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Chirurgie > Infectii Chiru - 14-17 > Flashcards

Infectii Chiru - 14-17 Flashcards

1
Q

D care au raport apropiat cu corticala palatinala

A

ILmax
PM1 max
Mmax

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2
Q

Etiologie abces perimandibular - leziuni dentoparo cronice la ce dinti

A

PM si M mand

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3
Q

Exteriorizare colectie PAAE in abces V se face in functie de

A

Lungimea radacinii
Loc insertie musculatura periorala

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4
Q

Semne generale abces palatinal

A
  1. Febra
  2. Disfagie
  3. Odinofagie
  4. Otalgie reflexa
  5. Sialoree
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5
Q

Tegumente abces perimandibular

A

Hiperemiate
Dense
Lucioase

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6
Q

Drenaj abces vestibular

A

Tub/lama politen 24h minim
Daca exista hemoragie - mesa tifon in loc de tub, afanata, sa nu obstrueze drenajul

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7
Q

Drenaj abces palatinal

A

Mesa iodoforma in plaga - suprimat dupa 24h

  • indeparteaza marginile
  • rol hemostatic
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8
Q

Drenaj abces perimandibular

A

2 tuburi politen fixate la tegument
Se suprima dupa disparitia secretiei
24-48h

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9
Q

Sutura tubului de drenaj la lamboul de mucoasa evita

A
  1. Deplasare de la nivelul plagii
  2. Lezare parti moi
  3. Accidente - inghitire, aspiratie
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10
Q

Loc incizie abces palatinal

A

Depinde de localizarea colectiei

Anterioara - bombare maxima tumefactie

Spre MG sau feston
- decolare fibromucoasa cu decolator
- se patrunde in colectie

Spre linia mediana - paramedian, paralel cu artera palatina mare

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11
Q

Loc incizie abces perimandibular

A

Tegumentara

  • lungime de 3-5cm
  • SBM decliv de colectia supurata
  • 2 latimi de deget sub marginea bazilara mandibulara
  • dupa sectionarea planurilor anatomice superficiale - acces
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12
Q

Infectiile difuze OMF apar frecvent la pacienti cu

A
  1. Imunodeprimari - DZ, corticodependenta, radio/chimio
  2. Abuz ATB - R crescuta
  3. Igiena orala deficitara
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13
Q

Etiologie flegmon planseu bucal

A
  1. Pericoronarite M3mand
  2. D mand cu leziuni periapicale acute
  3. Complicatii a
    1) plagilor planseului bucal
    2) osteomielite mandibula
    3) sialolitiaze
    4) procese infectioase amigdale - rar
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14
Q

Etiologie flegmon difuz hemifacial

A
  1. Procese infectioase DLmax
  2. Furuncul
  3. Adenite geniene
  4. Traume
  5. Litiaza duct Stenon
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15
Q

Flegmon planseu bucal extindere catre

A
  1. Celelalte loji ale planseului
  2. Parenchim lingual
  3. Fosa infratemporala
  4. Spatiu laterofaringian
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16
Q

Flegmonul difuz hemifacial debut si extindere spre

A 
Debut ca un abces genian
Fuzeaza rapid catre
1. Fosa infratemporala
2. Loja SBM
3. Orbita
4. Loja maseterina
17
Q

Semne disfunctie organe in flegmon

A
  1. INR>1.5
  2. Trombocitopenie
  3. Creatinina creste
  4. Creste bilirubina
  5. Oligurie acuta
18
Q

Complicatii flegmon de planseu bucal

A
  1. Tromboflebita septica sinus cavernos
  2. Mediastinite acute
  3. Risc letal major
19
Q

Complicatii flegmon difuz hemifacial

A
  1. Os maxilar
  2. Tromboza vene faciale
20
Q

Edemul palbebral inferior din flegmonul difuz hemifacial se extinde rapid spre

A
  1. Regiunea temporala
  2. Regiunea parotideo maseterina
  3. Buza superioara - sterge relieful nazo labial
21
Q

