Precipitating Factors: Environmental Contaminated/Punctured Wound Lack of Immunization Bacterial Infection

Lack/Insufficient tetanus toxoid immunization

Stepped a contaminated wire cause of cuts

Presence of puncture

Spores of ''Clostridium tetani'' enter damaged tissue

Presence of anaerobic condition (oxidation-reduction potential, such as those with dead or devitalized tissue)

Spores transform into rod-shaped bacteria and germinate

Hypertermia Excessive sweating

Produce the 2 exotoxins

Tetanolysin

Tetanospasmin

This substance is a hemolysin with no recognized pathologic activity

It is synthesized as a 150-kd protein consisting of a 100-kd heavy chain and a 50kd light chain joined by a disulfide bond

The blood-brain barrier prevents direct entry of toxin to the CNS.It mediates binding of tetanospasmin to the presynaptic motor neuron and also creates a pore for the entry of the light chain into the cytosol The light chain is a zincdependent protease that cleaves synaptobrevin Toxin amplifies the chemical signal from the nerve Headache After the light chain enters the motor neuron. which arise at the point in the neck where the common arteries bifurcate. it travels by retrograde axonal transport from the contaminated site to the spinal cord in 2-14 days Localized Mild Case Generalized Severe Case develops when only the nerves supplying the affected muscle are involved Develops when the toxin released at the wound spreads through the lymphatics and blood to multiple nerve terminals. dysfunction in the interneurons that inhibit the alpha motor neurons of the affected muscles The brain receives blood with toxins from the internal carotid arteries. .

Lock Jaw Stiffneck .

Leads to unopposed muscle contraction and spasm . Synaptobrevin. Gamma-aminobutyric acid (GABA)-containing and glycine-containing vesicles are not released Good Prognosis loss of inhibitory action on motor and autonomic neurons Autonomic hyperactivity as well as uncontrolled muscle contractions (spasms) in response to normal stimuli.If treated: If Not treated: -tetanus immune globulin IV or IM -metronidazole IV for 10 days -diazepam -tetanus vaccination -tetanus shots -tetanus digestion Toxin reaches the spinal cord. which is integral to the binding of neurotransmitter containing vesicles to the cell membrane. The light chain cleaves the protein synaptobrevin. it enters central inhibitory neurons.

Drooling Dysphagia Excessive sweating Back Pain Hand/Foot Spasm Body Weakness Seizure .

-magnesium. Painful Contraction Uncontrolled /involuntary muscular contraction of the vocal cords Interferes breathing Breathin g foreign materials Fractures in spinal cord Laryngospas m Paralysis Lack of Oxygen receives Pneumon ia Bad Prognosis ?Medications: -human tetanus immunoglobulin injected intrathecally -tracheostomy and mechanical ventilation for 3 to 4 weeks. and at least 150 g of protein per day. -diazepam (known under the common name Valium) as a continuous IV infusion. as an intravenous (IV) infusion. Good Prognosis .If treated: If not treated: Severity muscle spasms -Require admission to intensive care -maintenance of an airway and proper nutrition are required -An intake of 3500-4000 calories. is often given in liquid form through a tube directly into the stomach -This high-caloric diet maintenance is required because of the increased metabolic strain brought on by the increased muscle activity -Full recovery takes 4 to 6 weeks because the body must regenerate destroyed nerve axon terminals. to prevent muscle spasm.

causing a protein called myoglobin to leak into the Pulmonary embolism Respiratory Failure rhabdomyolysis Cardiac Arrest acute kidney failure DEATH . causing the muscles of the heart to become damaged.Blockage of the main artery of the lung or one of its branches by a blood clot that has travelled from elsewhere in the body through the bloodstream flow of blood to the heart becomes restricted. muscle tissues are broken down.