Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OS II > management complex odontogenic infections > Flashcards

management complex odontogenic infections Flashcards

1
Q

Spread of Odontogenic Infections
* Odontogenic infection can spread from? to? can be?

A
  • Odontogenic infection can spread from their original sites to remote areas in the head and neck and can on occasions be life threatening.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Spread of odontogenic infections may involve what tissues/strucutures:

A

– Soft tissue/fascial spaces – More common
– Osseous structures (Osteomyelitis) – Less common
– Vital structures – Orbits, CNS, thoracic cavity, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Spread of Oro-Facial Infections
* Generally, infections follow?
* This is dictated by?
* Infective processes can spread by disruption of ?

A

Spread of Oro-Facial Infections
* Generally, infections follow the path of least resistance.
* This is dictated by anatomic location of teeth, position of muscle attachments, bone density, etc.
* Infective processes can spread by disruption of intervening fascial planes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Fascial Spaces

A
  • Potential spaces between the fascia and underlying organs/tissues.
  • In a healthy state, these spaces do not exist. However, these spaces can be distended by fluid or infective process.
  • Thus infective process can spread from one area to the adjoining ones by disruption of intervening fascial planes or around perforating blood vessels and nerves
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

primary maxillary spaces for infection

A
  • canine
  • buccal
  • infratemporal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

primary man spaces for infection

A
  • submental
  • buccal
  • sabman
  • sublingial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

secndary fascal spaces

A
  • masserteric
  • pterygoman
  • superficial and deep temp
  • lat pharyngeal
  • retropharyngeal
  • prevert
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Boundaries of Facial Space
* Understanding anatomical boundaries can help?

A

Boundaries of Facial Space
* Understanding anatomical boundaries can help Dentists/Oral and Maxillofacial
Surgeons manage complex Head and Neck infections by predicting their spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Boundaries of Facial Space components:

A
  • Fascial layers or planes
  • Muscles
  • Bone
  • Skin
  • Mucous membrane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Determine whether to be treated by dentist or a Oral and Maxillofacial
surgeon

A

– Who should treat?
* Rapidly progressing infection
* Difficulty breathing
* Difficulty swallowing
* Fascial space involvement
* Elevated temperature(>101F)
* Trismus(<10mm)
* Toxic appearance
* Compromised host defenses
– Need I & D?
– Need hospitalization?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Types of Drain available

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Space infections that can arise from a maxillary odontogenic infection

A
  • Canine/infraorbital space
  • Buccal space
  • Infratemporal space
  • Temporal space
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Canine/Infraorbital Space Infection

A

Infection spreads to the Canine/infraorbital space through the root apices of the maxillary teeth, usually
the canine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Canine/Infraorbital Space Infection I and D approach

A

Incision and Drainage achieved through Intra-oral approach
Direct surgical access is achieved via incision in the depth of the maxillary labial vestibule adjacent to the tooth causing the infection.
Gravity Dependent Drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Buccal Space Infection
shape

A

“Dome” shaped swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Buccal Space Infection

A

could be due to man or max tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

buccal space I and D apprroach

A

Incision and Drainage achieved through Intra-oral approach
Direct surgical access is achieved via incision through the depth of the buccal sulcus adjacent to the tooth causing the infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Infra -Temporal Space Infection

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Temporal Space Infection – Incision and Drainage approach

A

extraoral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

microbio considerations
Identification of bacteria?
– Representative specimen collected
- culture? submit for?
* Gram staining?

A

– Representative specimen collected via Aspiration or Swab
– Examine specimen
– Aerobic and anaerobic culturettes
– Submit for culture and sensitivity
* Gram staining
– Early diagnosis
– Guides antibiotic therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Common Mandibular Space Infections

A

 Sub lingual space
 Submandibular space
 Submental space
 Buccal Space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Sublingual Space Infection

A

above mylohyoid, commonly PM and 1st M (apices above mylohyoid line)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Sublingual Space Infection I and D

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Submandibular Space Infection

A

below mylohyoid, 2nd/3rd molars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

subman infection I and D

A

extraoral

26
Q

key sign of subman infection

A

no palpation of inf cortex

27
Q

subman space btwn which mm?

A

mylohyoid and platysma

28
Q

Submental Space Infection

A

also below mylohyoid, anterior teeth

29
Q

submental I and D approach

A

extraoral, gravity dependent drain

30
Q

Secondary Space Infections

A
  • Masticator (Sub-masseteric) space
  • Pterygomandibular space
  • Lateral pharyngeal space
  • Retropharyngeal Space
31
Q

how can we examine secondary infection sites?

A

CT scan

32
Q

Sub-Masseteric Space Infection/ I and D approach

A

Extraoral with gravity dependent drian

33
Q

Pterygomandibular Space Infection

A

spread from subman space to medial side of man beneath the medial pteryogid

34
Q

Pterygomandibular Space Infection common sign

A

trismus

35
Q

Retropharyngeal Space Infection

A

can compromise airway

36
Q

mediastinitis spread path

A
37
Q

ludwigs spread path

A
38
Q

cavernous thrombosis spread path

A
39
Q

Assessment of a Patient with Complex Oro-Facial Infections
Determine the severity of?
- Determine the state of the patients?
- imaging?

