1. The document discusses various types of tissue space infections, including Ludwig's angina, which is a potentially life-threatening bilateral infection of the submental, sublingual, and submandibular spaces.
2. It describes the surgical anatomy and contents of different tissue spaces like the submandibular, sublingual, pterygomandibular, and submental spaces.
3. Causes, clinical features, treatment and importance of properly draining abscesses are covered for different tissue space infections.
Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine
Al-Azhar University. The Pathogenesis of infection in oro-facial region due to odontogenic origin is a common clinical issue. bacterial invasion to deeper tissues usually a spread from diseased dental pulp. Recent evidences indicated a multi-microbial nature. The spread of infection is governed by the thickness of the investing bone and the anatomical relation of the tooth root to the attached muscle. Infection could spread from one facial space to another, and the condition may be aggravated to life threatening situations.
Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine
Al-Azhar University. The Pathogenesis of infection in oro-facial region due to odontogenic origin is a common clinical issue. bacterial invasion to deeper tissues usually a spread from diseased dental pulp. Recent evidences indicated a multi-microbial nature. The spread of infection is governed by the thickness of the investing bone and the anatomical relation of the tooth root to the attached muscle. Infection could spread from one facial space to another, and the condition may be aggravated to life threatening situations.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
2. Tissue space infection
Space is misnomer so it is clefts
(apotential space between the fascial
layers which contain CT AND Various
anatomical structures ) there is no voids in
the tissue.
10. bacteriology
Aerobes and anaerobes are the causative
agents
Aerobes account for 5%
Anaerobes account for 35%
Both or both account for 60%
11. Life threatening features
Respiratory impairment
Difficulty in swallowing
Impaired vision
Change in voice (hot potato)
Lethargy
Decrease level of consciousness
Agitation, restlessness due to hypoxia
17. Masticator space infection
It is space lie along the lower border of the
mandible,ramus of the mandible and the mscles
of mastications
Outer sheath (masseter ,temporalis muscles)
The inner sheath cover (mylohoid m.)
Poteriorly cover the m.ptregoid m
Parotid space laterally,parapharyngeal space
medially ,it attach to temporal m. superiorly
18. The space of burns (suprasternal )
The superficial layer split below the level
of hyoid to form 2 spaces
The lower part of ant. Triangle (2layers
attach to) sternum
The lower part of post.Triangle (2layers
attach to manibrum of the clavicle
19. The space of burns (suprasternal )
Contents
The sternal head of sternocliedomastoid
Communication between the anterior
jugular v.
Lymph gland
The interclavicular ligament
21. Stages of infection
Periapical abcess
A.infection confined within bone
B.tooth extruded from socket
C.painful tooth to biting and percussion
24. Site of dental infection and direction
of sread from jaw bones
Upper and lower central incisors and
canines and lower premolars the abcess
exit labially
Lower third molars it exit lingually from
bone
From other teeth it exit labially and
occasionally exit palataly or lingually
25. Clincal feature
Rubor (Redness)-calor (heat)-dolar (pain)-
tumor (swelling),fever
(pyrexia),headache,lymphadenopathy,diffi
culty inopening the mouth or swallowingor
brathing,increase salivation, change in
phonation ,bad breath
26. cellulitis
Def.oedematus swelling with all cardinal
signs of inflammation ,it is spreading
infection of loose connective tissue it
caused by streptococcus infection it does
not produce alarge collection of pus.
27.
28.
29.
30. Cellulitis Vs abcess
Duration acute phase
Pain severe generalise
Size large
Localization diffuse
border
Palpation douphy to
induration
Pus No
Seriousness degree
greater
Bacteria aerobic
Chronic phase
Localized
Small
Well circumscribed
Fluctuant
Yes
Less
Anaerobic-mixed
31. periapical Vs periodontal
periapical abcess
1.non vital tooth
2. severe pain
3.sinus formation is
usual
4.tooth tender to
periapical percussion
5.swelling in the apex
Periodontal abcess
1.vital tooth
2.dull pain
3.no sinus formation
4.Tooth tender to
horizontal percussion
5. Swelling in the
middle third of
alveolar process
32. Factors affecting the spread of
infection
1.type and virulance of microorganism
2.the state of pt. Health
3.the efficiency of pt,s immune system
4.failure of pus drainage
33. Anatomical factors influencing the
direction of spread of infection
1.site of the source of infection ;lower or
upper jaw molar region or premolar
,incisor ,canine .anterior or posterior
2.point at which pus escape from bone to
soft tissues ;labiolingual or buccopalatally
3.the natural barrier to spread ;fascia
,muscle ,bone.
