Question

You trip and fall and a scalpel ends up between your ribs and breathing becomes difficult. What has happened? How can it be fixed?

After your discharge from the hospital you go out for a nice dinner to celebrate. Puffer fish is on the menu. Turns out your previous patient is the chef and is less than motivated to carefully prepare your dinner. You end up with TTX poisoning. TTX blocks voltage gated sodium channels. How would this affect the firing of action potentials? Untreated, TTX poisoning is fatal due to asphyxiation. How? Would your death be quicker or slower at a high altitude? Why?

Answer 1

Ans - Penetrating injuury of the chest wall can be of multiple types but common is haemothroax, Pneumothorax or

combination of both. Haemothrox is accumulation of blood in the pleural cavity and Pneumothorax is accumulation

of air in pleural cavity. Both will abolish the negative intrapleural pressure and will lead to collpasing of underlying

lung parenchyma.

Emergency procedure include to seal the patch, final prodecure is to drain the blood or air from pleural cavity by

inserting intercostal drainage tube

Tetrodotoxin (TTX) is a potent neurotoxin, which is found in pufferfish, porcupinefish, ocean sunfish, and triggerfish;

TTX blocks voltage gated sodium channels, this will lead to block the firing of action potential because depolarisation of the motor neuron occurs due to influx of Na from volatge gated channels, and which lead to firing of action potential.

If untreated it will lead to paralysis of respiratory muscle i.e. diaphragm and intercosatal muscles which will lead to

respiratory failure.

At high altitude this process will be faster due to hypoxia