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75 Cards in this Set
- Front
- Back
Dental infections are also known as _____________, and are infections that involve the teeth or associated structures/tissues
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odontogenic infections
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Dental infections are caused by Oral pathogens that are predominantely _________ and are usually of multiple species and are found on dentition, gingival crevice, etc.
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anaerobic
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Treatment of dental infections consist of
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removal of the source of infection, systemic antibiotics, and area drainage
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Dental Infections can result in various types of lesions such as:
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Abscess, Cellulitis, and Osteomyelitis
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An _________ is a localized entrapment of pathogens from dental infection in closed tissue space
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Abscess
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the abscess is filled with __________, which is pus that contains pathogenic bacteria, WBC’s, tissue fluid, debris
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suppuration
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_____________ formation can occur with progressive caries when the pathogens invade the usually sterile pulp and the infection spreads apically
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Periapical abscess
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___________ is inflammation around the crown
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Pericoronitis
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True or False
An abscess should be detecable on a radiograph even during early stages |
False - During early stages it may not be detectable on radiograph
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in later stages of infection the abscess formation can lead to the formation of a _________________ in the skin, oral mucosa, or even bone that allows drainage of the infection and creates suppuration on a surface
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passageway or fistula (drainage)
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The opening of the fistula is called a
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Stoma
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The soft tissue over a fistula in the alveolar bone may also have an extraoral or intraoral __________, which is a small, elevated, circumscribed lesion of either the skin or oral mucosa that contains suppuration
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Pustule
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The location of the pustule is based on
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muscle attachments
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____________ of Face and neck can also occur with dental infections and is characterized by diffuse inflammation of soft tissue spaces
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Cellulitis
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the clinical signs and symptoms of Cellulitis are:
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- Pain, tenderness, redness, diffuse edema of involved soft tissue space, causing massive and firm swelling
- Dysphagia (difficulty swallowing), ptosis (restricted eye opening) |
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Cellulitis Can lead to
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Ludwig’s angina
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Treatment of Cellulitis involves
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removal of infection cause and antibiotics
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______________ is another type of lesion related to dental infection that is an inflammation of bone marrow
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Osteomyelitis
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Osteomyelitis inflammation develops from the invasion of the tissue of a long bone by pathogens, usually from a
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skin or pharyngeal infection
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In osteomyelitis involving the Jawbone, the pathogens are most likely derived from
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- abscess
- from extension of cellulitis - or contamination of a surgical site |
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Osteomyelitis most commonly occurs in
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Mandible
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Osteomyelits occurs rarely in __________ because the ___________ is less vascularized, and has thicker bone
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- Maxilla
- mandible |
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Untreated osteomyelitis leads to:
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- Resorption of bone and formation of Sequestrae
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___________ are pieces of dead bone separated from the sound bone within the area
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Sequestrae
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___________ or pins and needle sensation may develop in mandible due to proximity of IAN(inferior alveolar nerve)
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Paresthesia
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Treatment of osteomyelitis consists of
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- drainage
- surgical removal of any sequestra - and antibiotic regimen |
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Normal flora do not create infections, however if body’s natural defenses are compromised then they can create
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opportunistic infections
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Medically compromised patients include those with
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AIDS, diabetes, cancer, etc.
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Patients that have a higher risk of complications include those at risk for
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- Infective endocarditis
- or infection with their implanted prosthetic joints |
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More than 50% (half) of gram (-) anaerobic bacteria are capable of producing the ________________, which is responsible for the initial etiology of head and neck infections as well as many treatment failures in dental infections.
