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6 Cards in this Set

  • Front
  • Back
describe the normal process of neuromuscular transmission
1. exocytosis - release of 1 quanta
2. depolarization of the nerve terminal
3. Ca2+ release - triggers release of multiple quanta
4. release sites are directly opposite to the areas with the highest concentration of Ach
5. transmission depends on the # of Ach molecules redadily available to interact with receptors

any change that reduces the probablity of Ach interaction will result in failure of neuromuscular transmission
What can cause myasthenia gravis, in regard to the normal neuromuscular transmission process
1. not enough quanta release
2. too little # Ach per quanta
3. post synaptic effect of Ach
4. membrane/receptor damage
5. blocked binding sites *
what is the main theory behind the cause of myasthenia
- IgG competes with Ach for attachment at the same receptor, therefore preventing Ach from binding to the receptor site
Why is a careful Hx important in myasthenic pts
- 5% have a thymic tumor
- 5% have Graves diseaasw
- thymoma
- need chest X-ray
what are some Dx tests you can do to confirm myasthenia gravis as Dx
- sleep test
- ice test
- tensilon or prostignin
- EMG
describe the signs and symptoms of myasthenia
CPR - HOPE - PMF

Cogan's lid twitch - look down, then up - lid elevates too much then eye "flutters down"

Pupil fatigue

Retraction of lid (with thyroid)

Hopping of lid

Orbicularis oculi involved

Ptosis

Enhancement of Ptosis

Paradoxial reversal of ptosis

Myasthenic crisis

Facial snarl