65 year old man presents thyroidectomy yesterday this morning is complaining of pins and needles in his hands and feet difficulty getting breath his blood pressure is 90/60 heart rate is 70 pulse ox 87 percent on room air during blood pressure check hand develops a carpal spasm indicating a trousseau's sign calcium levels lesss than 8.5 mg/dl in this case are related to lack of PTH to respond to low calcium levels low calcium levels would normally cause PTH to rise leading to increased absorption of calcium this action would bring the calcium back to normal range inthe serum explain what the consequences of hypocalcemia including excitability of neurons events at the neuromuscalar junction and contraction at the sarcomere