infections

Question 1

how are fascial spaces classified

Answer 1

primary
- infection occurring by direct spread from oral cavity

secondary
- infection occurring by continued spread from another space

Question 2

anatomy of sublingual space

Answer 2

between FOM oral mucosa and mylohyoid muscle
anteriorly and laterally: mandible
posteriorly: submand space

Question 3

anat of submand space

Answer 3

• continuous with sublingual space along the posterior free border of the mylohyoid muscle
• anteriorly: anterior belly of digastric
• posteriorly; posterior belly of digastric
• superiorly: inferior surface of mandible and mylohyoid
• inferiorly: digastric tendon and platysma
• submand space is separated from parapharyngeal space by posterior belly of digastric

Question 4

what is the most common reason for involvement of submental space

Answer 4

extension of a submandibular space

Question 5

what is ludwigs angina

Answer 5

involvement of all perimandibular spaces
when infection form one submand space passes through the submental space to involve the contralateral submand space

Question 6

anatomy of submental space

Answer 6

• between mylohyoid muscle and superficial layer of deep cervical fascia
• bounded laterally by the anterior digastric muscle
• further inferiorly is hyoid bone

Question 7

what does the masticator space comprises

Answer 7

• submasseteric space (located deep to masseter)
• pterygomandibular space (located between medial surface of ramus and superficial to the medial pterygoid)
• superficial temporal space
• deep temporal space (infratemporal space is the inferior portion of the deep temporal space)

Question 8

most common etiology for pterygomandibular space involvement

Answer 8

direct spread from mandibular third molars into the space

Question 9

anatomy of pterygomandibular space

Answer 9

• medially: medial pterygoid
• laterally: ascending ramus of mandible
• superiorly: lateral pterygoid
• anteriorly: buccal space
• posteriorly: parotid gland
• contents of pterygomandibular space: IAA and IAN, sphenomandibular ligament, CNV3

Question 10

what is the common clinical presentation of a pterygomandibular space infection

Answer 10

trismus due to involvement of medial pterygoid, so i/o examination may be difficult for the reason stated above, but may be able to see marked erythema and oedema of the anterior tonsillar region and deviation of the uvula to the unaffected side

e/o swelling is minimal in an isolated pterygomandibular space infection

but if masticator space is involved (because there is direct communication from pterygomandibular to masticator space), then it will present as a swelling on either side of the ramus

Question 11

what spaces first to be infected when mandibular third molar implicated

Answer 11

submasseteric space and pteryomandibular space

submasseteric space is sandwiched between masseter and lateral surface of ascending ramus