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Sympsoiums yr2 > 10- Local anaesthesia > Flashcards

10- Local anaesthesia Flashcards

1
Q

What does the conduction of a nerve depend on?

A

changes in the electrophysical status of the nerve

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2
Q

How does an impulse travel through a nerve

A

Impulse stimulates neurone, Na+ channels open, Na moves into cell depolarising the membrane, triggers action potential

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3
Q

What does local anaesthetic do?

A

Blocks the sodium channels, stopping the depolarization of the nerve

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4
Q

What are 2 categories of local anaesthetic?

A
  1. Amino-esters

2. Amino-amides

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5
Q

Give an example of amino-ester?

A
  • procaine
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6
Q

Give an example of amino-amides?

A
  • lidocaine
  • mepriocaine
  • prilocaine
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7
Q

What category is lidocaine?

A

Amino-amide

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8
Q

What is potency?

A

the minimum concentration of local anaesthetic needed to produce the same effect

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9
Q

What is the most potent LA?

A

Lidocaine

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10
Q

What is the least potent LA?

A

Procaine (amino-esters)

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11
Q

Where are amino-esters metabolised?

A

in the blood

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12
Q

Where are amino-amides metabolised?

A

In the liver

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13
Q

Which LA would you give to a patient with liver problem?

A

amino ester i.e. procaine

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14
Q

Name the three branches of the trigeminal?

A

V1 - Ophthalmic branch
V2 - Maxillary branch
V3 - Mandibular branch

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15
Q

What does the ophthalmic branch innervate?

A

sensory innervation to :

  • lacrimal gland
  • conjunctiva
  • skin between nose and eyes
  • skin of upper eyelid
  • forehead
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16
Q

What does the maxillary branch innervate?

A

sensory innervation to:

  • teeth of maxilla and soft tissue
  • buccal gingiva of upper jaw
  • mucous membrane of cheek
  • interdental papilla
  • periodontal ligament
  • hard palate
  • side of the nose
  • upper lip
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17
Q

What does the mandibular branch innervate?

A
  • motor branches for muscles of mastication
  • skin of anterior temple
  • lower teeth
  • gingiva of lower teeth
  • skin of lower lip
  • chin
  • taste buds
  • submandibular and subgingival glands
  • lingual gingiva
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18
Q

What position should you put the patient in when injecting maxilla?

A

Flat/ supine (should be perpendicular to the floor)

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19
Q

What position should you put the patient in when injecting mandible?

A

Semi-supine

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20
Q

What must you do to the soft tissue before you apply topical anaesthetic?

A

must dry the soft tissue

21
Q

What 4 things should be written on the LA Cartridge

A

1, LA drug

  1. Vasoconstrictor
  2. Expiry date
  3. Batch number
22
Q

What is unique about the ultra-safety plus XL?

A

can be resheathed

23
Q

What are the different types of anaesthesia of the upper jaw?

A
  • infiltration
  • posterior, middle, anterior alveolar nerve block
  • greater palatine nerve block
  • nasopalatine nerve block
  • anterior, middle, superior nerve block
  • 2nd division nerve block
24
Q

What are the different types of anaesthesia of the lower jaw?

A
  • infiltration (soft tissues)
  • mental nerve block (mental foramen)
  • inferior alveolar nerve block
  • long buccal nerve
  • lower anteriors
  • lower first premolar and anteriors
  • lower molars and second premolar
25
Q

Where should you aim when injecting upper jaw?

A

Aim for root of tooth, inject on mucogingival line

26
Q

How much should you inject when infiltrating the upper jaw?

A

1/2 cartridge

27
Q

What teeth does does the greater palatine nerve block cover?

A

all upper molars and premolars (i.e. area distal to canine) 4-8

28
Q

What teeth does the nasopalatine nerve block cover?

A

Canine to canine 3-3

29
Q

What LA would you use when doing restorative work in the maxillary teeth?

A

Buccal infiltration

30
Q

What LA would use when extracting maxillary teeth?

A

(SINGLE TOOTH) = buccal and palatal infiltration

(MULTIPLE TEETH) = nasopalatine and greater palatine nerve block

31
Q

What is unique about the maxilla that makes it easier to inject?

A

maxilla is a spongey bone, easier for LA to reach

32
Q

Why is it harder to inject the lower jaw?

A

Mandible made up of cortical bone which is extremely dense

33
Q

What does infiltration in mandible cover?

A

only soft tissues

34
Q

What does the mental nerve block in the mandible cover?

A

premolars and anterior teeth

35
Q

Where should you aim inferior alveolar nerve block?

A

around lingula (do this by finding coronoid notch, internal oblique ridge, pterygomandibular raphe

36
Q

How much of the cartridge do use when doing iD block?

A

at least one whole cartridge

37
Q

What does the long buccal nerve block cover in mandible?

A

Only soft tissues around molars/wisdom teeth

38
Q

Where do you inject long buccal in mandible?

A

slightly anterior to coronoid notch depression

39
Q

What injection should you do when working on lower anterior teeth?

A
  • Buccal infiltration (pulp)

- Lingual infiltration (lingual soft tissues)

40
Q

What injection should you do when working on lower first premolar and anterior?

A
  • Mental nerve block (pulp)

- Lingual infiltration (lingual soft tissue)

41
Q

What injection should you do when working on lower molars and second premolar?

A
  • ID nerve block
  • Lingual nerve block (can be done when doing ID)
  • Long buccal nerve block
42
Q

What are some of the general complications of LA?

A
  1. Psychogenic
  2. Toxic
  3. Allergy reaction
  4. Drug reaction
43
Q

Name some psychogenic reactions?

A

-palpitations
-restlessness
-fainting
-cold sweat
-excittion
(ATYPICAL= clonic convulsions, rolling of eyes, rigidity)
(HYPOXIA= blood pressure drops, patient holding breath)

44
Q

Name some Toxic reactions?

A
  • convulsions
  • loss of consciousness
  • respiratory disease
45
Q

How do toxic complications occur?

A

overdosing i.e injecting more than patient can take

- consider patient having a liver problem (unable to break down anaesthetic)

46
Q

Why would an allergic reaction occur?

A

often due to the presence of sodium metabisulphate

47
Q

What might LA have a drug interaction with?

A

non cardio-selective beta blockers

48
Q

Name some local complications

A
  • contaminated needles
  • infected area
  • trismus
  • laceration of nerve or blood vessels
  • facial paresis
  • LA injected too fast or too much

Sympsoiums yr2 (27 decks)

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