Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

infectious disease > 6 abscesses > Flashcards

6 abscesses Flashcards

1
Q

abscess

A

a swollen, inflamed area in body tissues, in which pus gathers and would presumably drain from

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what determines the pathogens within the abscess

A

flora of the region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what determines the site of the abscess?

A
  • head and neck anatomy
  • syndromes you must recognize
  • therapeutic principles/guidelines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how can organisms involved in abscesses reach a normally sterile internal area?

A

blood borne
penetration/trauma
extension from a nearby non-sterile area, such as a mucosal surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

blood borne

A

hematogenous spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

penetration/trauma

A

knife wound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

extension from a nearby non-sterile area such as a

A

mucosal surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

most brain abscesses are from

A

oral focus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

eusobacterium

A

oral flora that can spread to brain tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

commensal

A

normal flora

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

streptococcus pyogenes

A

group A strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what adheres well to oral epithelial cells and

A

strep pyogenes (group A strep)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

S salivarius and veillonella species colonize

A

tongue + buccal mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

S mutans + mitis and actinomyces viscosus colonize

A

dental surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

staphylococcus aureus is present on

A

skin and nares

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

pelvic abscess is an extension of an

A

intestinal wall infection (diverticulitis) + contains a mixture of bacteria that originated in the large intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

abdominal abscesses

A

aeropic organisms + anaerobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

aerobic organisms of abdominal abscesses

A

e. coli which tolerate anoxic conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

anaerobes of abdominal abscesses such as bacteroides

A

not killed by tiny doses of oxygen, and have enzymes such as superoxide dismutase to detoxify oxygen radicals and catalase to break down hydrogen peroxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

anaerobes

A

clostridia, anaerobic and facultative anaerope, strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

strict anaerobe

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

facultative anaerobe

A

2-8% oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

abscesses in gluteus muscle

A

cardiac infection (endocarditis) allowed bacteria to spread to the butt via the bloodstream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what causes cardiact valve infections?

A

staphylococcus + streptococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

distant site abscess is a pure culture of the

A

single organism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

hematogenous spread= bacteremia common with

A

skin infections, pneumonia, uti/kidney infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

secondary sites of hematogenous spread

A

large joints (hips, elbows), bones, lungs, liver, spleen`

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

bacteriology of the abscess may be anticipated from

A

the microbial flora of the originating focus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

most abscesses originate from

A

teeth, dental crevices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

most abscesses harbor

A

harbor four or five organisms, mainly oral anaerobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

infections arise from the pharynx contain oral anaerobes and

A

strep pyogenes + staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

polymicrobial synergy

A

typical deep neck ifnections + abscesses include on average 5 or 6 bacterial species
-synergy between a # of species renders the whole pathogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

upper airway harbors large numbers of what kind of bacteria?

A

anaerobic bacteria of limited virulence unless allowed entry into sterile areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

some pathogens need no assistance! no polymicrobial synergy

A

staph + strep fusobacterium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

how do polymicrobibal synergistic infection species work?

A

add something necessary but not sufficient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

pyrosequencing

A

many uncultured species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

example of pyrosequencing

A

bacteroids fragilis has a capsular polysaccharide complex (CPD) with (+) and (-) charges promoting abscesses; without CPD, no abscess is formed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

with polymicrobial synergistic infections, tx has to be aimed at

A

different kinds of bacteria, not just one

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

abcesses can be

A

polymicrobial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

how are organisms introduced during abscess formation

A

trauma or via bloodstream (local)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what can narrow the mixture of organisms?

A

early presence of oxygen and then later, the lack of oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

host response to abscess

A

walls off organisms with fibrin deposition, eventually thick-walled fibrous collagen capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

inside an abscess

A

live/dead cells, bacteria, debris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

healthy tissue is well oxygenated unless you have

A
  • interruption of blood flow (surgery + trauma)
  • ischemic necrosis from tumors
  • adjacent infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

adjacent infections produce

A

cytotoxic and necrotizing factors extending infection; organisms can consume oxygen rednering tissue anaerobic, which means dead tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

are most oral infections anaerobic or aerobic?

A

anaerobic (oral abscesses, periodiontal lesions, pulp, periapical lesions0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

oxygen tolerance varies from species to species

A

-requires low [02] and reduced oxidation-reduction potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

anaerobes outnumber aerobes by how much in the oral cavity and skin

A

10:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

anaerobes outnumber aerobes by how much in the colon

A

1,000 : 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

few anaerobes by themselves are very virulen

A

fusobacterium, clostridium, + bacteroides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what presents on gram negs, and have a strong correlation with pulp + periodontal damage and endotoxin?

