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Case Study on Skeletal Muscle Physiology
“Time to scrub in,” says Dr. Hodges. The appendectomy you are about to observe is your second surgical case in surgical technician school. The patient, David Sims, is an 18-year-old male who was healthy until two days ago when he began having severe abdominal pain, fever, and vomiting resulting in a diagnosis of appendicitis. David is in excellent health and has never had surgery before, so you anticipate the procedure to go smoothly.
Your instructor asked the anesthesiologist, Dr. Hodges, if you can observe her today during the procedure. “All of the patient’s vital signs and lab work are within normal limits so we are good to go,” says Dr. Hodges as David is brought into the operating room. You help get David ready by applying the heart monitor, oxygen saturation monitor, and blood pressure cuff. After David has been sedated, Dr. Hodges places a special tube down his esophagus to measure his core body temperature and another in his trachea (an endotracheal tube) to help him breathe during the procedure. While Dr. Hodges places the endotracheal tube, she comments, “His jaw muscles are a bit tight so it is very important to check and record his vital signs every 10 minutes. That is your job today while I monitor his respiratory status.”
The case has been in progress for about 20 minutes when you notice David’s heart rate jump up to 120bpm, setting off the ECG alarm on the monitor. You are concerned and ask, “Can he feel what is happening? His heart rate just went up.” Dr. Hodges looks at you and asks, “What is his core temperature?” You show her the chart and see that David’s temperature has gradually begun to rise and is now 101.8° F (38.8° C). Dr. Hodges' face turns serious and she says, “His exhaled carbon dioxide levels have also begun to rise. We need to get the malignant hyperthermia cart right away!”
David is now two days post-operative and is recovering in the Surgical Intensive Care Unit. You recall all of the activity that occurred to save his life by treating his malignant hyperthermia. You researched this condition and discovered that it is an inherited disease. While under general anesthesia, the affected person will experience a rapid rise in body temperature and severe muscle contractions. Dr. Hodges drops by to see David and says to you, “I was impressed how you handled yourself during a very stressful situation. Good job.”
Short Answer Questions:
1.David’s body temperature rises above normal during the surgery (hyperthermia). How does skeletal muscle tissue contribute to body temperature?
2. During malignant hyperthermia, there is an increased amount of calcium released into the sarcoplasm of skeletal muscle cells.
a. What organelle stores calcium in muscles cells?
b. Describe the events that must occur in the muscle cell before calcium is released from this organelle.
3. Jaw muscle contraction (masseter spasm) is one of the key physical findings seen in David’s case of malignant hyperthermia. Explain how calcium functions to cause contraction of a skeletal muscle cell.
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- Question Completion Status: QUESTION 1 Match the Following: Actin Sarcolemma + Perimysium Sarcomere Tendon ✰ Endomysium ✰ Epimysium Myosin A. Connective tissue that connects muscle to bone B. Unit of muscle contraction C. Thin Filament D. Connective tissue that covers the entire muscle E. Cell membrane that surrounds the muscle fiber F. Connective tissue that lies between muscle fibers G. Connective tissue that lies between muscle fascicles H. Thick filament QUESTION 2 Click Save and Submit to save and submit. Click Save All Answers to save all answers. MacBook Airarrow_forward1 pts List the following events in order as they would occur inside a skeletal muscle fiber: 1) cross-bridge 2) action potential (AP) arrives at the motor end plate 3) AP travels down the t-tubule 4) calcium pumped into sarcoplasmic reticulum 5) opening of voltage-gated calcium channels O 2, 5, 4, 3, 1 O 5, 1, 2, 4, 3arrow_forwardSubject: Neurophysiology Would a skeletal muscle fire an AP if a single quanta of ACh was secreted? Why or why not?arrow_forward
- Question 6 B. Increasing fremency of stimulation Using the Myogram above, what does line C represent? Contractile period Latent period O Summation Residual force Tidal volume Tetanus Lag time Fatigue electromyography Relaxation periodarrow_forwardReview & Practice Sheet Section A Part A Match each term listed with the correct description. Reset Help Repolarization Contraction with no relaxation cycles: Acetylcholine Length changes more than tension: Isometric contraction Return of membrane to resting potential: Complete tetanus Fatigue Reduction in contraction and performance: Isotonic contraction Tension changes more than length: Neurotransmitter: Submit Request Answerarrow_forwardPlease helparrow_forward
- match to correct boxarrow_forwardHow are contractions timed? Include frequency, duration and list 3 intensity levels of contractions. How is the intensity of the contraction assessed?arrow_forwardName 4 exercises that include VARIOUS DIRECTIONAL LOCOMOTOR & BALLISTIC MOVEMENTS, 3 PLANES OF MOVEMENTS.arrow_forward
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