A

Determine the severity of the infection
- Complete history
- Clinical examination
- Determine the state of the patients host defense
- Advanced Radiography (C.T. Scan with contrast)

40
Q

danger signs of clinical exam

A
  • trismus
  • no palpation inferior border
  • visual changes
  • malaise/fever
  • SOB
  • difficulty swallowing
41
Q

trismus with infection

A

Indicates involvement of muscles of mastication, Difficult airway access

42
Q

Inability to palpate inferior border of mandible

A

Indicates spread to the submandibular space

43
Q

Visual changes

A

\
Indicates ocular involvement

44
Q

Malaise +/- Fever

A

Indicates advanced disease with systemic response

45
Q

Shortness of breath

A

Indicates airway embarrassmen

46
Q

Difficulty in swallowing with secretions

A

Indicates oro-pharyngeal involvement

47
Q

Radiographic Examination options

A
  • Periapical
  • Panorex
  • Plain Films
    * CT Scan with contrast
48
Q

C.T. Scan with contrast use

A

C.T. Scan with contrast helps as follows,
-It clearly delineates the position and size of the infection process as well as its relationship with the adjacent
anatomic structures.
-It is also useful to evaluate any changes to the patient’s upper airway(due to edema) as it occurs in more advanced
infections of the head and neck.

49
Q

CT contrast will exhibit what around infection

A
50
Q

CBC use with infections

A

CBC (Complete Blood Count) with differential count – large outpouring of immature
granulocytes indicate severe infection

51
Q

Treatment of Complex Oro-Facial Infections
* Maxillofacial infections are what problems?
* Medical therapy is used?

A
  • Maxillofacial infections are surgical problems.
  • Medical therapy is used adjunctively. Alone, it will not suffice, and only delays
    necessary treatment
52
Q

Treatment of Complex Oro-Facial Infections
* Treat the?
* sx?
* Send the purulent discharge for?
* Support the patient?
* Choose and prescribe the appropriate?
* Re-evaluate?

A
  • Treat the cause of infection (Etiology)
  • Treat the infection surgically (Incision and drainage)
  • Send the purulent discharge for Culture and Sensitivity
  • Support the patient medically (Infectious disease consultation)
  • Choose and prescribe the appropriate Antibiotic (Culture and sensitivity) I.V Antibiotics
  • Re-evaluate the patient frequent
53
Q

Serious Space Infections

A

 Ludwigs Angina.
 Cavernous Sinus Thrombosis

54
Q

Ludwigs Angina

A
  • Ludwig’s Angina is a fulminating, bilateral sublingual, submandibular, submental and cervical infection or cellulitis displacing the tongue with potential airway obstruction.
    • Life-threatening condition
    • Aetiology: Usually related to periapical abscess related to the lower molar teeth
55
Q

Ludwig’s Angina – C.T Scan examination
Airway?

A

Airway is significantly narrowed causing severe respiratory distress.

Due to this situation, intubation during general anesthesia also becomes very challenging

56
Q

Ludwig’s Angina –Management
– Patient must be?
– C. T. Scan?
– Consultative services?
– Blood and tissue culture?
– IV?
– Extensive?
– Close monitoring?

A

– Patient must be hospitalized immediately
– C. T. Scan with Contrast
– Consultative services e.g. infectious diseases and respiratory therapy
– Blood and tissue culture and sensitivity test specially for anaerobes
– Intravenous antibiotic therapy
– Extensive surgical drainage
– Close monitoring (Airway

57
Q

Ludwigs Angina – Incision and Drainage

A
58
Q

Cavernous Sinus Thrombosis:
* Serious condition that is recognised by the appearance of? as a result of?
* uni or bilateral?
* more or less common than ludwigs?

A
  • Serious condition that is recognised by the appearance of marked oedema and congestion of the eyelids and conjunctiva as a result of impaired venous drainage.
  • This start as a unilateral and rapidly becoming bilateral.
  • This condition is not as common as Ludwig’s Angina
59
Q

Cavernous Sinus Thrombosis - Aetiology

A
  • Hematogenous spread of infection from the jaw to the cavernous sinus may occur anteriorly via the inferior or superior opthalmic vein or posteriorly via emissary veins from the pterygoid plexus. Direct extension through the
    opening in the cranial bones.
60
Q

Cavernous Sinus Thrombosis
Signs & Symptoms
– Ocular?
– fever?
– Periorbital and conjunctival?
– exopthalmamus/retina?
– pupils?
– Other cranial nerves?

A

– Ocular pain.
– High fluctuating fever, chills, and sweating.
– Periorbital and conjunctival oedema, starting unilaterally and progressing to bilateral as a result of thrombophlebitis.
– Pulsating exophthalmos and retinal haemorrhage
– Ophthalmoplegia, paralysis, dilated pupils and loss of corneal reflexes
– Other cranial nerve involvement e.g. trigeminal nerve

61
Q

Cavernous Sinus Thrombosis - Management
– Hospital?
– consult with?
– Abx?
– Rx for thrombosis?

A

– Hospitalization.
– Neurosurgical consultation.
– Intensive antibiotic therapy.
– Heparin to prevent extension of thrombosis

OS II (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions