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A Perfect Storm in the Operating Room

Anesthesia and Skeletal Muscle Contractions


Kelley W. Grorud
Biological Sciences Department
Edgewood College


In this interrupted case study, a high school biology student shadows her uncle, an anesthesiologist, at a hospital for a school assignment. She witnesses a patient who has an unusual reaction to his anesthesia and nearly dies.  As they try to diagnose the problem, students read a biomedical research report on the effects of anesthesia, play a sequencing game related to muscle contraction, and write about what they learn. Developed for use in an undergraduate anatomy and physiology course, the case could be adapted to A&P courses at other levels or used in an animal physiology course.


  • Tie anatomy of a skeletal muscle fiber to physiological processes leading to muscle contraction.
  • Explore the physiological processes that lead to skeletal muscle contraction.
  • Understand how electrical and mechanical processes are linking during skeletal muscle contraction (excitation-contraction coupling).
  • Describe the important role of small ions/molecules in skeletal muscle contraction, including Na, K, Ca, and ATP.
  • Relate mechanical contraction to the production of heat in muscle contraction.
  • Explain how malignant hyperthermia is triggered and how the disease alters normal skeletal muscle physiology.
  • Link animal physiology research to clinical observations.
  • Describe how the drug Dantrolene reverses the effects of malignant hyperthermia.
  • Practice translating technical information into a language that a lay person can interpret and comprehend.


Skeletal muscle; muscle contraction; malignant hyperthermia; metabolic storm; anesthesia; adenosine triphosphate; ATP; membrane potential; Dantrolene

Topical Areas


Educational Level

High school, Undergraduate lower division, Undergraduate upper division



Type / Methods

Interrupted, Journal Article



Subject Headings

Physiology  |   Biochemistry  |   Medicine (General)  |   Biology (General)  |   Anatomy  |  

Date Posted


Teaching Notes

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Teaching notes are intended to help teachers select and adopt a case. They typically include a summary of the case, teaching objectives, information about the intended audience, details about how the case may be taught, and a list of references and resources.

Supplemental Materials

The case requires that students read specified portions of the paper Making Anesthesia Safer: Unraveling the Malignant Hyperthermia Puzzle by Marilyn Green Larach (Breakthroughs in Bioscience, FASEB) at certain points in the case. The paper includes explanations of how malignant hyperthermia was discovered in humans, the animal research that led to an understanding of how the disease works, and the drugs that were designed to treat the disease. Instructors can download a PDF copy of the paper using the link below.

  Making Anesthesia Safer

Answer Key

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