Anesthesia Part III Flashcards
Maxillary Incisors are innervated by what nerve?
What type of injection would you do if you want to anesthetize the soft tissues?
Nasopalatine
Nasopalatine (don’t need to go into Foramen)
If a pt gets an electric shock with IA, what has happened?
Needle has touched the nerve
What is a long acting LA w/out a vasoconstrictor?
Prilocaine
*mepivacaine is short acting
What nerve innervates the Maxillary PM’s?
What injection for the Maxillary PM’s?
MSA
MSA, AMSA, ASA (not PSA)
*the nerve is the MSA, the injection could be previous 3
What is the volume an anesthetic cartridge?
What is the volume of the anesthetic solution?
- 0 mL
1. 8 mL
What injection are most concerned about having a Local Complication?
Why?
PSA
Venous Plexus
3 reactions to Intravenous Epi injection:
Fearful
Palpitations
Increased BP
Where should you inject if a pt has an infection?
Inject away from site
If the Mx 1st molar is infected, what type of injection should you do?
*what shouldn’t do?
PSA (away from site)
*not infiltration
What 2 things are being anesthetized in an IA block?
What is anesthetized w/ Lingual and Long buccal?
Mandibular teeth on that side (central incisor to distal molar), soft tissue anterior to the molars
Tongue, buccal soft tissues of molars
What is the position of the thumb when giving an IA?
Coronoid notch, vestibule of soft tissue
What 4 nn. does the Gow Gates anesthetize?
Lingual
IA
Long Buccal (75%)
Mental
What injection is most likely to produce a positive aspiration?
Which is most likely to produce hematoma?
IA
PSA
What do you do with a positive aspiration?
Withdraw needle?
Change location
Yes if too much blood in cartridge and can’t see
What is the challenge with Mandibular Infiltration?
What is the exception to this rule?
Dense Cortical Bone
Articaine (don’t know why this workd)
Where is the Lingual n. in relation to the IA n.?
Anterior and Medial
*get as withdraw from IA block
What is the reason for giving a Long Buccal?
Buccal soft tissues of Molars
How much solution is administered for the IA (keeping in mind we have to give Long Buccal/Lingual on the way out)?
1.4 - 1.5 mL
3/4 cartridge
Where is the Long Buccal n.?
2 data points
External Oblique Ridge
Cusps of the Mandibular Molars
How far is penetration for the Long Buccal n.?
2-3 mm
*when touch bone
Where is the barrel of the syringe when administering an IA?
Contralateral PM’s
What is the depth of penetration for a PSA?
16 mm
What is the depth of penetration for an IA?
If you contact bone too soon, you get no anesthesia and _____
20 - 25 mm
potentiate drug overdose
What is a major contributor to missing the IA by going too deep?
*proper technique is contacting bone, backing out ___mm, depositing
Hand moves forward
1 mm
What injection has the highest degree of failure?
IA
What is the opening of the needle (not the bevel)?
How is it measured?
Lumen
gauge
*large means small
How far above the Mandibular Occlusal Plane do we give the IA injection?
1.5 cm
15 mm
How long is the Long Needle?
How long is the Short Needle?
32 mm
What needle breaks?
30 gauge
sometimes the 27
Why are Blocks better than Infiltrations?
Less injections, Less drug delivered
What method of anesthetic delivery is prone to OD?
Infiltrations
*b/c give more
Working on a Maxillary 1st Molar with a PSA, pt reports sensitivity - what did we most likely miss?
What injection can we give?
MB root
ASA Nerve Block (which is different from ASA)
*MSA is another option, but won’t be on test
2 most used Maxillary injections:
Infiltration
PSA
PSA gets Molars, buccal soft tissues, and supporting bone, but not…
Palatal Soft tissues/Bone
PSA gets the MB root of the Mx 1M __%
72%
ASA infiltration:
ASA Nerve Block:
Incisors - Canine
Infraorbital (Incisors - MB root Mx 1M)
AMSA location:
halfway between mid-palatal suture and FGM
between PM’s
Greater Palatine NB location:
*Also V2
halfway between mid palatal suture and FGM
5 mm Anterior soft palate
Nasopalatal NB location:
What is unique about this injection?
P-ASA goes where?
PM level, lateral to Incisive Papilla
Only bilateral
Into Incisive Foramen
Long buccal Penetration site is distal to the 3rd Molar and contacts bone at ____ mm
2-3 mm
Gow Gates gets IA, lingual, auriculotemporal, mylohyoid, and log buccal nn. - it is inserted close to what?
toward head of condyle
Vazirani - Akinosi NB gets IA, Lingual, Long Buccal, and is done blind, and has what complication?
*going after V3 on lingual aspect of mandibular ramus
Trismus
Difference between Mental and Incisive NB?
Incisive palpated
PDL injections and Intraosseous anesthesia - won’t use much
True
