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Abscess
PBL 7
Muscles of mastication
MUSCLES OIGIN INSERTION INNERVATION ACTION
Masseter superficial part: ramus of the
maxillary process of mandible
the zygomatic
bone
deep part:
zygomatic arch of
the temporal bone Mandibular nerve closing the mouth
(V3)
Temporalis temporal fossa coronoid process Retract mandible
of the mandible
Medial Pterygoid maxilla & LP plate
of sphenoid
Neck of mandible
Lateral Pterygoid Sup head: greater protract the
wing of sphenoid mandible;
Inf head: LP plate Side to side jaw
of sphenoid movement
Other organisms cause sore throat
(Pharyngitis)
Streptococcus
Mycoplasma pneumoniae
Chlamydia pneumoniae
Neisseria gonorrhoeae
Corynebacterium diphtheriae
most commonly with a viral upper respiratory infection (URI)
Haemophilus influenza – adult (beta lactamase)
*throat extends from the nasal passages above and behind the mouth to the esophagus (tube
that carries food to the stomach) in the neck
*complication: lead to tonsillitis, if longstanding infection ensuing quinsy, which affects CT of
tonsil
*Sore throat related to viral URI usually resolves without medication.
*Bacterial pharyngitis is treated with antibiotics
TRISMUS
3. Peritonsillar abscess
Severe throat pain
Fever
Drooling
Foul breath
Trismus (difficulty opening the mouth) – complication: The fascial spaces of the neck are interconnected. Once
inflammation exceeds the limits of the peritonsillar space, involvement of the masticator space (with increasing
degrees of trismus) occurs.
Altered voice quality (the hot-potato voice)
TONSILITIS
Other etiology:
1. Recurrent tonsillitis (polymicrobial) - Staphylococcus aureus, and
Haemophilus influenzae are the most common bacteria isolated in
recurrent tonsillitis, and Bacteroides fragilis is the most common anaerobic
bacterium isolated in recurrent tonsillitis.
2. Chronic tonsillitis (polymicrobial) - beta-hemolytic streptococcal species, S
aureus, H influenzae, and Bacteroides species
TONSILITIS
Pathogenesis
The nidus of accumulation is located between the
capsule of the palatine tonsils and the constrictor muscles
of the pharynx. The anterior and posterior pillars, torus
tubarius (superior), and pyriform sinus (inferior) form the
boundaries of this potential peritonsillar space. Because
this area is composed of loose connective tissue, severe
infection may rapidly lead to formation of purulent
material. Progressive inflammation and suppuration may
extend to directly involve the soft palate, the lateral wall
of the pharynx, and, occasionally, the base of the
tongue.
Nice to know. . .
soft diet
a diet that is soft in texture, low in residue, easily digested, and well tolerated. It
provides the essential nutrients in the form of liquids and semisolid foods, such
as milk; fruit juices; eggs; cheese; custards; tapioca and puddings;
strained soups and vegetables; rice; ground beef and lamb; fowl; fish;
mashed, boiled, or baked potatoes; wheat, corn, or rice cereals; and breads.
Omitted are raw fruits and vegetables, coarse breads and cereals, rich
desserts, strong spices, all fried foods, veal, pork, nuts, and raisins.
It is commonly recommended for people who have GI disturbances or acute
infections and those unable to tolerate a normal diet
SWOLLEN TONSILS
DUE TO BACTERIAL
SWOLLEN UVULA INFECTION WITH
WHITE SPOTS
SWOLLEN SOFT
PALATE
DISEASE Acute bacterial Acute Bacterial tonsillitis Peritonsillar abscess
DIAGNOSTIC/LAB TESTS pharyngitis
Lab studies • Throat culture • Throat cultures (GABHS FBC, electrolyte level
• Rapid antigen infection) measurement, and
detection tests • Monospot serum test, blood cultures;
FBC, and serum monospot test
electrolyte level (heterophile
• Rapid antigen antibodies); throat
detection test (RADT) swab and culture
TREATMENT
benzathine penicillin than 6 episodes of
G streptococcal
pharyngitis)
BACTERIAL PHARYNGITIS
Acute retroviral syndrome
Peritonsillar Abscess
Viral Pharyngitis
TONSILITIS & PTA
Gastroesophageal Reflux Disease
Dental infection