34. The spread of infection can be
1.direct depend on the anatomical
barriers
2.by lympatic
3.by blood (haematogenus)
35. pericoronitis
It is inflammation of the soft tissues
covering the crown of partially erupted or
unerupted tooth.it can be
1.unilateral
2.bilateral (infectious mononucleosis or
vincient ulcerative gingivitis
36. pericoronitis
Aetiology unknown
But the causes could be food collection
which is good media for bacteria to florish
due to 1.darkness,moist,food
(nutrition),absence of oxygen (anaerobic
conoization)
42. treatment
Irrigtion e normal saline
Antiboitic
Analgesics
Removal of the cause
Rehydration
Nutrition
Bed rest
Reduction or extaction of opposing tooth or offender
tooth
Operculectomy
Incision and drainage and culture and sensitivity test
43. Sublingual space
Firm painfull swelling in the ant. Part of
floor of the mouth
Raise the tongue
Little not exetnded swelling
44.
45. Sublingual space
Boundery
V-shaped space
Medially the muscles of tongue
(genio,hyoglossus m.)
Inferiorly mylohoid m.
Laterally the lingual aspect of the
mandible
Superiorly the mucosa of the floor of the
mouth.
46.
47.
Surgical therapy aim
1.toget rid of toxic purulent material
2.to decompress the abcess
3.to allow better perfusion of
blood,containing antiboics and defense
elements
To increase the oxygenation of infected
area
49. Submental space
Boundry :Superiorly ;the mylohoid m.
Inferiorly ;skin,platysma, deep cervical
fascia
Laterally; the anterior belley of daigasric
m.
Anteriolaterally ;lingual surface of the
body of the mandible
Posterioly ;the hyoid bone
50. Submental contents
Submental LN embbeded in adipose tissue
The source of infection:tip of the tongue
Lower incisors,anterior part of floor of the
mouth,lower lip skin or infection from the
submandibular space
51. Submandibular space
Surgical anatomy between the anterior
and posterior belly of diagastric m.
Medially the mylohyoid &hyoglossus m.
Inferiorly the investing layer of deep
cervical fascia
Laterally the medial aspect of the
mandible
56. Submandibular space
CF
Swelling of the submandibular region
Pain tenerness,dysphagia
Systemic toxic effect
Discomfort
Difficult opening of the mouth
57. HILTON METHOD
THE METHOD OF OPENING THE ABCESS
ENSURES THAT NO BLOOD VESSELS OR
NERVE IN THE VICINITY IS DAMAGE
58. HILTON METHOD
TOPICAL ANAESTHESIA
STAP INCISION IN MORE FLUCTUATION
REGION
CLOSED FORCEP PUSH TO DEEP FASCIA
OPEN FORCEPS TO DECOMPESS
PLACEMENT OF DRAIN UNTIL SOPP
DRAININD
DRESSING
59.
60.
61. Ludwig angina
Apotential life threatining Bilateral massive
diffuse septic gangernous cellulitis of
submental , sublingual ,submandibular
region
Surgical anatomy of sublingual space
Surgical anatomy of submental space
Surgcal anatomy of submandibular space
69. Ludwig angina
Ttt
massive Antiboitics
Early intubation to control the airway
Nasotracheal intubation,cricotherodotomy and tracheostomy (late
stage)
Surgical drianage
Culture &sensetivity test
Bed rest fluid and electrolytes balance
Monitring of vital signs
Nutrition (multivitamines ,high protein diet (forceval)
analgesics
Folow up
76. Submassetric space
The masseter muscle has 3heads e
insertion into the ramus seprated from
each other by bare areas the space
beteen the middle &deep head called
(submasseteric space) the origin the lower
border and medial surface of zygomatic
arch insertion in the lateral aspect of the
ramus of mandible.
