ctrl alt del, and cmd prmt not working help please!

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Ok, so here's the problem my ctrl alt delete doesn't open, and any time I try to access my command prmt, it opens for a split second then closes. So I ran virus checks, deleted some viruses found. Ran Ad-Aware, cleaned up that, Ran spyware doctor and cleaned up all of that and still nothing. Aside from when I ctrl alt delete after all that I can see it show up on my task bar but it won't fully open. On top of all that, I have spyware doctor running in the backround and every 2 seconds it keeps blocking the same application, rundll32.exe

AND on top of all of THAT I'm still getting spam when I open IE or firefox, the same excat spam, saying that my computer is infected blah blah blah and for a free scan blah blah blah.

I've pretty much tried everything, tried safe mode cleaning, virus scans, read threads on this site with people with the same problem, and tried what they suggested nothing seems to work. Am I totally screwed here? do I have to reformat....again? If anyoooone has any idea of how to fix this please help!!
 
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