Taking It on the Chin: A Case Study on the Nervous System
by Stephanie DeMarco, Caitlyn Woods, and Phil Stephens Biology Department Villanova University
Part I—The Dentist
John Gower, a retired -year-old man, gets up early and goes directly to his dentist for a root canal. He doesn’t even notice the beautiful spring day with mild temperatures, a stiﬀ warm breeze, or even the characteristicsmell of newly laid mulch around the dentist’s oﬃce. Nancy Gower sits in the waiting room as her husband walks directly into the surgery. The nurse sets him up for the anesthetic, and he mentions that the room seems hot and stuﬀy. The nurse smiles and asks, “Would you like me to open the window? The landscaping crew is putting mulch on the gardens and the smell is very strong.” “That’s ﬁne. I’drather have the breeze.” The nurse pulls the window open and quickly closes it again because the wind blows the curtains and brings some mulch into the surgery. “Maybe I’ll just leave it cracked open,” she says. Mr. Gower nods and the nurse picks up pieces of mulch from the carpet and the chair before the dentist comes in. Dr. Pincher comes in to administer the Novocain and begins the procedure onMr. Gower’s molar. A little while later the root canal is done. Dr. Pincher tells his patient that the procedure went well and that the anesthetic should wear oﬀ soon. He explains to the older couple that Mr. Gower’s mouth will feel tender and may be sensitive to hot and cold substances. He should take it easy for the next few days and take ibuprofen, as needed. The dentist assures them that Mr.Gower’s recovery should be ﬁne, and that if he has any questions or suﬀers from any side eﬀects, he should call the oﬃce. Mr. and Mrs. Gower leave and go straight home. Later that day and into the evening, Mr. Gower feels light headed, but thinks that it might be the last traces of the Novocain. He tells his wife that he will probably be ﬁne in the morning.
. List the symptomsexperienced by Mr. Gower. . Novocain blocks action potential production at the site of injection. How do you think Novocain works on the axon membrane, and how does it block the sensation of pain?
“Taking It on the Chin” by DeMarco, Woods and Stephens
Part II—Day 2
“Mrs. Gower wakes up. She lets her husband continue sleeping. She smiles as she closes the bedroom door because he isusually up early, but she understands that yesterday’s root canal must not have been easy for him. About an hour later, she checks on her husband and ﬁnds that he is awake but he has had a very rough night. “My jaw is really stiﬀ, Nancy, and it hurts more than the last time I had a root canal.” Mrs. Gower brings him some ibuprofen and tells him to stay in bed until it gets into his system. When shereturns, Mr. Gower tells her that his jaw is still stiﬀ and that every time he tries to get up, he feels faint and has no energy or strength. This makes Mrs. Gower very concerned. “I’ll get the blood pressure machine, John.” Mr. Gower smiles. They bought the machine when Nancy was diagnosed with high blood pressure, and now, every time he felt sick, she took his blood pressure with it. “It’s over , John, and it’s usually over .” Mrs. Gower calls the dentist’s oﬃce, and they tell her that his problems are probably due to the procedure. They suggest that Mr. Gower stay in bed and drink plenty of ﬂuids, and that she should call again if he gets worse. Mr. Gower eats nothing during the day, and just drinks fruit juice. At dinner time, his jaw is so stiﬀ he has trouble opening hismouth to eat the soup and rice pudding his wife has made for him. Mr. Gower goes to sleep early that evening with the hope that he will be better after a good night’s sleep.
. . . . What new symptoms does Mr. Gower exhibit? Which of these symptoms could be due to the previous day’s procedure? Why can’t Mr. Gower open his mouth? What are the possible diagnoses for Mr. Gower’s...
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