Spread Of Infection Flashcards
Where may infection in a maxillary tooth travel?
Draining palatal sinus (very painful, less common due to thick palatal bone)
Draining buccal sinus - below buccinator insertion
Into maxillary sinus - sinusitis
Into buccal space, superior to insertion of buccinator - swelling of cheek
Where may an infection travel from a lower tooth?
Perforate above mylohyoid muscle - sublingual abscess in sublingual space
Perforate below mylohyoid insertion - submandibular abscess
Bucally - sinus or into buccal space
What is the pterygomandibular space?
Space between mandible and two pterygoid muscles
Where is the infratemporal space?
Temporal fossa region beyond temporalis
What is the superficial and deep temporal spaces?
Superficial is space superficial to temporalis muscle
Deep is below the temporalis muscle
What is the Masseteric space?
Space between masseter and the mandible
What runs through the lateral pharyngeal space?
Carotid sheath
- internal jugular vein
- internal carotid artery
- CNIX, X, XI, XII
What might someone with a pharyngeal space infection present with?
Lump in the back of the throat around the pharynx
Where can infection from the lateral pharyngeal space travel?
To the retropharyngeal space
Then to the prevertebral space
How may infection enter the skull?
Draining infection goes into infratemporal space, close to pterygoid venous plexus
From here, it can pass through valveless veins to the cavernous sinus
How can infection reach the skull?
Mandibular Infection gets into infratemporal space, and then into pterygoid venous plexus
Infection travels up the valveless veins and into cavernous sinus
Maxillary tooth infection can go to infra orbital space, then infection into veins and into cavernous sinus
Typically, where would upper anterior tooth infection spread to?
Lip
Nasiolabial region
Lower eyelid
Where would maxillary lateral incisors typically drain to?
Apex of root is palatally placed, so can spread to palate
Where would maxillary premolars and molars typically spread infection to?
Cheek
Infra temporal region
Maxillary antrum (very rare)
Palate
What is this? Most likely cause?
Palatal abscess
Grossly carious lateral incisor
What is this? Most likely cause?
Infection which has spread above buccinator muscle and gone into the buccal soft tissues
Swelling caused closure of eye and also discolouration / whiteness around the nose
Most typical cause for an infra-orbital spread of infection?
Canine, long root
Where would lower anteriors typically spread to?
Mental and submental spaces, often tend to stay here
Where would lower premolars and molars typically spread?
Buccal space
Submasseteric space
Sublingual space
Submandibular space
Lateral pharyngeal space
(Lowers tend to go back)
(Uppers tend to go up, not down)
What are the main aims of surgical removal of infection?
Establish drainage
- e.g. open pulp or incise
Removal of source of infection
- tooth, or extirpate pulp
Antibiotic therapy
- Immunocompromised
- systemically unwell
- not always if fully drained
What signs are there that a patient is systemically affected by infection?
Raised temperature
Raised heart rate
Raised respiratory rate
Raised white cell count
When extra orally incising a submandibular swelling, what consideration must be made
Proximity to marginal mandibular branch of facial nerve
Incise 2 finger widths below the inferior border of mandible
What is Ludwig’s angina? Signs and symptoms?
Severe bilateral infection of the sublingual and submandibular spaces, leading to large swelling beneath the neck
Difficulty breathing and swallowing
Drooling
Raised tongue
Diffuse redness and bilateral swelling
