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Oral surgery II 2020 > Odontogenic infections > Flashcards

Odontogenic infections Flashcards

1
Q

What are the 4 stages of infection?

A
  • Inoculation
  • Cellulitis
  • Abscess
  • Rupture
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2
Q

When does the inoculation stage of infection occur?

A

Over 0-3 days

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3
Q

When does the cellulitis stage of infection occur?

A

-Over 1-5 days

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4
Q

When does the abscess stage of infection occur?

A

-Over 4-7 days

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5
Q

What is the difference between cellulitis and an abscess?

A

-An abscess has PUS

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6
Q

When an abscess ruptures where does it spread?

A

-Path of least resistance

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7
Q

What type of bacteria account for the majority of odontogenic infections?

A

-Aerobic and anaerboic mixed bacteria

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8
Q

What are the most common pathogens in orofacial infections?

A
  • Strep. milleri
  • Peptostreptococcus
  • Other anaerobic streptococci
  • Prevotella
  • Porphyromonas
  • Fusobacterium
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9
Q

Where can maxillary periapical abscesses spread?

A
  • Canine space
  • Infratemporal space
  • Orbit via infratemporal space
  • Buccal space
  • Parotid space
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10
Q

Where can mandibular periapical abscesses spread?

A
  • Poratid space
  • Buccal space
  • Submandibular space
  • Sublingual space
  • Lateral pharyngeal space
  • Masticator space (masseteric Pterygoid Temporal)
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11
Q

What can cause a muffled voice?

A

-Epiglottitis

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12
Q

What spaces if infected can cause trismus?

A
  • Masticator space

- Pterygomandibular

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13
Q

What is considered trismus?

A

-Opening mouth less than 30 mm

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14
Q

What is cellulitis?

A

-Inflammation spreads through the soft tissue or organ

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15
Q

How does the swelling develop in cellulitis and what might be associated with it?

A

-Develops rapidly with a high fever

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16
Q

T/F In cellulitis the skin becomes very red and there is no throbbing pain as the inflammation localizes

A

False

-There is severe throbbing pain

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17
Q

What type of bacteria do you see in Cellulitis?

A

-Mixed aerobic and anerobic

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18
Q

T/F Cellulitis associated with oral infections is potentially dangerous because it can travel quickly to sensitive tissues such as the eye or brain

A

True

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19
Q

When an infection from a mandibular periapical abscess goes to the submandibular or sublingual space where can it spread?

A
  • Lateral pharyngeal space

- Masticator space

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20
Q

When an infection from a mandibular periapcial abscess goes to the lateral pharyngeal space where can it spread?

A
  • Carotid sheath
  • Retropharyngeal space
  • Masticator space
  • Submandibular and sublingual spaces
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21
Q

Where can an infection in the retropharyngeal space spread to?

A
  • Mediastinum
  • Carotid sheath
  • lateral pharyngeal space
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22
Q

Where can infection in the carotid sheath spread?

A
  • Cranium
  • Mediastinum
  • Retropharyngeal space
  • lateral pharyngeal space
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23
Q

What clinical signs do you see with a vestibular space infection?

A
  • Diffuse facial swelling
  • Elevation of the oral vestibule
  • May or may not have a draining sinus
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24
Q

In a vestibular space infection there is a potential space between what?

A

-Oral mucosa and muscles of facial expression

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25
Q

Sub-periosteal abscesses perforates what layer, but does not perforate this layer?

A
  • Cortical layer

- periosteum

26
Q

Where do you see a buccal space abscess?

A

-Subcutaneous space

27
Q

What does the Buccal space connect to?

A
  • Infraorbital space
  • Periorbital tissues
  • Superficial temporal space
28
Q

What teeth can be involved in a buccal space infection?

A
  • Maxillary molar and premolar
  • Mandibular molar or premolar
  • Canine teeth on both jaws
29
Q

In children what are most buccal space infections caused by?

