Clinical History:
Muscle biopsy was performed on this 60-year-old patient to evaluate for subjective complaints of muscle weakness. Several small intramuscular nerve twigs were noted on glutaraldehyde-fixed toluidine blue stained thick sections.
What normal structure is demonstrated in the electron microscopy images?
Answer:
- Neuromuscular junction (aka motor end-plate)
- The first two images appear to be at a branch point of the terminal axon.
- The third image is an enface section of the post-synaptic muscle membrane.
Reference(s) / Additional Reading:
- Nishimune H, Shigemoto K. Practical Anatomy of the Neuromuscular Junction in Health and Disease. Neurol Clin. 2018 May;36(2):231-240. doi: 10.1016/j.ncl.2018.01.009. PMID: 29655446; PMCID: PMC5903580.
- Slater CR. The Structure of Human Neuromuscular Junctions: Some Unanswered Molecular Questions. Int J Mol Sci. 2017 Oct 19;18(10):2183. doi: 10.3390/ijms18102183. PMID: 29048368; PMCID: PMC5666864.
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