Intro to odontogenic infections

Question 1

most common aerobic responsible for odontogenic infection? anaerobic? gram +/-?

Answer 1

aerobic: gram-positive cocci = strept. spp
anearobic: gram + cocci = streptococcus, peptocccus, peprostreptocossus AND gram - rods =bacteroides, fusobacterium

Question 2

anatomic PRIMARY spaces of the face (10)

Answer 2

temporal
vestibular
subcutaneous
subperiosteal
submental
submental
submandibular
sublingual
parotid
buccal
palatal

Question 3

anatomic secondary spaces of the face

Answer 3

parotid
submasseteric
buccal
lateral pharnygeal
pterygomandibular
retro-pharyngeal

Question 4

vetibular space aka? boundaries?

Answer 4

subperiosteal ~ any tooth
boundaries: alveolar bone on maxilla / mandible and oral mucosa
*can still cause significant facial edema

Question 5

boundaries of canine space
source of infection?

Answer 5

canine fossa,
levator anguli oris, levator labii superioris
source: anterior maxillary dentition, typically canine

Question 6

clinical findings in canine space infection

Answer 6

obliteration of nasolabial fold, can involve periorbital tissue
clinical concerns - cavernous sinus thrombosis –> anterior facial vein to superior opthalmic vein

Question 7

buccal space boundaries and clinical source of infection

Answer 7

skin, buccinator muscle, pterygomandibular raphe
source: maxillary or mandibular dentition

Question 8

spaces at floor of the mouth?

Answer 8

sublingual space
submandibular space

Question 9

boundaries of sublingual space? communicates with?

Answer 9

oral mucosa, mandible, mylohyoid, extrinsic musculature of the tongue
communicates with- submandibular, masticator, and lateral pharyngeal spaces

Question 10

boundaries of submandibular space? communicates with?

Answer 10

inferior border of mandible, mylohyoid, platysma, anterior belly of digastric

communicates posteriorly with: sublingual space, masticator space, and lateral pharyngeal space

Question 11

clinical findings associated with sublingual infection?
submandibular?
submental?

Answer 11

sublingual: fullness of floor of the mouth upon elevation of the tongue leading to dysphagia and dysphonia

submandibular: unable to palpate the inferior border of the mandible

submental: midline right under the chin - fluctuant usually

Question 12

ludwings involves?

Answer 12

BILATERAL submental, submandibular, sublingual
- airway emergency and pt. is tri-poding - self positions to facilitate handling of secretions / maintaining airway

Question 13

masticator space boundaries
communicates with?/ infection can spread from?
common clinical finding?

Answer 13

boundaries: parotid gland, ascending ramus, masseter muscle, inferior border of mandible, zygoma

can spread from buccal space infection, periocoronitis of 3rd molars, angle of mandibular fracture

patients will commonly have very limited opening due to trismus

Question 14

pterygomandibular space
trace from?
boundaries
infection from?

Answer 14

trace from medial pterygoid muscle medially
boundaries: parotid gland , medial pterygoid muscle, ascending ramus, inferior border of mandible, lateral pterygoid muscle

infection can spread from submandibular or sublingual, infection with 3rds, infection from contaminated needle for IAN nerve block

Question 15

lateral pharyngeal space
boundaries
spread from?

Answer 15

inverted cone shaped situated just medial to pterygomandibular space extending from skull base to hyoid bone

boundaries: medial pterygoid and superior constrictor, parotid, carotid sheath, and pterygomandibular raphe

spread from pterygomandibular space, submandibular space

Question 16

retropharyngeal space location? boundaries? spread from?

Answer 16

extends from base of skull to upper mediastinum to level of C6

anteriorly bounded by posterior pharynx
posteriorly bounded by danger space

spread from lateral pharyngeal space - thin fascia easily ruptures in setting of infection

Question 17

can perform I&D for which space infections?

Answer 17

vestibular
canine
buccal
and some sublingual space abscesses

Question 18

disadvantages to steroid uses?

Answer 18

increase blood sugar, diminish immune response, falsely elevated WBC count

Question 19

antibiotic selection for odontogenic source of infection

Question 20

cephalsporin MOA
cover which species?

Answer 20

bacteriociadl
blocks cell wall sythesis