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5th - OD - Infections > Bacterial Infection - Spread > Flashcards

Bacterial Infection - Spread Flashcards

1
Q

What governs spread dentoalveolar infection?

A

By site of origin and the surrounding tissue planes - limited by fascial layer and muscle insertion

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2
Q

What muscles affect spread in mandible?

A

Buccinator

Mylohyoid

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3
Q

What happens if infection tracks laterally in mandible?

A

Present on buccal or lingual surface

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4
Q

If infection on apex mandibular tooth that lies above mylohyoid attachment how will infection present?

A

Present sublingual space

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5
Q

Is sublingual presentation where did infection origintate from?

A

Apex mandibular tooth which lies above mylohyoid attachment

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6
Q

How will infection present if tracked below mylohyoid?

A

Present submandibular space - lower border of mandible

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7
Q

When will get presentation of infection in mandibular buccal sulcus?

A

Infection track buccal - perforate buccal cortex bove attachement of buccinator

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8
Q

When will get infection at angle of mandible?

A

Infection tracked inferior to buccinator

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9
Q

How can infection track in maxilla?

A

Lateral or palatal

Potential for superior infection into maxillary sinus

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10
Q

What is important in understanding how infection spread?

A

Fascial planes and tissue space

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11
Q

What are 3 separate parts of deep fascia?

A

Investing layer
Visceral layer
Prevertebral fascia

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12
Q

What is investing fascial layer?

A

Superficial layer wraps around mandible and masticatory msucles

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13
Q

What is visceral fasical layer?

A

Deep to investing layer - form fasical tube from base skull to aotric arch

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14
Q

What is pre-vertebral fascial layer?

A

Wraps around spinal cord and verterbra

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15
Q

What does spread of infection in mandible relate to?

A

Relation of tooth to insertion of buccinator and mylohyoid

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16
Q

How does buccinator attach?

A

Lateral cortex of mandible adjacent to molar teeth

17
Q

How does mylohyoid attach?

A

Mylohyoid ridge - medial lingual cortex

18
Q

If have mandibular abscess which tracks laterally above buccinator where will it present?

A

Intra-oral

19
Q

If have mandibular abscess which track laterally below buccanator where will it present?

A

Facial skin

20
Q

If abscess track medial above mylohyoid where will it present?

A

Sublingual space

21
Q

If abscess track medial below mylohyoid where will it present?

A

Submandibular space

22
Q

Where can infection 2nd/3rd mandibular molars track?

A

Posterior into masticatory sapce/ phayngeal space = see profound trismus/ compromised airway

23
Q

Where do most maxillary infection track?

A

Buccal - bone thin = least resistance

24
Q

If have palatal infection where tracked from?

A

Lateral incisors

Palatal root first molar

25
Q

What can happen if apex maxillary canine above origin levator anguli?

A

Infection present medial canthus of eye

26
Q

When see deep neck space infection?

A

Rare but most dental in origin

From mandibular 2nd/3rd molars - apex often below mylohyoid

27
Q

Presenting feature deep neck space infection?

A 
Fever
Pain
Sore throat 
Diff/ pain swallowing
Trismus
28
Q

Management deep neck space infection?

A

General and local measures
Airway management
IV ab
Surgical drainage

29
Q

What is a complication that can happen from spread infection from upper anterior tooth?

A

Drainage into cavernous sinus = cavernous sinus thrombosis

30
Q

Presenting symptoms of cavernous sinus thrombosis?

A

Loss eye mvement
Ptosis = drooping upper lid
Proptosis = bulging eye
Chemosis = red eye

31
Q

When should ab be given?

A

Systemic infection: fever, malaise, nausea
Sign spreading infection
Chronic infection despite local measure
Immuno-or medically compromised

32
Q

What conditions should ab be given with even if limited systemic involvement?

A

Osteomyelitis
ANUG
Sialdentitis

33
Q

How prescribe antimicrobials?

A

Aim at organism present
Dose be 4-8x MIC in blood
Present long enough to penetrate site

34
Q

Issue w/ broad spec ab?

A

Associate rise clostridium difficile

35
Q

Example broad spec ab?

A

Amoxicillin

Tetracycline

36
Q

When take care w/ broad spec ab?

A

Pt GI disease
Elderly
Consider prescribe PPI

37
Q

When NOT prescribe ab fro dental disease?

A

Pulpitis

Prevention dry socket

38
Q

Why may ab not work?

A

Agent doesn’t reach site
Impaired defence
Inappropriate agent - resistance
Poor pt compliance

39
Q

Why may ab not reach site infection?

A

Inadequate drainage
Poor blood supply
Presence foreign body
Inadequate duration

5th - OD - Infections (5 decks)

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