A

-H. influenze cellulitis (URI)

30
Q

What is Ludwigs angina?

A

-Bilateral submandibular space with crossing over submental and sublingual

31
Q

What are the clinical manifestations of Ludwigs angina?

A
  • Mouth pain
  • Stiff neck
  • Drooling
  • Dysphagia
  • No trismus
  • Woody inflammation
  • Protruding tongue
  • No lymph node involvement
32
Q

Where can Ludwigs angina rapidly spread?

A
  • Lateral pharyngeal

- Retropharyngeal space

33
Q

What is worrisome about Ludwigs angina?

A

-Can rapidly obstruct upper airway

34
Q

How do you get a submental space infections?

A

-Secondary spread from submandibular space

35
Q

What spaces can the submental space be part of?

A

-Sublingual and Submylohyoid spaces

36
Q

Where does a submental space infection come from?

A

-Periapical abscesses of mandibular molars (2nd and 3rd)

37
Q

Maxillary molars and premolars will most likely cause abscesses in what area?

A

-Buccal space

38
Q

What is your LA drug of choice for an infection?

A

-Carbocaine

39
Q

What are the two areas in the retropharyngeal space?

A
  • Anterior (muscular compartment)

- Posterior (neurovascular compartment)

40
Q

Which areas would be safer of the two compartments to drain in the retropharyngeal space?

A

-Anterior is safer

41
Q

What do you find in the posterior compartment of the retropharyngeal space?

A
  • Carotid sheath
  • 9-12 CN
  • Sympathetic trunk
42
Q

What are the clincial manifestations of an anterior compartment of a retropharyngeal infections?

A
  • Dysphagia
  • Trismus
  • Pain
43
Q

What are the clinical manifestations of a posterior compartment of a retropharyngeal infections?

A
  • No trismus
  • Neurologic/vascular
  • Edema epiglottis/larynx
44
Q

What is the potential complication of the posterior compartment?

A

-Vagal nerve damage

45
Q

What is delinaeated by fascial planes: 3 layers of deep cervical fascia?

A

-Retrophyarngeal space/Prevertebral/Danger space

46
Q

Where can the retropharyngeal space spread to?

A
  • Mediastinal

- Pleural/pericardial spread

47
Q

What is the location of the retropharyngeal space?

A

-Base of skull to C7/T1

48
Q

What is the danger space?

A

-Base of skull to diaphragm

49
Q

What is the prevertebral space?

A

-Between prevertbral fascia and vertebral bodies

50
Q

Where can an Orbital space infection spread?

A

Cavernous sinus to cause Cavernous sinus thrombosis

51
Q

T/F Orbital infection can spread directly to the brain

A

True

52
Q

What three spaces come together to make the masticator space?

A
  • Pterygo-mandibular space
  • Superficial/deep Temporal space
  • Masseteric space
53
Q

What space is behind the 3rd molar?

A

-Pterygo-mandibular space

54
Q

Where is the superficial/deep Temporal space?

A

-Side of the head by temporalis

55
Q

Where is the masseteric space?

A

-Under masseter and over the ramus of mandibile

56
Q

What can a masticator space infection cause?

A

-Severe trismus

57
Q

T/F Anaerobic bacteria are mostly penicillin resistant

A

True

58
Q

What is your antibiotic of choice for early infections?

A
  • Penicillin (Pen VK)
  • Clindamycin
  • Keflex (cephalosporin)
59
Q

If a pt has a penicillin allergy what do you use in early infections?

A
  • Clindamycin

- Keflex

60
Q

What is your antibiotic of choice for late infections (after 3 days)?

A
  • Clindamycin
  • Penicillin + Metroniadzole
  • Ampicillin + sublactam
  • Amoxicillin-Clavulanate
61
Q

If a pt has a penicillin allergy what is your drug of choice in late infections?

A

=Clindamycin

  • Cephalosproin IV
  • Ciprofloxacin

Oral surgery II 2020 (12 decks)

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