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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
Care e diferenta dintre flegmoane si fasciita necrozanta cervicala
In fasciite planurile musculare subiacente sunt doar partial afectate
26
De ce apate osteomielita mai frecvent la mandibular decat la maxilar
1. Corticala mai densa 2. Defavorizeaza drenan secretiei 3. Stagneaza in os spongios 4. Vascularizatie de tip terminal a osului
27
Fasciinta necrozanta cervicala - factori favorizanti
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
Etiopatogeni fasciita necrozanta cerviacala
1. Streptococi pyogen beta hemolotici grup A 2. Stafilcoci
29
De ce apare siderarea perfuziei in fasciita necrozanta cervicala
1. Creste P intratisulara 2. Tromboze vasculare induse de exotoxinele bacteriene
30
De ce apare siderarea perfuziei in fasciita necrozanta cervicala
1. Creste P intratisulara 2. Tromboze vasculare induse de exotoxinele bacteriene
31
Examen imagistic fasciita necrozanta cervicala
Lichefiere si dispersare structuri in tesutul suprafascial sau in planul muscular subiacent Fara formare de abcese
32
Tratament chiru fasciita necrozanta cervicala
Excizie tuturor tesuturilor necrozate - necretomii Debridare extensiva Drenaj loje cervicale Irigatii cu solutii antiseptice
33
Complicatii fasciita necrozanta cervicala
1. Sepsis 2. Soc 3. Insuficienta multipla de organ 4. Deces
34
Osteomielita supurata acuta RX
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
Osteomielita supurata cronica Rx
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
Osteomielita supurata acuta tratament
Drenaj Explorare Irigatii
37
Tratament chiru osteomielita supurata cronica
1. Sechestrectomie 2. Corticotomie + perle de gentamicina la nivelul geodei osoase 3. Extractie D cauzal si D implantati pe sechestre
38
Colectia purulenta se exteriorizeaza in functie de
1. lungimea radacinii 2. insertia musculaturii periorale
39
Simptome anestezice in osteomielita supurativa acuta
- maxilar - n infraorbitar - mandibular - labio-mentoniera

Chirurgie (8 decks)

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