Spread Of Infection Flashcards

1
Q

Where may infection in a maxillary tooth travel?

A

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

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2
Q

Where may an infection travel from a lower tooth?

A

Perforate above mylohyoid muscle - sublingual abscess in sublingual space

Perforate below mylohyoid insertion - submandibular abscess

Bucally - sinus or into buccal space

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3
Q

What is the pterygomandibular space?

A

Space between mandible and two pterygoid muscles

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4
Q

Where is the infratemporal space?

A

Temporal fossa region beyond temporalis

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5
Q

What is the superficial and deep temporal spaces?

A

Superficial is space superficial to temporalis muscle

Deep is below the temporalis muscle

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6
Q

What is the Masseteric space?

A

Space between masseter and the mandible

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7
Q

What runs through the lateral pharyngeal space?

A

Carotid sheath
- internal jugular vein
- internal carotid artery
- CNIX, X, XI, XII

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8
Q

What might someone with a pharyngeal space infection present with?

A

Lump in the back of the throat around the pharynx

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9
Q

Where can infection from the lateral pharyngeal space travel?

A

To the retropharyngeal space

Then to the prevertebral space

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10
Q

How may infection enter the skull?

A

Draining infection goes into infratemporal space, close to pterygoid venous plexus

From here, it can pass through valveless veins to the cavernous sinus

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11
Q

How can infection reach the skull?

A

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

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12
Q

Typically, where would upper anterior tooth infection spread to?

A

Lip

Nasiolabial region

Lower eyelid

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13
Q

Where would maxillary lateral incisors typically drain to?

A

Apex of root is palatally placed, so can spread to palate

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14
Q

Where would maxillary premolars and molars typically spread infection to?

A

Cheek

Infra temporal region

Maxillary antrum (very rare)

Palate

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15
Q

What is this? Most likely cause?

A

Palatal abscess

Grossly carious lateral incisor

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16
Q

What is this? Most likely cause?

A

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

17
Q

Most typical cause for an infra-orbital spread of infection?

A

Canine, long root

18
Q

Where would lower anteriors typically spread to?

A

Mental and submental spaces, often tend to stay here

19
Q

Where would lower premolars and molars typically spread?

A

Buccal space

Submasseteric space

Sublingual space

Submandibular space

Lateral pharyngeal space

(Lowers tend to go back)

(Uppers tend to go up, not down)

20
Q

What are the main aims of surgical removal of infection?

A

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

21
Q

What signs are there that a patient is systemically affected by infection?

A

Raised temperature

Raised heart rate

Raised respiratory rate

Raised white cell count

22
Q

When extra orally incising a submandibular swelling, what consideration must be made

A

Proximity to marginal mandibular branch of facial nerve

Incise 2 finger widths below the inferior border of mandible

23
Q

What is Ludwig’s angina? Signs and symptoms?

A

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