Oral Surgery (dockeno) Flashcards
1
Q
extra-oral skin incision
A
10
2
Q
stabbing (incision & drainage)
A
11
3
Q
distal areas (w/ Hook)
A
12
4
Q
major organ for hemostasis
A
Liver
5
Q
Most common problems hemostasis
A
Loss of visibility
Formation of hematomas
6
Q
Major problems
A
Hypovolemic or hemorrhagic shock
7
Q
to check the viscosity of the blood
A
INR
8
Q
What test is required for px with insulin-dependent diabetes mellitus
A
FBS
HbA1c
9
Q
What test is required for patient taking ASPIRIN
A
BUN & Creatinine
10
Q
small vessels will last for
A
20-30 sec.
11
Q
Large vessels will last for
A
5-10mins
12
Q
Use of heat of end of cut vessel
A
Mosquito Hemostat
Electrocautery
13
Q
best method to control bleeding
A
Surgicel
14
Q
WOUND REPAIR
A
- Inflammatory Stage
- Fibroplastic (Proliferative ) Stage
- Remodeling Stage ( Wound Maturation)
15
Q
begins the moment tissue injury occurs (2-5 days)
EVENT: Fibrin formation occurs
A
Inflammatory Stage
16
Q
insoluble protein formed from FIBRNOGEN during the clotting of blood.
It forms a fibrous mesh that impedes the flow of the blood
A
Fibrin
17
Q
last for 2 days to 3weeks Events: *Granulatiom tissue formation occurs *Fibrinolysis happens via PLASMIn * Fibronectin formation
A
Fibroplastic ( Proliferative) Stage
18
Q
What are the components of granulation tissue?
A
Cells & Proliferative Capillaries
19
Q
How many days after injury does fibroblast arrive in the wound
A
2-5:days
20
Q
where collagen fibers are being replaced by a new collagen which are oriented to better resist tensile force on the wound.
Keloid & scar can form under this stage
A
Remodeling stage (Wound Maturation)
21
Q
most important proteins
A
Elastin
Collagen
22
Q
Other name of Scar
A
Cicatrix
23
Q
oral cavity has the highest chance to form SCAR?
A
Labial frenum
24
Q
1st type collagen arrived in wound healing
A
Type III- Reticular
25
Most abundant collagen present in wound healing
26
NO tissue loss are placed & stabilized in essentially the same anatomic position they held before injury
Ex. Well repaired, well-reduced bone fractures, odontectomy
Primary Intention
27
gap between the edges of an incision or between bone or nerve ends after repair
Ex. Extraction socket, poorely reduced fractures, deep ulcer, & large avulsed injuries
Secondary Intention
28
when healing of wounds through the use of tissue grafts in large wound healing by secondary intention
Tertiary Intention
29
It is concussion of nerve only. This is least severe
Degeneration: None
Regeneration: 1-1.5mm per day
Neuropraxia
30
damaged epineural sheat but not axon
Sign: Paresthesia
Degeneration: Segmental Demyelination
Regeneration: Axonal regeneratiom
Axonotmesis
31
complete loss of nerve continuity. Most severe
| Degeneration: Wallerian Degeneration
Neurometmesis
32
It is a disintegration of the distal part of the nerve via phagocytosis
Regeneration: None
Wallerian Degeneration
33
Best time to removed impacted tooth
2/3 of the root is formed
34
worst time
completed root formation
35
least difficult
MA
| VA
36
Most difficult
DA
37
A severe MA which requires bone removal & tooth sectioning
Horizontal
38
Lower 3rd
| easiest to hardest
MA- Horizontal- Vertical - DA
39
Upper 3rd
DA- Vertical- Horizontal- MA
40
it the crowm is completely ant. to the ABR
Class I
41
approximately 1/2 of the crowm covered by ramus
Class II
42
tooth located completely in to the ramus
Class III
43
nearly to the occlusal plane of the adjacent molar
Class A
44
between the occlusal plane & cervical line of the adjacent molar
Class B
45
below the cervical line of the adjacent molar
Class C
46
assess the position of the impacted lower tooth
WAR lines
47
refers to the highest point pf impacted relation to adjacent tooth
White line
48
refers to the portion of impacted exposed to extenal oblique ridge
Amber Line
49
level of access for elevating the impacted
Red line
50
Pre-surgical Procedures
1. Scrub technique
2. Surgical Drapping
3. Eye Patch (pads)
51
The most commonly used flap is ____ with the use of ___ for the initial incision in mand. impacted tooth
while_____ for the initial incision in Max. impacted teeth
```
Envelope flap
# blade15
# blade 12
```
