1. LA

Question 1

Cartridges for LA contains ____mL of LA agents.

Answer 1

1.8-2.2 mL

Question 2

27 Gauge is _____(larger/smaller) than 30 Gauge

Answer 2

Larger

Question 3

What technique do we use when assembling LA cartridge?

Answer 3

Aseptic techinique

Question 4

Syringe is not reusable. True or False?

Answer 4

False

Question 5

Define infiltration

Answer 5

• Depositing LA solution close to the tissues to be anaesthestised - The solution diffuses around the fine branches of the sensory nerves in that area

Question 6

Define infiltration

Answer 6

• Zone of anaesthesia is limited to the structures innervated by those nerves - Good success so long as no barriers to diffusion - Barriers: thick cortical bones, facias etc.

Question 7

Define regional nerve block

Answer 7

• Deposit LA solution around a main trunk of sensory nerve - Blocks all branches of the nerve -Wider fild of anaesthesia than infiltration technique

Question 8

General tips of applying LA

Answer 8

• Use topical (wait for it to work) - Don’t wave needle in front of patient - Hold mucosa taut at injection site - Pressure on palate before palatal injection - Inject slowly - LA temperature close to body temperature (or room temp.) - Place small amount of LA first to numb the region before injecting the bulk - Aspirate to check for vascularity (DONT inject intravascular) - Do Not inject subperiosteally

Question 9

_____(short/long) needle is needed for maxilla infiltration

Answer 9

Short

Question 10

Needle should aim for _______ during maxilla infiltration

Answer 10

Apex of tooth

Question 11

Extraction and Scaling of the maxilla region, LA should be placed at the ______ region

Answer 11

Palatal. Palatal infiltration (the greater palatine nerve and/or of the nasopalatine nerve) numbs the soft tissue/bone on the palatal side. BUT they do not achieve pulpal (teeth) anaesthesia (so, maxillary infiltration on the buccal side is still needed)!

Question 12

The buccal gingiva of the maxilla is innervated by_______?

Answer 12

The infraorbital nerve (incisor to premolar region) and the posterior superior alveolar nerve (molar region)

Question 13

The nasopalatine nerve innervates _______?

Answer 13

From maxilla canine to canine palatal soft tissue and bone, but not pulpal anesthesia

Question 14

Palatal infiltration, the needle is injected at________?

Answer 14

The junction of alveolus and hard palate (where the mucosa is thicker) near the greater palatine fossa (for GP nerve) or the incisive canal (for NP nerve)

Question 15

Mandibular infiltration can only be used on ________ to establish pulpal anaesthesia?

Answer 15

Incisors, the bones are relatively thin there. Whereas in other regions, the bones are thick and only buccal mucosa anaesthesia can be established

Question 16

In the maxilla region, the bones are generally thin except for the________?

Answer 16

Zygomatic buttress

Question 17

Inferior alveolar block, the needle is placed into the ______ space.

Answer 17

Pterygomandibular space

Question 18

The gingiva of the lingual side of teeth is innervated by?

Answer 18

The lingual nerve. (the sublingual nerve, a branch of the lingual nerve)

Question 19

The gingiva of the buccal side of lower incisors and canines are innervated by?

Answer 19

The mental nerve (a branch of the IAN) Which also innervates the skin and lips around the mental nerve

Question 20

The gingiva of the buccal side of lower premolars and molars are innervated by?

Answer 20

The long buccal nerve.

Question 21

Describe the direct technique of inferior alveolar block

Answer 21

• place thumb on external oblique ridge
• 2nd, 3rd and 4th fingers on posterior boarder mandible
• angle syringe across from premolars on contralateral side
• pierce mucosa at a point 1cm up from the occlusal plane within the ‘V”
• needle should be parallel to the occlusal plane
• advance until touching bone, half way between thumb and finger (approx. 2cm)
• if advanced to far down to hub, try again (into the paraotid region)
• aspirate before injecting to check for vascularity

Question 22

What are the attachments of the sphenomandibular ligament?

Answer 22

Spine of sphenoid to lingula

Question 23

Where is the pterygomandibular raphe?

Answer 23

Attached superiorly to the pterygoid hamulus of the medial pterygoid plate, and inferiorly to the posterior end of the mylohyoid line of the mandible.

Question 24

In the indirect technique of Inferior alveolar block, the needle is obstructed by the _______before swinging to the contralateral side and advance.

Answer 24

Internal oblique ridge

Question 25

True/False

The buccal nerve is quite variable, thus buccal infiltration can be used to anaesthetise the buccal mucosa of the premolar/molar regions

(injecting into the sulcus)

Answer 25

True