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Final Flashcards > Anatomy and physiology > Flashcards

Anatomy and physiology Flashcards

1
Q

what are normal BP readings, elevated BP, high BP etc?

A
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3
Q

In congenital heart defects, what are cyanotic defects?

A

When the blood travels from the body to the lungs.

The 5 Ts are examples (don’t have to know!)

Tetralogy of Fallot, Truncus arteriosus, Transposition of great vessels, Tricuspid atresia, Total anomalour pulmonary vascular return

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4
Q

In congenital heart defects, what are Acyonotic?

A

When the blood returns from the lungs to the body.

5 defects that have 3 letter abbreviations (don’t have to remember).

Atrial septal defect, Ventricular septal defect, Hypertrophic cardiomyopathy, Patent ductus arteriosus, Coarctation of arota

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5
Q

What is systolic pressure?

A

Pressure against the vessel walls when the heart beats

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6
Q

What is Diastolic pressure?

A

Pressure against vessel walls when the heart relaxes.

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7
Q

What is acute hypertension?

A

Occurs on physical exertion, anxiety and stress

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8
Q

What is chronic hypertension?

A

Remains higher than normal with or without stimulus

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9
Q

What do SDCEP guidelines recommend on the use of antibiotic prophylaxis?

A

Antibiotic prophylaxis is not recommended routinely for people undergoing dental procedures

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10
Q

What prescription should be given to patients requiring antibiotic prophylaxis?

A

Amoxicillin 3g oral powder sachet one hour before procedure.

In patients who are allergic to penicillin, 600mg clindamycin capsules one hour before procedure

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11
Q

What is considered normal blood pressure?

A

Systolic <120, diastolic <80

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12
Q

What is considered elevated blood pressure?

A

Systolic 120-129, diastolic <80

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13
Q

What is considered high blood pressure?

A

Systolic 130-139, diastolic 80-89

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14
Q

What are some causative factors in high blood pressure?

A

Obesity, smoking, lack of physical activity, diet/alcohol, age, familial history/genetics, pain, medications (stimulants, decongestants, immunosuppressants), diseases (chronic kidney disease, hyperthyroid, acromegaly, sleep apneoa)

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15
Q

What are some oral side effects caused by HPB medication?

A

Dry mouth, taste changes, and ulcerations. Gingival hyperplasia related to calcium channel blockers. Angioedema related to ACE inhibitors and renin-angiotensin-aldosterone system blockers.

Gingival bleeding related to direct vasodialators

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16
Q

A 68 year old female with a history of a fractured neck of femur has been given medication to prevent her getting another fracture.

What two drugs is she likely to be taking?

A

Bisphosphonates

Calcium and vitamin D

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17
Q

What oral condition may arise from a patient taking bisphosphonates?

A

Osteonecrosis of the jaw

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18
Q

How can MRONJ be managed?

A

*Conservative approach

* Antiseptic mouthwash

* Antibiotics

* Surgical debridement

* Primary closure

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19
Q

How can MRONJ best be avoided in the first place?

A

* Avoid extractions

* Avoid trauma

* Good OH

* Aid healing by packing/suturing post ext

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20
Q

Briefly explain the main features of Stage 1 oral transportation in the context of food ingestion and mastication

A

Food gathered on tongue tip. Tongue retracts taking food back to the level of the posterior teeth

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21
Q

Briefly explain the main features of stage 2 oral transport in the context of food ingestion and mastication

A

Sufficiently masticated food is transferred to the oropharynx by a squeeze back mechanism in which the bolus is squeezed between the tongue and the palate

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22
Q

What are the 4 stages of swallowing?

A
  1. Oral phase; move food posteriorly. Some can pass onto pharyngeal surface of tongue. Liquid remains in the mouth in front of pillars.
  2. Pharyngeal phase. Bolus passes into pharynx. Misdirection of bolus is prevented by tongue blocking oral cavity, soft palate blocking nasal cavity and epiglottis blocking larynx.
  3. Oesophageal phase. Upper oesophageal sphincter constricts and bolus passes downwards.
  4. Lower oesophageal sphincter relaxes to admit bolus to stomach
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23
Q

Name two biological factors that can affect masticatory performance of a human being?

A

Number of occluding teeth.

Biting force

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24
Q

To which group of chemicals does chlorhexidine digluconate belong?

A

Bisbiguanides

25
Q

Describe the mechanism of action of chlorhexidine digluconate

A

Chlorhexidine binds to the microbial cell walls causing cell wall damage and interfering with cell wall permiability. Leakage of cel contents leads to cell death. Dicationic; one ion binds to the oral surfaces and one ion to the bacterial cell membrane

26
Q

The activity of an oral antiseptic depends on its substantivity. How is substantivity defined and provide two examples of factors that may influence the substantivity of chlorhexidine in the oral cavity

A

* Defined as the capacity of a chemical agent to continue its therapeutic effect for a prolonged period after its initial application.

* Adsorption to the oral surfaces

* Maintenence of antimicrobial activity

* Slow neutralisation of antimicrobial activity

* Concentration of chlorhexidine

* Presence/levels of anionic neutralising agents

27
Q

What is the general advice for all patients taking an anticoagulant/antiplatelet?

A

* Plan treatment early in the day and early in the week.

* Provide pre treatment instructions

* Treat atraumatically, only discharge when haemostasis is achieved.

* If travel time to emergency care is a concern, place emphasis on preventive measures

* Provide patient with post op advice and emergency contact details

28
Q

Name 2 DOACs and the advice on dental procedures

A

Direct oral anticoagulants. Apixaban, Dabigatran, Rivaroxaban, Edoxaban.