Drenaj flegmon planseu bucal

A

2 tuburi de politen per loja explorata - minim 4-5 zile, poate fi necesara inlocuirea
Securizate la tegument cu fire neresorbabile
Irigatii cu solutii antiseptice abundente 4-6x pe zi alternand solutiile

22
Q

Unde se pozitioneaza inciziile suplimentare la flegmonul difuz hemifaciam

A

Juxtazigomatic
Periorbital

23
Q

De ce sunt contraindicate inciziile intraorale in flegmonul hemifacial difuz

A
  1. Drenaj insuficient
  2. Vindecare per secundam - dificil
24
Q

Fasciinta necrozanta cervicala - necroza caror tesuturi?

A

Fascie cervicala
Tesut adipos subcutanat

25
Q

Care e diferenta dintre flegmoane si fasciita necrozanta cervicala

A

In fasciite planurile musculare subiacente sunt doar partial afectate

26
Q

De ce apate osteomielita mai frecvent la mandibular decat la maxilar

A
  1. Corticala mai densa
  2. Defavorizeaza drenan secretiei
  3. Stagneaza in os spongios
  4. Vascularizatie de tip terminal a osului
27
Q

Fasciinta necrozanta cervicala - factori favorizanti

A
  1. Barbati
  2. Varsta medie 45-55 ani
  3. Comorbiditati cu risc infectios -DZ, imunosupresie
  4. Alti factori de risc - consum droguri, etilism cronic
28
Q

Etiopatogeni fasciita necrozanta cerviacala

A
  1. Streptococi pyogen beta hemolotici grup A
  2. Stafilcoci
29
Q

De ce apare siderarea perfuziei in fasciita necrozanta cervicala

A
  1. Creste P intratisulara
  2. Tromboze vasculare induse de exotoxinele bacteriene
30
Q

De ce apare siderarea perfuziei in fasciita necrozanta cervicala

A
  1. Creste P intratisulara
  2. Tromboze vasculare induse de exotoxinele bacteriene
31
Q

Examen imagistic fasciita necrozanta cervicala

A

Lichefiere si dispersare structuri in tesutul suprafascial sau in planul muscular subiacent
Fara formare de abcese

32
Q

Tratament chiru fasciita necrozanta cervicala

A

Excizie tuturor tesuturilor necrozate - necretomii
Debridare extensiva
Drenaj loje cervicale
Irigatii cu solutii antiseptice

33
Q

Complicatii fasciita necrozanta cervicala

A
  1. Sepsis
  2. Soc
  3. Insuficienta multipla de organ
  4. Deces
34
Q

Osteomielita supurata acuta RX

A

Vizibile dupa ce osteoliza ajunge la 50-60%, la peste 3-4 saptamani
Alternanta zone Rtransparenta cu zone Ropace de osteocondensare, cu contur neregulat

35
Q

Osteomielita supurata cronica Rx

A

ADULT
Imagine in capac de sarcofag
Sechestru osos radioopac delimitat de o zona de radiotransparenta cu contur neregulat
Focar osteolitic

COPIL
Zona centrala de radiotransparenta
Bordata de reactie periostala
frecvent < mandibular

36
Q

Osteomielita supurata acuta tratament

A

Drenaj
Explorare
Irigatii

37
Q

Tratament chiru osteomielita supurata cronica

A
  1. Sechestrectomie
  2. Corticotomie + perle de gentamicina la nivelul geodei osoase
  3. Extractie D cauzal si D implantati pe sechestre
38
Q

Colectia purulenta se exteriorizeaza in functie de

A
  1. lungimea radacinii
  2. insertia musculaturii periorale
39
Q

Simptome anestezice in osteomielita supurativa acuta

A
  • maxilar - n infraorbitar
  • mandibular - labio-mentoniera

Chirurgie (8 decks)

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