Question 1: What is the treatment of choice for a post-operative abscess?
- A. Hydration
- B. IV antibiotics
- C. Image guided aspiration (Correct Answer)
- D. Reexploration
Explanation: ***Image-guided aspiration***
- This is often the **first-line treatment** for a post-operative abscess, especially if it is well-localized.
- It involves **draining the pus** under imaging guidance, relieving pressure and removing the infectious material.
*Hydration*
- While important for overall patient management, especially in cases of infection or sepsis, **hydration alone does not treat an abscess**.
- It is a supportive measure but does not address the **localized collection of pus**.
*IV antibiotics*
- Antibiotics are typically indicated as an **adjunct to drainage**, especially in cases of systemic infection or cellulitis.
- However, **antibiotics alone are often insufficient** to resolve an abscess as they have difficulty penetrating the necrotic core and thick capsule.
*Reexploration*
- **Surgical reexploration** is a more invasive option usually reserved for abscesses that are **large, multiloculated, not amenable to percutaneous drainage**, or when initial drainage attempts fail.
- It carries greater risks and is not the initial treatment of choice for every post-operative abscess.
Question 2: Which muscle is attached to the disc of the temporomandibular joint?
- A. Buccinator
- B. Lateral pterygoid (Correct Answer)
- C. Masseter
- D. Temporalis
Explanation: ***Lateral pterygoid***
- The superior head of the **lateral pterygoid muscle** inserts directly into the **articular disc** and the neck of the condyle, playing a crucial role in the movement and stability of the TMJ.
- Its contraction pulls the disc and condyle forward during mouth opening and protrusion.
*Buccinator*
- The buccinator muscle forms the **muscular portion of the cheek** and is primarily involved in smiling, whistling, and preventing food from accumulating between the teeth and cheeks.
- It does not have any direct attachment to the temporomandibular joint or its disc, as it is located superficially and anteriorly to the joint.
*Masseter*
- The masseter is a powerful muscle that **elevates the mandible** (closes the mouth) and assists in protrusion.
- While it is a muscle of mastication and originates from the zygomatic arch and inserts into the lateral surface of the ramus and angle of the mandible, it **does not attach to the articular disc** of the TMJ.
*Temporalis*
- The temporalis muscle is responsible for **elevating and retracting the mandible** (closing the mouth).
- It originates from the temporal fossa and inserts into the coronoid process and anterior border of the ramus of the mandible, with **no direct attachment to the TMJ disc**.
