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Description : Case of an afebrile baby. Radiograph of the involved extremity and spine on the right was unremarkable. Electromyography and nerve conduction velocity studies shows absent motor responses to stimulation of tibial nerve. Stool culture was positive for Poliovirus type 3.

Tags : Functional organization of skeletal muscle, excitation contraction coupling, Muscle twitch, Quantal summation, Frequency summation, physiology of paralysis, poliovirus, causation of paralysis

Published on : Feb 02, 2021 | Views : 1864 | Downloads : 13

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MUSCLE
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CASE AB, 6 month old female presents at the Emergency department with weakness in the right leg. One week prior to consult her mother noticed that the baby had cough, colds and low grade fever (38.2oC) that spontaneously resolved. No consult was done. Past medical history revealed normal birth history and appropriate well baby check ups. Immunization records showed she had a BCG vaccine, 2 shots of Hib, DPT, OPV and pneumococcal vaccines. Physical Examination revealed an afebrile baby with To of 37.2oC; RR is 21 bpm; HR is 95 bpm. Right leg appears to be flaccid and with absent deep tendon reflex (DTR) nor Babinski’s sign. Baby responds to sensory stimulation. Muscle tone, motor activity, sensations and DTRs of the left leg are within normal limits. The rest of the systems were unremarkable. Radiograph of the involved extremity and spine on the right was unremarkable. Electromyography and nerve conduction velocity studies shows absent motor responses to stimulation of tibial nerve. Stool culture was positive for Poliovirus type 3. Diagnosis: Poliomyelitis, right
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Functional organization of skeletal muscle
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Excitation-Contraction Coupling
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Muscle twitch and its phases
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MUSCLE TWITCH Mechanical response brought about by a single action potential followed by relaxation 3 PHASES OF MUSCLE TWITCH Latent Phase Contraction Phase Relaxation Phase
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Differentiate: Quantal summation and Frequency summation
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QUANTAL SUMMATION Summation of individual muscle fiber contractions happens by increasing the number of motor units contracting simultaneously.
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QUANTAL SUMMATION (Size Principle)
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FREQUENCY SUMMATION Intensity is constant and at its maximal state but the frequency of applying the intensity is increased.
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FREQUENCY SUMMATION (Tetanization) Applying same intensity but with an increasing frequency while the muscle is not allowed to completely relax
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FREQUENCY SUMMATION (Treppe/Staircase Phenomenon)
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QUANTAL SUMMATION vs. FREQUENCY SUMMATION
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Explain the physiology of paralysis of the patient. What is the role of the poliovirus in the causation of paralysis?
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Compare the type of paralysis induced by Botulinum toxin and Tetanus toxin with the patient’s condition
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