransmitter and therefore is needed to chant down the contraction of the musculuss in Mr. Gower’s mouth. However. the lockjaw toxin decreases the sums of GABA release from presynaptic membrane. Diazepam binds to GABA receptors and causes an immediate addition in chloride ions of post-synaptic nerve cell which hyperpolarize the nerve cell and hence makes it less excitable despite holding a greater sum of EPSP than IPSP. This in bend. chant down the contractions in the motor nerve cells of Mr. Gower’s mouth antagonizing the effects of the toxin.

26. What feature does Mr. Gower possess that would do him be more susceptible to the lockjaw toxin? Some features that made Mr. Gower more susceptible to the lockjaw toxin are that he did non acquire a Tetanus vaccinum. he has a weaker immune system because he is old. and that he happens to be in the same room as the bacterium when he undergo the root canal remotion.

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