A Perfect Storm in the Operating Room

Question #1

-Action potential arrives at axon terminal of motor neuron;

-Acetylcholine (ACh) is released and binds to receptors on sarcolemma;

-The sarcolemma’s Ion permeability changes;

-depolarization occurs locally in the sarcolemma;

-This local change in membrane voltage ignites Action Potential in sarcolemma;

-Action Potential travels across the entire sarcolemma and along the T tubules;

-Sarcoplasmic Reticulum (SR) then releases Calcium which binds to troponin in the thin filament, exposing myosin-binding sites;

-Myosin heads bind to actin causing contracytion to begin.

Question #2

Malignant Hyperthermia is a hereditary condition in which a person, upon receiving certain types of anesthesia, has their muscles contract vigorously causing a rapid increase in body temperature.

Question #3

MHis triggered by certain anesthetics often used during surgery, once administered to a person with this condition.

Question #4

Metabolic Storm refers to the symptoms that occur in MH: patient’s muscles become rigid, respirations become very rapid, heart begins to beat fast and irregularly, skin becomes mottled, body temperature increases extremely, and blood pressure lowers to dangerous levels quickly.

Question #5

In MH, the SR in the skeletal muscle cell is affected, causing Calcium to be released into the cell, resulting in a drastic increase in intracellular Calcium levels and muscle contraction. This causes a cycle where muscle maintains contraction.

Question #6

During MH, body temperature rises because of the heat that is produced by the severe muscle contractions that are occurring in the person’s body.

Question #7

The standard test for MH is through a muscle biopsy (CHCT). In CHCT, they remove a large portion of the muscle from the patient in surgery and immediately take it to the lab for testing. There is genetic testing for this condition available, but it only detects about 30%. People usually find out they have this condition...