The Anatomy and Physiology of Myasthenia Gravis

Myasthenia gravis is a condition in which there is a particular autoimmune neuromuscular disease that makes the body to become weak especially at the skeletal muscles. The affected muscles are usually crucial for breathing and body movement with the vital body parts involved including parts such as the arm and the legs. It is a term derived from the Latin language to mean grave or severe in the weakness of muscle. Statistically, it is understood to be a rare disease because it affects fewer than 200,000 Americans at any given time (Gooch, 2014). The challenge, however, is that even though 100000 people in the US have it, they are unaware that they are suffering from the condition because of lack of information and sensitization of the public on the significance of the disease and the adverse effects in complications (Wang, Zhang, & He, 2017).

The anatomical understanding of how it results from the myoneural junction that results in the effect of varying degrees of weaknesses of the voluntary muscles. The muscles that are usually affected are those that are involved in the coordination of body processes. The physiological process that results in MG is best understood in the context of an interruption in the communication process between the nerve and the muscles especially following a disruption at the neuromuscular junction (Koneczny, Martinez, & De Baets, 2016). The diagnosis of the condition is quite a challenge with the primary intervention relying on clinical suspicion. Nevertheless, early identification and diagnosis are critical to initiating prompt treatment to avert the possibility of complications.

Normal Anatomy of the Major Body System Involved one para

In the understanding of the anatomy of the disease, it is worth describing it in the context of the muscles that are involved. Each of the muscles is connected to a nerve fiber that branches from the motor neuron (Gooch, 2014). The act of stimulating the muscle results in a contraction process. The motor neuron and the muscle fibers are innervated at the motor unit. The neuromuscular junction constitutes that part here the motor neuron attaches to the muscle cell. It is also critical to understand the motor end plate structure that represents the sole plate, the presynaptic membrane, synaptic cleft, and the postsynaptic membrane. The sole plate is a specialized section of the muscle that links with the axon terminal. The axon terminals are made up of the synaptic vesicles and are composed of mitochondria. The motor end plate is made of a region of the sole sarcoplasm that is rich in a large quantity of Golgi complexes, ER, and mitochondria (Koneczny et al., 2016).

Normal Physiology of the Major Body System one para

The assessment of MG also constitutes the neuromuscular transmission presynaptic events that propagate down the axon. The invasion results in the depolarization of the presynaptic terminal region. It then initiates the flow of Ca2+ into the boutons that pass through the Ca2+ channels that have been activated by voltage effect. The end is that there will be a fusion of the synaptic vesicles and the presynaptic membrane leading to the and release of packets that are composed of a quanter of transmitters (Koneczny et al., 2016). Acetylcholine is then released when a neuromuscular junction is involved in the mix. It is worth noting that some transmitters that are released are directly related to the amount of carbon dioxide that is later freed with the Ca2+ to enter the bouton (Gooch, 2014). The outcome is that amplitude and direction will directly influence the invasion of the action potentials. The channels that are involved in the process are not located on the axon, but rather, they are situated on the terminal bouton. The end is that the vesicles fuse though asset of specialized docking proteins that are located on the coking proteins.

Mechanism of Pathophysiology

It is thus appropriate to relate the anatomy of the structure that makes up the MG to the physiological process that is entailed. There are varying immunological mechanisms that are involved. The first is the degradation process of the receptor site by the complement activation process with the immunoglobulin IgG playing a crucial role in the process (Gooch, 2014). The following activity entails the mechanism where there is an acceleration of the degradation of the anticholinesterase receptor in the phenomenon that is cross-linking in nature. The last process of the MG is the degradation and the blocking of the receptor site. The effect is that the number of the neuromuscular junction will get decreased by about 20 percent of the state of equilibrium (Koneczny et al., 2016).

The thymus plays a significant role in the pathophysiology of the myasthenia gravis considering the autoimmune processes involved. It is based on the background that the motor neuron comprises the plate, the presynaptic membrane, synaptic cleft, and the postsynaptic plates are also directly involved. The motor end plate is made up of the sole sarcoplasm that constitutes the Golgi complexes, ER, and mitochondria (Wang et al., 2017). The presynaptic terminal region is then depolarized following the invasion of the axon that leads to the release of Ca2+. Thymic pathogens are critical players in the understanding of MG and tend to be apparent both to men and women. The thylomas are involved in high autoreactivity that later reduce the tolerance processes of the individual. They are best understood from the perspective of the follicular hyperplasia that entails the expression of ectopic germinal centers that are common in autoimmune disorders. The autoreactive T cells are thus primarily eliminated in the interaction that involves the thymocytes and the thymic stromal cells (Koneczny et al., 2016). The thymus further plays a crucial role in immune regulation because they are the primary sources of regulatory T cells and are thus involved in the physiological process of autoimmune diseases.

