V.
Pathophysiology
 PREDISPOSING FACTOR                                     Tetanus                           PRECIPITATING FACTOR
                                                                                              o lifestyle
 Age : 18 years old
                                                                                               Dental infection
 Sex: Male
                                       Clostridium tetani enters body through a wound
                                      Anaerobic conditions allow germination of spores
                                                  and production of toxins
                                Toxins are produced and disseminated via blood and lymphatic
          Tetanospasmin enters the nervous system peripherally at the myeoneural junction and is transported
                                          centripetally into neurons of CNS
                                                                                                                 Sx:
                                  Interferes with neurotransmitter release to block inhibitors
                                                                                                           Lockjaw
                                       Leads to unopposed muscle contraction and spasm                o     BP
                                                                                                           Stiffness
                                                                                                           temperature
                                                                                                           Neck rigidity
                                                                                                           sweating
                                                                                                           Dysphagia
       Without Intervention                                                                                Restlessness
                                                                                                      o     Reflex spasms
                                                                                                      o     SEIZURE
                                                                                                      o     opisthotonos
Toxins acts at the synapse of           Spasms of the vocal cords or
 interneurons of inhibitory             muscles involved in breathing
                                                                                    Cardiovascular complications
pathways and motor neurons
                                         Obstructions(by secretions,
                                                                                        Hyperactivity of the
                                          exhaustionand pulmonary
Blockage of spinal inhibition                                                        sympathetic nervous system
                                                 aspiration)
  General Muscle Rigidity
                                              Respiratory Failure                                         Sx:
                                                                                                                o Tachycardia
 Uninhibited afferentstimuli                                                                                     Sweating
                                       Facial muscle spasm                                                       Fever
       entering CNS
                                                     Sx:
                                                                                      Severe Vasoconstriction
                                                  Lock jaw
   o   Seizure(as an effect of                Difficulty swallowing
       the toxin in the brain )                                                            Hypertension
                                         Aspiration Pneumonia
                                                                                  Increasedbasal sympathetic activity and
                                                                                    episodesof sympathetic over activity
       Progressive muscle spasm
                                                                                    o   Sx:Reflex Spasms
               o   Sx:opisthotonos
                                                                                Autonomic Dysfunction
     Legend:
          Manifested by the
                                           Death
             patient
         o NotFracture
                  manifested by the
             client
(Bones to break and joints to dislocate)   Bad Prognosis
     Sx Sign And Symptoms