Surgical Infections Flashcards
(65 cards)
What local factors impact the infection outcome?
- anatomical site
- mucosal barriers
- local immune response (acute inflammation)
What does the infection outcome depend on?
- virulence of the organism involved
- host resistance to infection (local and systemic)
- local anatomy (fascial spaces)
- treatment of infection
What systemic factors affect the infection outcome?
(immune status)
* age of host
* stress
* pregnancy
* underlying host pathology e.g. neoplastic illness
* nutritional state of host
* type of drug therapy
What are the local signs of infection that are present upon examination?
- pain
- redness
- tenderness
- swelling- firm/fluctuant
- sinus
- pus
What systemic signs can be examined in suspected infection?
- temperature
- malaise
- fatigue
- pulse
- respiratory rate
- lymphadenopathy
What is the state of the pulp in infections of periapical Vs periodontal origin
Periodontal: pulp usually vital
Periapical pulp usually non-vital
Where is swelling present in infection of periapical VS periodontal origin?
Periapical: tenderness or swelling over apex
Periodontal: swelling near gingival margin
Describe the mobility experienced in infection of periapical VS periodontal origin
Periapical: mobility is late
Periodontal: mobility is early
Where is radiolucency present in infection of periapical VS periodontal origin ?
Periapical: periapical radiolucency
Periodondal: lateral radiolucency
Describe the result of the percussive test of an infection of periapical VS periodontal origin
Periapical: TTP +++
Periodontal: TTP +
What are the 4 stages of infection?
- inoculation
- cellulitis
- abscess
- rupture
Outline the fascial spaces of the neck
- retropharyngeal space
- danger space
- prevetebral space
- carotid space
- infrahyoid fascial space
- pretracheal space
Cellulitis can progress into…
an abscess
What are the characteristics of cellulitis ?
- 3-7 days duration
- severe and generalised pain
- large size
- diffuse localisation
- hard on palpation
- tender appearance
- reddened skin
- thickened surface
- hot and severe loss of function
- semi sangeuineous fluid
- mixed bacteria
- severe seriousness level
What are the characteristics of an abscess?
- duration over a 5 day period
- moderate and localised pain
- small in size
- circumscribed location
- fluctuant and tender on palpation
- periphery is reddened on appearance
- centrally undermined on the skin
- moderately heated on skin temp
- moderately severe loss of function
- pus filled
- moderate degree of seriousness
- anaerobic bacteria
What special investigations are appropriate for a suspected surgical infection ?
- vitality
- TTP
- Mobility
- radiograph
- culture and sensitivity (to determine Abx)
What type of penicillin is now recommended for anaerobic bacteria?
Penicillin V
Irreversible pulpitis can lead to…
- pulpal necrosis —> periapical inflammation
What symptoms are associated with reversible pulptis?
- poorly localised pain
- follows stimulation
- short duration
- non spontaneous
- relieved with analgesiics
- not kept awake
- tooth remains vital
What symptoms are associated with irreversible pulpitis ?
- pain poorly localised
- continuous pain
- spontaneous
- analgesics ineffective
- kept awake
- tooth non vital?
What are the symptoms of acute periapical periodontitis?
- severe pain
- well localised
- swelling or redness at apex
- elevation of tooth
- pain on biting
- very TTP
- non-vital
- mobile?
- radiographic appearance?
What are the symptoms of chronic infection (granuloma/cyst) ?
- often asymptomatic
- egg shell crackling
- radiopacity
- usually not TTP
- tooth may be mobile
- draining sinus
Acute periapical periodontitis can develop into…
periapical abscess (supparation) –> spread (alveolar abscess) —> subperiosteal —-> drain into mouth or spread into fascial spaces
What is trismus?
inability to open the mouth widely