78. Submassetric space
CF
Facial swelling outline the masseter m.
Swelling does not extend beyond the
posterior border of ramus or lift the lobe
of ear (DD.Acute parotitis)
Trismus
Pyrexia,malaise
80. Buccal space
Boundries
Anteriomedially the buccinator m.
Posteriorly :the masseter m.
Laterally ;paotid fascia covered by platysma
Limited below by the attachement of deep
cervical fasciato the mandible &depressor
angularis oris
Limted above by zygomatic process of maxilla
&zygomaticus major and minor.
81.
82.
83. Parotid space
Deep cervical fascia at the angle of the
mandible covere it large swelling posterior
to masseter m.
It raise the lobe of the ear
Doesnot cause trismus
85. Infratemporal space
it form the upper exteremty of the
pterygoid space
Boundry
Laterally the ramus of the mandible
&the temporalis
Medially the lateral ptregoid m plate
Superiorly infratemporal surface of
the greater wing of sphenoid
88. Peritonsillar (QUINSY)
It is locaized infectionin the CT between
the tonsil& superior constrictor m.between
the ant. And pos. pillar of fauces.
Aetiology
Tonsillar cyrpts and supratonsillar fossa
infection
Pericoronal infection.
90. Parapharyngeal space
Lateral pharyngeal space+retrophayngeal
space (Prevertebral spce)
Space form ring around the pharynx
extended to mediastinum and
communicate e submandibular space
anterinferiorly and retromandibular space
posteriorly
92. Lateral pharyngeal space
The medial wall is superior constrictor
The laterl wall the medial ptregoid
m.,down to the angle of the mandible
&Submandibular gland
The posterior border is prevertebral fascia
It consists of 2 components
1.anterior component (muscular)
2.posterior component (vascular )
93. Lateral pharyngeal space
Aetiology
Lower third mlar infection
Tonsillar abscess
Sublingual,submandibular infection
CF
Prexia,malaise,swelling below the angle of
mandible,intraoral swelling in the lateral
wall of pharynx.
97. Retropharyngeal space
Midlinespce between the pharyngobasillar
fascia which attach the pharyngeal
constrictor to base of skull and
prevertebral fascia
Aetiology
Lateral pharyngeal space infection
99. Canine space
Lie deep into muscles of facial expression
involve upper lip (levator labii
superioris,levator angularis oris ,labii
superioris alaeque nasi )
Levator anguli oris below the infraorbital
n.levator labii superioris above it
Short canine level below levator angulii
oris.
100. Canine space
CF
Oedema of upper lip & cheek
Obliteration of nasolabial fold
Drooping of the angle of the mouth
Swelling of medial corner of lower eyelid
Complication cavernous sinus thrombosis
101. Cavernous sinus thrombosis
It is serious condition consisting formation of
thrombus in the cavernous sinus or it is
communicating branches
2routes
External route face,lip –facial –angular vein-
opthalmic v.-superior orbital fissure –cavenous
sinus
Internal route ;dental infection –ptregoid
v.plexus-inferior opth. V. inferior orbital fissure –
cavernus sinus
105. Cavernous sinus thrombosis
Or ptregoid v. plexus –emissary v.-foramen
ovale –cavernous sinus
Rapid complications lead to death because
Short distance from facial region to the
sinus
Frequent anastomosis of vein(direct
communication)
Valveless vessels (no protection )
106. Cavernous sinus thrombosis
TREATMENT
Antiboitics (chlormaphenicol 1g 6h)
Mannitol (reduce oedema)
Anticoagulants (heparin 20000 unit in
1500 ml 5% dextrose)
Surgical drinage
Culture &sensitivity ,bed rest ,fluid
,nutrition,follow up of general heath.