A

endotoxin; metabolites (hydrogen sulfide, ammonia) and injurious enzymes are made

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

host neutrophils require oxygen for their

A

metabolic burst but is lacking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

beta- lactamases mediate

A

penicillin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

bacteria have acquired antibiotic resistance like

A

beta lactamase + penicilin lactamase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

anaerobic infections characteristics

A
  • polymicrobial, usually endogenous + opportunistic
  • occur in closed spaces
  • smell foul (cadavers)
  • accompanied by thrombophlebitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

thrombophlebitis

A

bacterial enzymes promote clot formation; gram neg endotoxins activate clotting cascade, bad since clotted vessels lead to death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

why are abscesses often biphasic

A

phase 1 acute inflammation phase 2 local abscess formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

resurgent infection

A

some anaerobes (bacteroides) are resistant to antibiotics, so initial tx with antibiotics may kill off bacteria, but not the bacteroides, leading to resurgent infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

resurgent infection

A

kils of bacteria that are sensitive to antibiotics, but the ones that aren’t still survive, so youthink people are fine, but they are in fact still sick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

cervical fascia

A

muscles, vessels, and visceral structure of the neck are eveloped in fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

interfascial spaces

A

potential areas where abscesses can sit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

what are borders for infections

A

fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

pediatric neck abscessse commonly in

A

submandibular and posterior triangle and submental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

superficial fascia

A

subcutaneous tissues of neck which are continuous with platysma anteriorly; begins at nuchal line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

what does the superficial fascia enclose

A 
trapezius
SCM
strap mmms
submaxillary glands
parotid glands
66
Q

middle or pretracheal fascia

A

often involved in dental infections that have extended from site of origin

67
Q

infection in what artery with compromise blood flow to brain

A

carotid

68
Q

second spaces

A

within submental + submandibular triangles, between mucosa of floor of mouth and superficial layer of deep fascia

69
Q

what divides the second spaces

A

myelohyoid mucsle into submandibular + sublingual spaces

70
Q

clinical syndromes

A
  • peritonisillar, parotid, parapharyngeal and submandibular abscesses
  • parapharyngeal space abscess
  • pterygopalatine, infratemporal, + temporal fossa abscesses
  • retropharyngeal abscesses
  • lung abscesses
71
Q

*sore throat and trismus is sean in

A

peritonsillar , parotid, parapahryngeal, and submandibular abscesses

72
Q

trismus

A

inability to open the jaw; pressure or infection of the muscles of mastication

73
Q

trismus involves motor branch of which nerve

A

trigeminal

74
Q

dysphagia (can’t eat) + odynophagia (can’t swallow

A

inflammation of cricoarytenoid joint

75
Q

dysphonia + hoarseness

A
  • neck infection (10th cranial nerve)

- unilateral tongue paresis (12th cranial nerve

76
Q

stridor + dypsnea

A

local pressure or spread of infection to mediastinum

77
Q

unilateral tongue paresis

A

nerve problems

78
Q

patients w/ peritonsillar, parotid, parapharyngeal, and submandibular abscesses have

A
  • facial + neck swelling, erythema, purulent oral discharge
  • pooling of saliva in mouth and asymmetry of oropharynx to help determine where problem is\
  • adenopathy
  • flucuation
79
Q

adenopathy

A

enlargement of lymph nodes anywhere in body

80
Q

characteristic signs of deep pus

A

pitting or a doughy feeling on firm deep palpation

81
Q

Is ludwig’s angina an abscess?

A

no, but can be consued with on

82
Q

ludwig’s angina

A

rapidly spreading cellulitis, not an abscess

83
Q

what anatomical feature does ludwig’s angina include

A

floor of the mouth and loose areolar tissue above the myelohyoid diaphragm

84
Q

what are the dominant flora in ludwig’s angina

A

oral flora = strep and anaerobes

85
Q

what precedes ludwig’s angina in a most cases

A

recent lower molar extraction

86
Q

what is critical to control during ludwig’s angina

A

airway control, asphyxiation is a route of death, as is sepsis

87
Q

why does ludwig’s angina look like an abcess?