Prevention of the Pathophysiology

            Various approaches can be used in preventing the occurrence of the disease. The primary approach involves avoidance of emotional stress or assisting the patient to develop better health from their emotionally depressed state. Furthermore, it is advisable that one should try to limit the exposure to an extreme temperature that could affect them. It is also advised that those at risk should try and avoid further health complications especially those resulting from respiratory infections (Koneczny et al., 2016). Scientists have also described that targeting to have proper nutrition can aid in the prevention of the disease occurrence with the objective of ensuring that one maintains a healthy weight and nutrition to support their optimal health. The prevention approach could also involve informing the informing the neurologist of any medications that are being taken at the time and avoiding further mediations that could adversely affect the way the drugs work. Overall, it is imperative that the preventive measures are considered at the patient level rather than the physician perspective considering that it is an autoimmune disorder (Wang et al., 2017).

Treatment of the Pathophysiology

            Even though the theme of therapy lacks consistency, it is illustrated that MG is one of the most treatable neurologic diseases. One key mechanism would involve the use of anticholinesterase medication and immunosuppressive agents both of which involve pharmacologic therapy (Wang et al., 2017). Researchers have widely described the use of Acetylcholine esterase (AChE) inhibitors as the preferred treatment approach when opting for pharmacologic therapy. The drugs have wide variability in their application. Example of drugs that can be used in this context include corticosteroids and nonsteroid immunosuppressants such as cyclophosphamide, mycophenolate and intravenous immune globulin (IVIg) (Koneczny et al., 2016). Alternatively, the treatment could also involve the use of Plasmapheresis and thymectomy approaches. Further problems in treatment are often limited to the perspective of the complications of intravenous (IV) access that primarily involves central line placement. However, the complications could as well be described in the aspect of hypotension and coagulation and for both cases, the treatment approach will require monitoring of the fibrinogen.

Clinical Relevance and Significance

The autoimmune disorder MG is clinically relevant in varied ways. One key factor is that it enables people to understand that all ethnic groups and all genders are affected. Another critical factor is the understanding of the mechanism involved in its progression from the defect in the transmission of nerve impulses. The significance of the awareness is that it allows further development and research into the conditions into devising ways of diagnosing and treating it through the use of better approaches. For example, one area that is developing in the subject is the investigation into the synthetic protein that has the capabilities of counteracting the damage to the muscles in those with the condition (Koneczny et al., 2016). Furthermore, research into the condition is in progress with the main advances being geared at seeking to conceptualize the role of the brain and the nervous system and apply the knowledge in the understanding of neurological problems (Wang et al., 2017). The success of such projects others that are similar requires that there is an understanding of the anatomy and physiology of the structures involved in the causation of disease. 

Conclusion

In summary, it is worth noting that myasthenia gravis is an autoimmune disease. Overall, the muscles that are involved in the occurrence of MG are interconnected. The disease occurs when the neuromuscular junction is affected. The relation of the anatomy takes the form of understanding how the structures are involved in the building process in the development of the disease. There are three primary ways including the complement activation that results in the degradation process of the receptor site, the acceleration of the degradation of the anticholinesterase receptor, and the degradation and the blocking of the receptor site.

Most importantly, the thymus plays a key role in the autoimmune disease as the thylomas are involved in high autoreactivity. The T-cells are eliminated, and thus MG becomes profound. The preventive approaches are aimed at avoidance of stress and other risk factors while the medications in treatment are essentially those that involve improvement in neuromuscular transmission such as through the use of Anticholinesterase agents. The significance of the subject has necessitated further studies through research as scientists seek to describe approaches that can be used to diagnose and treat the disease better and faster.

References

Gooch, C. L. (2014). Myasthenia Gravis. In Encyclopedia of the Neurological Sciences

(pp. 221–229). http://doi.org/10.1016/B978-0-12-385157-4.00624-2

Koneczny, I., Martinez, P. M., & De Baets, M. (2016). Myasthenia Gravis. In Encyclopedia of Immunobiology (Vol. 5, pp. 168–179). http://doi.org/10.1016/B978-0-12-374279-7.15006-4

Wang, L., Zhang, Y., & He, M. (2017). Clinical predictors for the prognosis of myasthenia gravis. BMC Neurology, 17(1). http://doi.org/10.1186/s12883-017-0857-7