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beta-lactamase enzyme
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The beta-lactamase survives _________ therapy
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penicillin
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Many odontogenic infections start in the
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dentition and associated oral tissues
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Normally a localized abscess establishes a fistula in the
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skin, oral mucosa, or associated bone, and etc)
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Maxillary sinuses can become infected as a sequelae of
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odontogenic infection
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Secondary sinusitis occurs mainly near the maxillary sinuses because the
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maxillary posterior teeth (PMs/Ms) and associated tissues are close in proximity to these sinuses
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_____________ can be caused by spread of infection from a periapical abscess perforation or post-extraction infection due to residual fragments
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maxillary sinusitis
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However most common infections of maxillary sinuses are not of dental origin but are caused by an _____________ that has spread to the sinuses and can be fatal due to communication to other sinuses
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Upper respiratory infection
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Maxillary sinusitis symptoms include
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headache, foul-smelling nasal or pharyngeal discharged, fever, weakness
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The skin over sinus can be _____________ and difficulty breathing (Dyspnea) occurs
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tender, hot, red due to the inflammation in the area
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Radiographically – early evidence of sinusitis is the thickening of sinus walls, with subsequent radiographic evaluation showing
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increased radioopacity, and possible perforation – may need MRI
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_____________ usually responds to aggressive antibiotic regimen and drainage (decongestant)
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Acute sinusitis
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_____________ may require surgical intervention to increase drainage (canine fossa)
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Chronic sinusitis
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the Vascular System of head and neck can allow the spread of infection from the teeth and associated oral tissues because pathogens can travel in the _________ and drain the infected oral site into other tissues or organs
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veins
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The spread of dental infection by way of the vascular system can occur because of
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bacteremia or an infected thrombus
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__________ is caused by bacteria traveling in the vascular system
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Bacteremia
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Bacteremia can occur during a dental treatment and can have an effect on
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- infective endocarditis (antibiotic premedication)
- newly-placed joint prosthetics - medically compromised patients |
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and infected intravascular clot (thrombus) can dislodge from the inner blood vessel wall and traveal as an
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embolus
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___________ is the most likely to be involved in the possible fatal spread of dental infection
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Cavernous sinus
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An infection in the cavernous sinus is called a
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cavernous sinus thrombus
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Cavernous sinus is located on
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side of the body of sphenoid
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The left cavernous sinus and the right side cavernous sinus communicate with each other and also communicate with the ___________ and with the _____________
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- pterygoid plexus
- ophthalmic vein |
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The Pterygoid plexus and ophthalmic vein anastomose with the
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facial vein
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Bacteremia potential is due to
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lack of valves in veins of head to prevent flow of blood back into the cavernous sinus
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Needle track contamination to ____________ if PSA block administered incorrectly
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pterygoid plexus
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Nonodontogenic infections of the area considered to be the “dangerous triangles of the face” are the
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orbital, nasal, paranasal sinuses
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Signs and Symptoms of cavernous sinus thrombus include:
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Fever, drowsiness, rapid pulse
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in a cavernous sinus thrombus there is also a loss of function of CN VI (abducens nerve paralysis) resulting in
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impaired eye movement, diplopia, eyelid edema, lacrimation, exophthalmus
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Other CN damage involved in cavernous sinus thrombus may invlove the following CN:
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CN III, CN IV, CN V
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Lymphatics can allow the spread of infection from the teeth and associated oral tissues, because pathogens can travel in the ________ through the lymphatic vessels that connect the series of nodes from the oral cavity to other tissues or organs
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lymph
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These pathogens travel in the lymph from the __________ near infected site to a ___________ at a distant site
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- primary node
- secondary node |
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Mandibular incisors drain into submental node which drain into the
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submandibular node or into deep cervical node
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Maxillary third molars drain into
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superior deep cervical nodes
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All other dentition (except mandibular incisors, maxillary M3s) drain into ____________ which drain into _____________
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- submandibular nodes
- superior deep cervical node |
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True or False
The Fascial Spaces of the head and neck can allow spread of infection from the teeth and associated oral tissues because the pathogens can travel within the fascial planes, from one space near the infected site to another, more distant space by means of the spread of the related inflammatory exudates. when involved infections, the space can undergo cellulitis. |
True
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If Maxillary dentition and associated teeth are infected, the infection can spread into
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Maxillary vestibule, buccal space, canine space
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If Mandibular dentition and associated teeth are infected, the infection can spread into the
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Mandibular vestibule, buccal space, submental space, sublingual space, masticator spaces, space of body of mandible
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Infection in relationship to mylohyoid muscle dictates
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which mandibular subspace will be effected
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Apex of mandibular M1 (and all other mandibular dentition anterior to this point) is located above the mylohyoid muscle so involvement of this tooth or teeth anterior to this will involve the
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sublingual space
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Apex of M2 and M3 located below mylohyoid muscle and infection here will first spread to the
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submylohyoid space
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_____________ is on of the most serious lesions of the jaw region
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Ludwig's Angina
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Ludwig's Angina is cellulitis of the
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submandibular space
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Ludwig's angina involves spread of infection from any of the mandibular teeth to one space initially (submental, sublingual, submandibular space) and will later involve bilateral _________________ and then spread to the _________________ and then to the ___________________ of neck and cause swelling.
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- submandibular spaces
- spread to parapharyngeal space - retropharyngeal space |
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Ludwig's angina leads to
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difficulty swallowing, difficulty breathing, fever, excessive drooling
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Ludwig's angina can also lead to respiratory obstruction of retropharyngeal space and will then ultimately lead to
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Asphyxiation and death
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an emergency __________ may be required to open airway in patient with Ludwig's angina
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cricothyrotomy
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