Low bleeding risk procedure; treat without interrupting medication.

Higher risk procedure; advise patient to delay or miss morning dose.

Treat patient early in the day, limit treatment area and assess bleeding. Consider sutures and packing

29
Q

Name a vitamin k antagonist and the advice on dental treatment

A

Warfarin, Acenocolimarol, Phenindione

Check INR ideally not more than 24 hours before dental treatment (up to 72 hours if patient is stable)

INR < 4 treat without interrupting medication

INR of 4 or over delay treatment or refer if urgent

30
Q

Name an injectable anticoagulant and the advice on dental treatment

A

Dalteparin, enoxaparin, tinzaparin.

If low (prophylactic dose) treat without interrupting medication (consider sutrures and packing)

If higher dose or uncertain, consult prescribing clinician

31
Q

What classification of drug is aspirin and what is the advice regarding dental treatment?

A

Antiplatelet drug. Treat without interrupting medication. Use local haemostatic measures

32
Q

Besides aspirin, name another antiplatelet drug and the advice regarding dental treatment

A

Clopidogrel, dipyridamole, prasligrel, ticagrelor (taken on its own or with aspirin)

Treat without interrupting medication. Expect prolonged bleeding. Limit initial treatment and consider staging treatment. Strongly consider suturing and packing

33
Q

What is the advice regarding dental treatment for a patient who is on a combination of anticoagulant and antiplatelet therapy

A

Consult with patients prescribing clinician

34
Q

For what patients should anticoagulant/antiplatelet therapy not be stopped?

A

* Patients with prosthetic metal heart valves or coronary stents

* Patients who have had a pulmanory embolism or DVT in the past 3 months

* Patients on anticoagulant therapy for cardioversion

35
Q

Name some bisphosphonate drugs

A

Alendronic acid

Risedronate sodium

Ibandronic acid

36
Q

Name a RANKL inhibitor

A

Denosumab

37
Q

Name an anti-angiogenic

A

Bevacizumab

Sunitinib

38
Q

What 3 factors put a patient at high risk of developing MRONJ?

A

* Previous diagnosis of MRONJ

* Pt is taking anti-resorptive or anti-angiogenic drugs for management of cancer

* Pt has taken bisphosphonate drug for more than 5 years

39
Q

What foramen does the opthalamic branch of the trigeminal nerve pass through?

A

Superior orbital fissure

40
Q

What foramen does the maxillary branch of the trigeminal nerve pass through

A

Foramen rotundum

41
Q

What foramen does the mandibular branch of the trigeminal nerve pass through

A

Foramen ovale

42
Q

List the cranial nerves and how you would test each one

A

Olfactory - can patient smell, ie hand sanitiser

Optic - check field of vision with fingers, left to right up and down

Occulomotor - ask pt to follow finger with eyes

Trochlear - ask pt to follow finger with eyes

Trigeminal - light touch to both sides, forehead, cheeks, chin

Abducense - ask pt to follow fingers with eyes

Facial - ask patient to smile, wiggle eyebrows, blow out cheeks, scrunch eyelids and try to open against resistance

Vestibulocochlear - hearing both sides, observe pts balance

Glossopharyngeal - ask pt to say ‘ahhh’ and observe soft tissues moving equally both sides

Vagus - ask pt to say ‘ahh and observe soft tissues moving equally both sides. Ask pt to shrug shoulders

Accessory - ask pt to say ‘ahh’ and observe soft tissues moving equally both sides.

Hypoglossal - ask pt to stick out tongue, wiggle from side to side

43
Q

What is the nerve supply for the submandibular glad?

A

Chorda tympani and submandibular ganglion

44
Q

What is the secretion of the submandibular gland?

A

Mixed serous and mucous

45
Q

What is the nerve supply for the parotid gland?

A

Glossopharyngeal nerve

46
Q

What is the secretion of the parotid gland?

A

Serous

47
Q

What is the nerve supply for the sublingual gland?

A

Chorda typani

48
Q

What is the secretion of the sublingual gland?

A

mixed but mostly mucous

49
Q

What are the intrinsic muscles of the tongue?

A

Transverse

Vertical

Superior longditudinal

Inferior longditudinal

50
Q

What are the extrinsic muscles of the tongue?

A

Palatoglossus

Genioglossus

Hyoglossus

Styloglossus

51
Q

What is the motor nerve supply to the muscles of the tongue?

A

Hypoglossal except the palatoglossus which is supplied by the vagus

52
Q

What is the sensory nerve supply to the tongue?

A

Anterior two thirds taste; chorda tympani

Posterior third glossopharyngeal

53
Q

What is the

origin

insertion

innervation

function

the masseter

A

Inferior border of zygomatic arch

Angle of mandible

Masseteric branch of V3

Elevate and protrude the mandible

54
Q

What is the

origin

insertion

innervation

function

of the temporalis

A

Temporal fossa

Coronoid process and anterior border of ramus

Temporal branch of v3

Elevate and retrude the mandible

55
Q

What is the

origin

insertion

innervation

function

of the lateral pterygoid

A

Superior head; greater wing of spenoid

Inferior head; lateral surface of lateral pterygoid plate

Insertion; anterior surface of neck of mandibular condyle

Lateral pterygoid branch of V3

Depress, protrude and lateral deviation of mandible

56
Q

What is the

origin

insertion

innervation

function

of the medial pterygoid muscle

A

Deep; medial surface of lateral pterygoid plate

Superficial; Maxillary tuberosity

Insertion; angle of mandible

Medial pterygoid branch of v3

Elevate and protrude the mandible

Final Flashcards (13 decks)

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