Pathophysiology of Tetanus [PDF]

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c
  
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p ›
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      body through a wound Anaerobic conditions allow germination of spores and production of toxins



Toxins are produced and disseminated via blood and lymphatic ÷ 
  enters the nervous system peripherally at the myeoneural junction and is transported centripetally into neurons of CNS Interferes with neurotransmitter release to block inhibitors Leads to unopposed muscle contraction and spasm



Without Intervention



Toxins acts at the synapse of interneurons of inhibitory pathways and motor neurons lockage of spinal inhibition



Πp ΠΠΠΠΠΠp p p



Spasms of the vocal cords or muscles involved in breathing



Cardiovascular complications



Obstructions(by secretions, exhaustionand pulmonary aspiration)



Hyperactivity of the sympathetic nervous system



General Muscle Ôigidity



Sx:



Ôespiratory Failure Uninhibited afferentstimuli entering CNS



p Tachycardia ΠSweating ΠFever



Facial muscle spasm



p Seizure(as an effect of the toxin in the brain )



  Lockjaw 
Stiffness temperature Neck rigidity sweating £ysphagia Ôestlessness Ôeflex spasms SEIZUÔE







Sx: Œ Lock jaw Œ £ifficulty swallowing



Severe Vasoconstriction Hypertension



Aspiration
neumonia Increasedbasal sympathetic activity and episodesof sympathetic over activity
rogressive muscle spasm p Sx:Ôeflex Spasms



p Sx:



 £eath Fracture ( ones to break and joints to dislocate)



Autonomic £ysfunction ad
rognosis



Legend: ΠManifested by the patient p Not manifested by the client Sx Sign And Symptoms



With Intervention £
    Tetanus is suspected upon a bite or puncture wound; £iagnosis is made thru clinical findings and history since C. Tetani exhibits such exquisite sensitivity to oxygen or difficult to grow from clinical specimen 

    Sedation, Antitoxin, Muscle relaxants,Antibiotic; some of the anti-tetanusmedication may include £ecavac, Tetanus Toxoid(absorbed or Fluid),
ediarix, Infantrix, Tripedia, Adacel, Tetanus Immune Globulin(Human),  
   V Mechanical Ventilator (respirator), Three principles apply: 1.
revent further toxin release. 2. Neutralize toxin present in the body outside the CNS. 3. Minimize the effects of the toxin already in the CNS. ×     1. Cleanse the wound with betadine solution or any antiseptic. 2. Encourage client to take anti biotic if having a wound as a prophylaxis. 3. Encourage Client to have immunization. 4. Teach preventive methods such as boiling water for 15 minutes. 5. Using sterile scissor when cutting umbilical Cord for neonatal tetanus. 



Optimum Level of Functioning



Good
rognosis