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oral cavity - BDS 1 > anaesthetisation and sedation :) > Flashcards

anaesthetisation and sedation :) Flashcards

1
Q

infiltration

A
  • Attempts to stop action potentials in or very near the target tissue
  • Delivered as near to the target tissue as possible
  • Anaesthetises a circumscribed area
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2
Q

nerve block

A
  • Attempts to stop action potentials in a main branch of the nerve before it branches to individual target tissues
  • Anaesthetic is delivered at an accessible point stance from the target tissues
  • Therefore, anaesthetises a wider field; i.e. all the nerve branches distal to the block
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3
Q

maxillary bone

A

thinner than mandibular
anaesthetic will diffuse through the the tissue
- infiltration can be used to anaesthetise maxillary teeth

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4
Q

mandibular bone

A

too thick to allow diffusion

nerve block used where nerve is acceptable

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5
Q

what is the exception for mandibuarl bone

A

incisors and canines

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6
Q

maxillary nerves

A

posterior superior alveolar nerve
anterior superior alveolar nerve
infraorbital nerve

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7
Q

what does the posterior superior alveolar nerve sipply

A

posterior teeth

buccal gingiva at the back

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8
Q

what does the anterior superior alveolar nerve supply and branch of …?

A

labial gingiva
apices of the anterior teeth
- branch of infra orbital nerve

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9
Q

Problems with maxillary infiltration

A

may be insufficient anaesthetic
can cause vasocontriction
infection in the areas makes it more difficult or swelling

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10
Q

how can maxillary infiltration cause vasoconstriction

A

aesthetic contains noradrenaline which vasoconstricts blood vessels

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11
Q

why does aesthetic have noradrenalin for

A

holds anesthetic in the area

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12
Q

innervation of the palate

A

nasopalatine nerve
greater palatine nerve
lesser palatine nerves

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13
Q

greater palatine nerve

A

supplies most of the palate

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14
Q

nasopalatine nerve

A

supplies the gingivae and maxillary anterior teeth

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15
Q

anaethisiing the hard palate

A

bound to underlying bone closely

need to inject slowly for the anaesthetic to diffuse slowly

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16
Q

innervation of buccal gingivae maxillary

A

PostSupAntN - posterior

InfFOrb nerve - anterior

17
Q

innervation of maxillary teeth

A

PSAN - posterior teeth

AntSupAlveoN - anterior teeth

18
Q

innervation of palatal gingivae

A

GreaPalaN - posterior

Naso P - anterior

19
Q

innervation of buccal gingiva mandibular

A

long buccal nerve - posterior

mental nerve - antihero

20
Q

innervation of mandibular teeth

A

inferior alveolar nerve

21
Q

lingual gingiva mandbualr

A

lingual nerve

22
Q

when would an infraorbital nerve block be used

A

when infiltration is contraindicated by presence of something else e.g. perioapical access

23
Q

why would a periapical access mean a infiltration cannot work

A

pus tends to stop diffusion of anaesthetic

24
Q

where is the infraorbital nerve is anaesthetised

A

infraorbital foramen

- anaesthetic diffuses along canal and blocks anterior superior alveolar nerves

25
Q

where is the infraorbital foramen

A
  • One fingers breadth below inferior orbital margin
  • In line with pupil if patient looks straight ahead
  • Palpable in most patients as a depression in maxilla
26
Q

what does the infraorbital nerve supply

A

lower eyelid
upper lip
part of nasal vestibule

27
Q

delivering an infraorbital nerve block

A

1) Palpate infraorbital foramen with index finger and retract lip with thumb
2) Introduce needle through mucogingival junction to level of index finger Keep finger pressed on the IF rim for 1 min after introduction of anaesthetic to prevent diffusion into orbit

28
Q

inferior alveolar nerve (mandible)

A

running with the mandible
supplies lower teeth
out of mental foramen as mental nerve to supply chin and lip

29
Q

lingual nerve (mandibular)

A

runs on inside of mandible
supplies anterior 2/3 tongue
floor of mouth
lingual gingiva

30
Q

what are the nerves on the mandible

A

lingual nerve
inferior alveolar nerve
long buccal nerve
mental nerve

31
Q

long buccal nerve

A

supplies the mucosa

crosses anterior border of mandible on occlusal plane

32
Q

where should you place inferior alveolar and lingual nerve block

A

pterygoid space between the rams and medial pterygoid muscle

- at the level of the occlusal plane of mandibular teeth

33
Q

how to inject for IA and lingual nerve block

A

1) Introduce syringe over opposite premolars keeping level with the occlusal plane
2) stretch the tissue as much as possible
3) Past finger and proceed gently lateral to the raphe until bone encountered then withdraw slightly

34
Q

what should be used for IA and lingual nerve block

A

aspirating syringe

  • presence of blood vessels in pterygoid space
  • can cause worse bleeds especially if in anticoagulants
35
Q

complications of IA block due to anatomical variation

A

1- anaesthesia does not work
-usually due to high mandibular foramen so angle needle slightly above occlusal plane
- successful if lip has gone numb
2- crossover innervation at incisor teeth
-infiltrate around affected teeth rather than that teeth
3- 8s still sensitive
-due to branches from lingual or mylohyoid nerve innervating these teeth so infiltrate on lingual side of affected teeth

36
Q

potential complications due to operator error

A

1) Direct hit on IAN or lingual nerve
- Calm patient down, remove needle a bit and repeat injection
- Is potential cause of nerve damage
2) Injection too far medial
- Injection into medial pterygoid muscle leading to trismus where they cant open their mouth properly
3) Injection too far posterior
- injection into parotid gland
- Patients face will be paralysed and lose tone in muscle, look like they’ve has a stroke

37
Q

mental nerve block

A

used for premolar teeth
mental foramen just between and below the apices of 4 and 5
- in line with the pupil if patient looking ahead
- palpable

38
Q

long buccal nerve anaesthsia

A

usually for extractions of lower molars, wide spread

oral cavity - BDS 1 (66 decks)

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