A

fluids and gases collect and can mimic collection of pus

88
Q

what is commonly seen with ludwig’s angina

A

people with bad oral hygiene and trismus

89
Q

tx ludwig’s angina

A

antibiotic therapy

90
Q

how does death occur during ludwig’s angina

A

suffocation (edema mouth, togue, glottis) mediastinitis, septicemia, pneumonia

91
Q

ludwig’s angina II

A

brawny or indurated edema of the neck, hard, does not give, no pus formation

92
Q

indurated

A

hardened

93
Q

who does acute bacterial parotitis usually affect

A

elderly, dehydrated, intubated, postoperative individual

94
Q

acute bacterial parotitis

A

salivary stasis permis retrograde seeding of stensen’s duct with virulen oral flora

95
Q

risk factors for acute bacterial parotitis

A

recent vigorous teeth cleaning, use of antcholinergic drugs and salivary calculi

96
Q

most common pathogen in acute bacterial parotitis

A

staphyloccoccus aureus but anaerobes, enteric gram neg bacterial and other organisms also seen

97
Q

acute bacterial parotitis patients present with

A

pain, swelling of parotid gland and dysphagia

98
Q

acute bacterial parotitis and stensen’s duct

A

pus can be expressed, it should be cultured and gram stained

-gland can suppurate and abscess may be present

99
Q

treatment for acute bacterial parotitis

A

hydration, antibiotics directly against staphlococci + mouth flora

100
Q

stone forms in stensen duct of acute bacterial parotitis

A

person is dehydrated, difficulty forign saliva, taking meds

101
Q

give lemon drops to patients with acute bacterial parotitis

A

to stimulate salivary production

102
Q

acute bacterial parotitis usually caused by

A

staph!

103
Q

true submental + submandibular abscesses

A

usually after an infected submandibular lymph node or salivary gland suppurates

104
Q

true submental + submandibular abscesses fluctuation is easy becasue

A

no overylying musculature and fascia is not dense

105
Q

submental abcesses usually ressult from

A

spread of an apical abscess of the lower incisors through the thin buccolabial acrolar plate and below the myelohyoid diaphragm or from suppuration of a submental lymph node

106
Q

true submental + submandibular abscesses

A

elevation of floor of mouth may be seen but swelling of ludwig’s angina is NOT PRESENT

107
Q

true submental + submandibular abscesses infection can be so bad that it destroys the

A

lymph node or salivary gland leading to an abscess

108
Q

parapharyngeal

A

lateral pharyngeal= pharygomaxillary space

109
Q

parapharyngeal space

A

upper neck, above the hyoid; inverted cone with base bounded by the skull and apex toward the hyoid bone

110
Q

parapharyngeal space close to the

A

carotid sheath

111
Q

6 lymph nodes

A

form a collar around the junction of head and neck; rest are chains

112
Q

6 lymph node groups

A 
occipital
mastoid
parotid
facial
submandibular
submental
113
Q

node chains

A

lateral and anterior cervical nodes

114
Q

common root for drainage of nodes

A

lateral cervical chain

115
Q

final conduit form from all lymphatics in the head and neck

A

large deep carotid sheath chain

116
Q

before antibiotics, half of all head and neck infections were from

A

infection in tonsils or pharynx

117
Q

what usually arises as a complication of peritonsillar abscess but infections of the parotid gland, dental roots, petrous pyramid, or after dental or pharyngeal surgery may extend into this space

A

parapharyngeal abscess

118
Q

triad of pharyngeal abscess

A

tonsillar prolapse with swelling of lateral pharyngeal wall, trismus, and parotid swelling

119
Q

abscess in parapharyngeal space

A

extension of abscess into the carotid sheath is frequent

120
Q

**erosion of the internal carotid artery leads to s

A

strokes, fatal hemorrhage, thrombophlebitis of the internal jugular vein with intracranial extension

121
Q

inferior extension to the pyriform sinus during parapharyngeal space abscess leads

A

obstruction of upper airway

122
Q

extension from the retropharyngeal space or carotid sheath during parapharyngeal space abscess leads to

A

mediastinitis

123
Q

septic thrombosis

A

blood flow through carotid only on one side so one side of the brain has no blood flow

124
Q

pterygopalatine fossa

A

maxillary nerve + branches, sphenopalatine ganglion, internal maxillary artery and branches

125
Q

infections of maxillary and spenoid sinuses can involve

A

abducens nerve, inferior branch of the oculomotor nerve, and maxillary nerves

126
Q

where do infections after a extraction of a maxillary molar tooth or after local anesthesia of the superior alveolar nerve cause infections?