52
It is used for reflecting the flap
```
Mucoperiosteal Elevator (MPE)
aka. Molt No. 9
```
53
mostly used for flap retractors
Austin & Minnesota
54
3 Principles of Elevator
1. Lever
2. Wedge
3. Wheel & Axle
55
most common principles of elevator
Lever
56
when using crossbar but it causes most trauma or fracture
Wheel & Axle
57
Main fx of suturing
To stabilize the flap
58
Most common suturing technique
Interrupted
59
Most commonly used suturing material
Silk 3.0
60
Imp. primary teeth extractiom
Palatal Force
61
Most common post - operative condition
Pain & Edema
| 1-2wks
62
Most common surgical complication
Root displacement
63
2-3mm displaced tooth
Minimal attempt or you can leave it in place
64
If large root fragment-if in the sinus do
Caldwell- luc approach
65
Used to elevate root tip
Cryer
66
Impacted Maxillary 3rd Molar
Infratemporal Space
67
Impacted Mandibular 3rd moladr
Submandibular
68
perforation of the sinus in the socket
Oro-antral Communicatiom
69
```
Oro-antral communication
small opening (2mm)
```
No tx
70
Medium opening (2-6mm)
Figure of 8 suture without Gel Foam
71
Large opening (>7mm)
Pedicle or Berger's Flap
72
done when suturing the wound under tension or too tight
Wound Dehiscence
73
most common area to have dehiscence
Internal Oblique Ridge
74
most common complication of traumatic tooth extraction.
| Develops 3rd-4th day result high levels of fibrinolytic activity due to TRAUMA
Dry Socket (Alveolar Osteitis)
75
Mosf common complain Dry socket
Pain & Fetid odor
76
Tx of Dry socket
Eugenol
Benzocaine
Balsam of Peru
77
area that remains devoid of tissue after closure of the wound
Dead space
78
Most accurate way check temp./ fever
rectal
79
least accurate
Axilla
80
Most common cause of hypoglycemia atteck in clinic
Px. skip breakfast
81
Suppressing Drugs
Alkylating agents
Antimetabolites
Cyclosporine A
Steroids
82
they keep the cell from reproducimg by damaging its DNA
Alkylating Agents
83
It interfere with DNA & RNA growth (Fluorouracil)
Antimetabolites
84
Mild cellulitis
Massive antibiotic
85
Severe Cellulitis
I&D with massive antibiotic
86
I&D with massive antibiotic
Abscess
87
used to drain abscess without damaging the neurovascular tissue with the use of LISTER SINUS FORCEPS
Hilton's Method
88
caused by Aerobic
Cellulitis
89
caused by Anaerobic
Abscess
90
Antibiotic of choice in cellulitis
Pen VK
91
If caused by staphylococcus?
Cephalexin
92
Most common cause of failure in tx abscess
Wrong choice of antibiotic
93
Done first before prescribing antibiotic for abscess
Culture test
94
Inflammatiom of operculum
Pericoronitis
95
Pericoronits is more common in
Lower caused by trauma
96
What is the cause of pericoronitis
Max. 3rd molars
97
Tx. Pericoronitis
Operculectomy
| Removal of 3rd molar
98
Most common sign of ESRD
Uremia
CC: Metallic taste
Best time if dialysis= 1 day after dialysis
99
Drug should be avoided with ESRD
NSAIDs
Meperidine
Morphine
Acetaminophen
100
Uncontrolled DM
| Most common concern due to the drugs that they are takin
Hypoglycemia
101
Suppressing Diseases
Leukemia
Lymphoma
Malignant Tumors
102
Effective Orally Administered antibiotics useful for odontogenic infections
1. Penicillin
2. Erythromycin
3. Clindamycin
4. Cephalexin
5. Metronidazole
6. Tetracycline
103
inhibit cell wall synthesis
Penicillin
104
if allergic to penicillin
Erythromycin
105
1st choice if caused by Actinomycosis Infection
Clindamycin
| Pseudomembranous Colitis
106
best antibiotic for anaerobic infection
Metronidazole
107
kill all except. Streptococcus
Tetracycline
108
Px. who are required to take prophylaxis
SBE
ABE
RHD
Artrial Septal Defect
109
affect mitral valve
SBE
110
Staph. aureus affect tricuspid valve
ABE
111
Antibiotic prophylaxis
to prevent Bacteria during overinstrumentations & multiple extraction
All layer of ❤️ infected - mitral valve
RHD
112
Most required antibiotic prophylaxis
Atrial Septel Defect
113
Adult
Amox:
Clindamycin
1-2g
| 600mg
114
Children
Amoxcillin
Clindamycin
50mg/kg
| 20mg/kg
115
Lifeline of the practice
RECALL
116
A thin potential space between the Levaror Anguli Oris (Caninus) & Levator labii superioris alaque nase muscles.
Most dangerous space infection
Canine Space
117
result from the superior spreas of infections via hematogenous route of CANINE SPACE INFECTION
CST
118
Anterior Boundaries of CST
1. Superior & Inferior Opthalmic veins
2. Drains into FACIAL VEIN
3. Angular Vein
119
Posterior Boundaries of CST
1. Pterygoid Plexus of veins
| 2. Emissary Veins
120
swelling below the zygomatic arch & above the imferior border of the mamdible
Cause: Maxillary > Mand. molars infections
Buccal Space
121
Important structures of Buccal Space
Buccal fat pad
Stensen's duct
Facial artery
122
space lies posterior to the maxilla ; bounded mesially by the lateral plate of the pterygoid process & superiorly by the base of the skull. It can also result to CST but infection spreads via PTerygoid Plexus Of Veins
Infratemporal Space
123
Primary Mandibular Space
1. Submental
2. Sublingual
3. Submandibular
124
It is due to infection of molars that lies inferior to mylohyoid
Imp. structures: Facial & Hypoglossal nerves
Submandibular (Submaxillary)
125
Bilateral indurated swelling of submental, submandibular & sublimgual spaces caused by Streptococcal infections
Ludwig's Angina
126
Clinical Appearance of Ludwig's Angina
Primary concern:
Standard Airway:
Elevated & displaced tongue
Breathing
Cricothyrotomy
127
Palpable soft tissue that appears HArd & dense
Induration
128
movable mass & compressible that appears soft
| ex. Pus
Fluctuant
129
infection from buccal space & mand. 3rd molar with pericoronitis
Masseteric Space
130
infection from submandibular & sublingual spaces
Nerves: Mental, Lingual, Inferior Alveolar, Auriculotemporal & Mylohyoid (Branches of Mand. Nerve)
Incision: Buccinator
Pterygomandibular Space
131
When infection is severe which gives DUMB- BELL Appearance
Temporalis Space
132
when masseteric, pterygomandibular & temporalis are taken as a group
Trismus is very common
Masticator Space
133
Due to infected mand. 3rd molar, tonsillar infections, pharyngitis & parotitis
Pathognomonic sign: Hot potato voice
Lateral Pharyngeal Space
134
**Deep Neck Space Infection**
1. Prevertebral space
2. Visceral Vascular Space
3. Retropharyngeal Space
135
1st paranasal sinus developed. It is lined with Pseudostratified Columnar Ciliated with goblet cells
Maxillary Sinus (Antrum of Higmore)
136
It involves non-vital teeth
Odontogenic Sinusitis
137
Odontogenic sinusis tx
Antibiotic 10-14 days
(co-amox or ampicillin)
caldwell - luc procedure
138
What are the causative agents of sinusitis
Strep. Pneumonia
Haemophilus influenza
Moraxella Catarrhalis
139
Location drainage of max. sinusitis
Frontal
Ethmoid
Sphenoid
Max. sinus
140
Diagnostic Tool
1. Sialography
2. Sialodochitis
3. Sialodenitis
4. Sialodendoscopy
141
gold standard in diagnostic salivary gland radiology that aids in detection of radiopaque stone (Sialolith)
Sialography
142
dilation of salivary duct "sausage like" pattern used to diagnose sialolith
Sialodochitis
143
Inflammation of acino-parenchyma of the gland. It is a PRE-CANCEROUS lesion
Sialodenitis
144
Most common malignancy of major salivary glands?
MEC?
145
Most common malignancy of minor salivary glands?
Adenoid Cystic Carcinoma
146
Which gland is most commonly affected with diseases?
Adrenal Gland?
147
Indications of Enucleation
Unilocular rdl
Asymptomatic
Less than 1-cm cystic lesion
148
Removal of 1-2mm of bone around the entire periphery of the cyst cavity after doing enucleation. It is used for very benign type of lesions
Objective: To prevent recurrence
Enucleation w/ curettage
149
Total removal of a cystic lesion WITH ruptured cystic lining
Main tx for OKC
Indication: Multilocular RDL
Curettage
150
Multilocular rdl DOAVO
```
Dentigerous Cyst
Odontogenic Keratocyst
Ameloblastoma
Vascular Malformation
Odontogenic Myxoma
```
151
creating a surgical window in the wall of the cyst & lining of the cyst if Left in situ
Obj. To spare vital structure from damage
Indication- Larger than 1cm cystic lesion
Symptomatic
Marsupialization (Partsch I technique / Decompression)
152
Combination of marsupialization with enucleation
Waldron's Technique ( Partsch II Technique)
153
mainly indicated in Ameloblastoma & CEOT (Pindborg tumor)
Resection
154
prevent cells from multiplying
Radiotherapy
155
Most common imfection in radiotherapy
Osteoradionecrosis?
156
Major adverse effect of radiation in the oral cavity
Xerostomia ( Dry mouth)
157
most common facial fracture. Repairing 7-10 days
Nasal
158
2nd most common facial fracture
Mandible
Condyle
Angle
Symphysis
159
Bucket Handle Appearance
Bilateral fracture of symphysis
160
Most common sign of mandibular fracture
Malocclusion
161
Most common sign of malignancy in mandible
Paresthesia
162
Muscle involved in displaced in mand. fracture
Mylohyoid
| Ant. Belly of Digastric
163
Midface Fractures
Le Fort I / Floating Jaw
Le Fort II / Pyramidal Fracture
Le Fort III / Dish face
164
Guerin sign an ecchymosis found in buccal mucosa & palTal areas
Guerin Sign
| Le Fort I
165
separation of maxilla & attached nasal complex from the orbital & zygomatic structures
Le Fort II (Pyramidal Fracture)
166
Dish face
Le Fort III
167
most common midface fracture
Zygomatic Complex fracture
168
Symptom:
Radiographic tx.
of Zygmatic Complex Fracture / Tripod fracture
Infraorbital nerve paresthesia
| Submentovertex / Jug handle view
169
Most severe fracture
Le Fort III / Tranverse / Craniofacial Dysostosis
170
Radiographic technique is recommende for LE FORT midface fractures
Submento Vertex / Jughandle
171
Best tool to diagnose midface fracture
CT scan
172
Blow in fracture
inward fractue w/ orbital rim
173
Types of Fractures
1. Greenstick ( Bamboo)
2. Simple (Closed fracture)
3. Compound (Open fracture)
4. Comminuted
174
incomplete fracture where one side of the bone is broken & other is bent.
Most common fracture children
Tx.
Greenstick (Bamboo)
| Bringing teeth normal occlusion with interdental wiring
175
complete transection of the bone with minimal fragmentation
Simple (closed fracture)
176
results in communication with the external environment of the oral cavity. Most common to have infection
Compound (Open fracture)
177
left on multiple segments. Most common to have blockage in breathing
Ex. Gunshot wound
Comminuted
178
Radial pulse
Adult
179
Carotid pulse
children
180
most common hereditary orofacial deformities
Cleft lip & Palate
181
Rule of 10
10 wks
10 lbs
10 cc
10,000 wbc count
182
Classification of Cleft by Veau
| Soft palate cleft sith slight cleft in hard palate
Class I
183
Soft palate cleft with hard palate cleft
Class II
184
Unilateral complete soft, hard, alveolar & lip cleft
Class III
185
Bilateral complete soft, hard, alveolar & lip cleft
Class IV
186
those who refuse surgical approach
Obturator
187
retained for 3-4 month post surgically for complete wound healing
Surgical Obturator
188
Types of Computed Tomography
1. SPECT- Single Photon Emission Computerized Tomography
2. Positron Emission Tomography
3. Cone Beam CR
189
used to determine active areas of bone metabolism. It is done after Nuclear Imaging
SPECT
190
how the organs & tissues inside your body are actually working
PET
| Positron Emission Tomography
191
assess the density & dimension of the bome
Cone Beam CT
