A 70-year-old woman attends a check-up with a family doctor. As a background, he has a total thyroidectomy for Graves' disease. Within his previous studies, an ionic calcium of 0.69 mMol / L (normal values: 1.1-1.3 mMol / l) is included. When blood pressure is taken, pedal carpal spasm is evident, known as the Trousseau sign. When the concentration of calcium ions in the extracellular fluid falls below normal, the nervous system becomes increasingly excitable due to the increased permeability of the neuronal membrane to the sodium ions (which allows easy initiation of the action potentials). At concentrations of calcemia approximately 50% below normal, the peripheral nerve fibers become so excitable that they begin to spontaneously discharge, initiating trains of nerve impulses that pass to the peripheral skeletal muscles to cause tetanic contraction. #Trousseau #Sign #PhysicalExam #Clinical #Photo
