Spread of Infection Flashcards
In the maxilla, if infection spreads through the bone buccally, above the insertion of the buccinator, where will the infection end up?
in the buccal space
In the maxilla, if infection spreads through the bone buccally, below the insertion of the buccinator, where will the infection end up?
Drains into the mouth
In the maxilla, if infection spreads through the bone palatally, where will the infection end up?
In the palate = very painful
In the maxilla, if infection spreads through the bone in an upwards direction, where will the infection end up?
in the maxillary sinus = leads to sinusitis
why is it unlikely that dental infection would spread to the palate?
bone is more dense
- infection usually follows path of least resistance
Dental infection from which teeth/roots are more likely to spread to the palate? (2)
commonly from palatal roots or lateral incisor (since root lies more palatally)
In the mandible, if infection spreads through the bone lingually, above the insertion of the mylohyoid muscle, where will the infection end up?
sublingual space
In the mandible, if infection spreads through the bone lingually, below the insertion of the mylohyoid muscle, where will the infection end up?
submandibular space
In the mandible, if infection spreads through the bone buccally, above the insertion of the buccinator muscle, where will the infection end up?
drains into the mouth
In the mandible, if infection spreads through the bone buccally, below the insertion of the buccinator muscle, where will the infection end up?
buccal space
In the mandible, where does infection usually spread to in posterior teeth and why?
infection usually perforates lingually since the bone is thinner
(infection usually follows path of least resistance)
above mylohyoid = sublingual
below mylohyoid = submandibular
In the mandible, where does infection usually spread to in anterior teeth and why?
infection can perforate the labial bone easier since its thinner
What happens to the surrounding muscles when infection enters the masticatory spaces (posterior potential spaces)?
go into severe spasm and cause trismus
list the masticatory spaces. (5)
• Superficial temporal space
• Deep temporal space
• Infratemporal space
• Pterygomandibular space
• Masseteric space
If infection enters the masticatory potential spaces, where can it travel to next? (3)
• Lateral pharyngeal space
• Retropharyngeal space
• Prevertebral space
Once infection reaches the posterior potential spaces including the Lateral pharyngeal space, the Retropharyngeal space and the Prevertebral space where can it spread to? (3)
the base of the skull
the superior mediastinum
the inferior mediastinum.
Describe how mandibular infection causes cavernous sinus thrombosis. (3)
Infection can travel back into the lateral pharyngeal space
enter the infratemporal space where the pterygoid Venus plexus lies
and then the infection can travel to the cavernous sinus via the plexus.
Describe how maxillary infection causes cavernous sinus thrombosis. (2)
Infection can travel up into the infraorbital space and enter the veins that lie within this space
the infection can be transported from the veins to the cavernous sinus.
(as the veins are valveless)
Where can infection from anterior maxillary teeth spread to? (5)
• Lip
• Nasolabial region
• Lower eyelid
• Palate = usually from lateral incisors as since the roots ae more palatally placed
(less common)
• infraorbital space = from canine (long root)
Where can infection from posterior maxillary premolars/molars spread to? (4)
• Cheek/buccal
• Infratemporal region
• Maxillary antrum (v rare)
• Palate (less common)
Where can infection from anterior mandibular teeth spread to? (2)
• Mental space
• Submental space (commonly resolve themselves by bursting and draining via the face)
Where can infection from posterior mandibular premolars/molars spread to? (5)
• Buccal space
• Submasseteric space
• Sublingual space
• Submandibular space
• Lateral pharyngeal space
How do we manage infection? (3)
• Drainage – extra oral or intra oral incision
• Removal of source of infection – extraction or extirpation
When is antibiotic therapy used In the management of infection? (2)
- Toxicity: are they systemically unwell? (SIRS – increased HR, respiratory rate, temperature and WCC)
- Medical history: are they immunocompromised?
What is Ludwig’s angina?
Bilateral cellulitis (infection/swelling) of the sublingual and submandibular spaces (from dental infection)
- Swelling on both sides
What are the extra-oral features of ludwigs angina? (2)
- Diffuse redness
- Bilateral swelling in submandibular region
What are the intra-oral features of ludwigs angina? (4)
- Raised tongue: hot potato speach
- Difficulty breathing
- Difficulty swallowing
- Drooling
What are the systemic features of ludwigs angina? (4)
- Increased HR
- Increased respiratory rate
- Increased temperature
- Increased WCC
(similar to SIRS of sepsis)