A

pterygopalatine, infratemporal, and temporal fossa infections

127
Q

fulminant cellulitis

A

involves upper molar gingiva, pterygopalatine, infratemporal, and temporal fossa, and then abscess formation in these spaces ensues

128
Q

proptosis of the ye bc pus in inferior orbit requires (pterygopalatine abscess)

A

surgical drainage

129
Q

what is the most important communication between the neck and the chest

A

retropharyngeal space

130
Q

retropharyngeal space

A

runs longitudinally from the base of the skull to the posterior mediastinum-between the prevertebral fascia posteriorly and the posterior aspect of the pretracheal fascia anteriorly

131
Q

what does the retropharyngeal space communicate with?

A

parapharyngeal space laterally, where it is bounded by carotid sheaths

132
Q

retropharyngeal abscess

A

results from lymphatic spread of infection in the pharynx or sinuses to the retropharyngeal lymph nodes . The nodes suppurate, leading to abscess

133
Q

retropharyngeal lymph node abcesses are common in

A

children age 3 or 4 bc that’s when these lymph nodes involute

134
Q

in older children or adults, abscess can occur after

A

accidental perforatoin such as with a fish bone or lollipop stick

135
Q

retropharyngeal abscesses are polymicrobial

A

with anaerobes, streptococci, and staphylococcci predominating

136
Q

retropharyngeal abscess symptoms

A
  • chillls and fever after pharyngitis
  • dysphagia
  • neck pain
  • dypnea
  • regurgitation
137
Q

children with retropharyngeal abscess may have

A

insidious onset with irritablility + refusal to eat

138
Q

neck during retropharyngeal abscess

A

hyperextended with local tenderness

139
Q

retropharyngeal symptoms

A

muffled voice (Dysphonia) + drooling followed by tachypnea + stridor

140
Q

what is the most important tool for diagnosis of retropharyngeal abscess

A

lateral neck radiograph

141
Q

what are treatments of retropharyngeal abscess

A

drainage and high dose penicillin or clindamycin

142
Q

thickened pre-vertebral fascial space

A

extra space between arrow and vertebral column- entire airway is pushed forward

143
Q

rupture of the abscess can lead to

A

aspiration of the pus into the lungs, and pneumonia and empyemia

144
Q

an abscess in the danger space between the alar and the prevertebral fascias may drain into the mediastinum , resulting in

A

mediastinitis

145
Q

hemorrhage suggest

A

involvement of the major blood vessels, and phlebitis or thrombosis of the internal jugular vein

146
Q

lung abscesses

A

aspiration of oral contents, anaerobic flora predominates, alcoholics, people who have been in the hospital, little gastric acid may have different flora

147
Q

lung abscesses

A

staphlococcus aureus, gram negative enterics often colonize the mouth and upper intestinal tract in those who belong to the latter group. thus, anaerobes, and at times S. aureus and gram negatives, are found in lung, again polymicrobial

148
Q

lung abscesses description

A
  • inoculum size must be big enough
  • acid may induce a chemical pneumonitis
  • occlusion of the airway by food or foreign objects renders the area anaerobic
  • synergism of diff bacteria
  • nutritional state and integrity of the host defenses are important
  • aspiration pneumonia now very common
149
Q

initially, lung abscesses begin with

A

a necrotizing pneumonia, often after aspiration

150
Q

lung abscesses- microabscesses

A

form and coalesce

151
Q

2 weeks after aspiration

A

lung abscess is seen

152
Q

location of lung abscesses depends on the dependent region

A

lower lobes more comon than upper
=people who have gotten drunk and passed out upside down before aspiration or inhalation of vomitus may be in upper lobes

153
Q

lung abscess drains into

A

bronchiole, causing foul sputum and foul oral odors

154
Q

if air gets into lung abscess cavity

A

then an air-fluid lvel may be seen on chest radiograph

155
Q

if a lung abscess drains into the pleura,

A

an empyema may form

156
Q

lung abscess tx

A

drain, long course of antibiotics-can be oral after iv

157
Q

bubbles in radiographs are probably

A

abscesses

158
Q

therapy of abscesses

A
  • activity against anaerobes or aerobes
  • bacteroides make beta lactamase limiting penicillin, therefore broad spectrium penicillins (beta lactam) + beta lactamase inhibitor are useful like ampicillin/sulbactam
159
Q

what is also used as therapy for abscesses

A

metronidazole, clindamycin btu bacteroides are becoming resistant to clinda

160
Q

clindamycin fights

A

strep, staph, anaerobes

161
Q

1st main cause of sore throat

A

strep

162
Q

2nd main cause of sore throat

A

gonorrhea

infectious disease (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions