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MODULE 5 ORAL SURGERY > SPREAD OF INFECTION > Flashcards

SPREAD OF INFECTION Flashcards

1
Q

List types of odontogenic infection

A

caries
periapical periodontitis
periodontitis
pericoronitis
osteomyelitis
maxillary sinusitis

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2
Q

describe cellulitis

A

diffuse inflammation of soft tissues
spreads through tissue spaces along fascial planes

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3
Q

fatal complication with periorbital oedema

A

cavernous sinus thrombosis

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4
Q

potential spread of infection from mandible leading to mediastinitis

A

laryngeal inlet - asphyxia
pretracheal fascia
prevertebral fascia
retropharyngeal space

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5
Q

bilateral involvement and oedema of the submandibular/ submental/ sublingual/ para and retro pharyngeal spaces

A

ludwigs angina

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6
Q

sign of cavernous sinus thrombosis?

A

difficulty of movement of eyes
build up of pressure leading to proptosis of eye

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7
Q

life-threatening organ dysfunction caused by dysregulated host response to infection

A

sepsis

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8
Q

signs of sepsis

A

slurred speech
extreme shivering
passed no urine in a day
severe breathlessness
illness
skin mortalling/ discolor/ cyanosis

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9
Q

how to differentiate a rash and septic rash

A

doesn’t blanch with pressure

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10
Q

sepsis ABCDE

A

temp >38 or <36
HR >90
resp rate >20
WCC >12 or <4
BP systolic <100

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11
Q

sepsis management

A

take blood cultures prior to antibiotics
take serum lactate >2mmol/l
give O2
give empirical IV antibiotics
give IV fluids
monitor urine output

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12
Q

management of odontogenic infection

A
  • eliminate cause of infection
  • provide path of least resistance
  • analgesics (paracetamol, ibuprofen)
  • review after 48-72 hours
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13
Q

co-codamol preparation

A

800mg codeine
500mg paracetamol

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14
Q

what is a sinus?

A

chronic infection - usually asymptomatic

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15
Q

where do sinuses present?

A

apex of tooth

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16
Q

an extraoral discharge resulting from infection?

A

orocutaneous fistula

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17
Q

orocutaneous fistula tx?

A

extirpate pulp/ xLA
excise fistula

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18
Q

feature of a orocutaneous fistula?

A

epithelial lined

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19
Q

what can a buccal space infection present as?

A

facial swelling which doesn’t proceed above zygomatic arch
can spread periorbitally

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20
Q

buccal space infection management in primary care

A

eliminate source of infection - most likely molar (max/man)
extirpate pulp/ xLA

21
Q

where may canine roots pass through?

A

muscles of facial expression

22
Q

clinical presentation of canine space?

A

infraorbital swelling
obliteration of nasolabial fold

23
Q

clinical presentation of infratemporal space infection

A

severe trismus
bulging of temporalis
cavernous sinus thrombosis

24
Q

what muscles does the infratemporal space lay between

A

temporalis
pterygoid

25
Q

presentation of submandibular space infection

A

firm swelling in SM region
trismus

signs of acute inflammation

26
Q

presentation of sublingual space infection

A

little extraorally
IO swelling FOM

27
Q

can you incise and drain SM space in primary care?

A

no

28
Q

can you incise and drain SL space in primary care?

A

yes

29
Q

what does SL space infection suggest?

A

root is closer to sublingual plate and short rooted - apex above mylohyoid

30
Q

what does SM space infection suggest?

A

long root and close to inferior border of mandible - under mylohyoid muscle into SM space

31
Q

what teeth normally cause submental space infection?

A

lower incisors

32
Q

clinical presentation of submental space infection

A

firm swelling under chin
discomfort on swallowing

33
Q

cause of submental space infection

A

lower incisors with long roots that contact the inferior border/ lingual plate of the mandible

34
Q

3 spaces that communicate from head to chest, leading to mediastinitis

A

prevertibral
retropharyngeal
lateral pharyngeal

35
Q

why doesn’t an infected area/ abscess not have a good blood supply?

A

the pus/ inflammation compresses the vessels

36
Q

how may a periapical collection of pus be drained?

A

through access cavity - creating path of least resistance - then place temp dressing

37
Q

what blade is used to incise abscess?

A

number 11

38
Q

when would you do blunt dissection?

A

when there is loculated pus

39
Q

what is used for blunt dissection?

A

artery forcep or scissors

40
Q

what are general measures post drainage?

A

adequate fluid intake
rest
diet

41
Q

what analgesics can be taken after incision and drainage?

A

paracetamol
ibuprofen
cocodamol

42
Q

indication for antibiotics

A

systemic involvement
significant cellulitis
compromised host defences
involvement of fascial spaces

43
Q

antibiotic of choice for most abscesses (anaerobic)

A

metronidazole

44
Q

what antibiotics may you combine in severe infections

A

metronidazole and penV

45
Q

when to refer?

A

rapid progression
difficulty breathing
difficulty swallowing
fascial tissue involvement
temp >39 degrees
severe trismus
compromised host defences
infection not responding to tx

46
Q

what sites may you use LA for drainage?

A

buccal/ labial sulcus
palate
SL space - buccal and parallel to sublingual fold

47
Q

Ludwig’s angina oral symptoms

A

rapid, board like swelling of FOM, elevation of tongue, dysphagia, dysarthria, trismus

48
Q

why is ludwig’s an anesthetic emergency?

A

compression of airway

49
Q

what is the technique of drainage performed under LA?

A

Bilateral Hiltons drainage

MODULE 5 ORAL SURGERY (7 decks)

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