Anesthesia Part III

Question 1

Maxillary Incisors are innervated by what nerve?

What type of injection would you do if you want to anesthetize the soft tissues?

Answer 1

Nasopalatine

Nasopalatine (don’t need to go into Foramen)

Question 2

If a pt gets an electric shock with IA, what has happened?

Answer 2

Needle has touched the nerve

Question 3

What is a long acting LA w/out a vasoconstrictor?

Answer 3

Prilocaine

*mepivacaine is short acting

Question 4

What nerve innervates the Maxillary PM’s?

What injection for the Maxillary PM’s?

Answer 4

MSA

MSA, AMSA, ASA (not PSA)

*the nerve is the MSA, the injection could be previous 3

Question 5

What is the volume an anesthetic cartridge?

What is the volume of the anesthetic solution?

Answer 5

2. 0 mL

1. 8 mL

Question 6

What injection are most concerned about having a Local Complication?

Why?

Answer 6

PSA

Venous Plexus

Question 7

3 reactions to Intravenous Epi injection:

Answer 7

Fearful

Palpitations

Increased BP

Question 8

Where should you inject if a pt has an infection?

Answer 8

Inject away from site

Question 9

If the Mx 1st molar is infected, what type of injection should you do?

*what shouldn’t do?

Answer 9

PSA (away from site)

*not infiltration

Question 10

What 2 things are being anesthetized in an IA block?

What is anesthetized w/ Lingual and Long buccal?

Answer 10

Mandibular teeth on that side (central incisor to distal molar), soft tissue anterior to the molars

Tongue, buccal soft tissues of molars

Question 11

What is the position of the thumb when giving an IA?

Answer 11

Coronoid notch, vestibule of soft tissue

Question 12

What 4 nn. does the Gow Gates anesthetize?

Answer 12

Lingual

IA

Long Buccal (75%)

Mental

Question 13

What injection is most likely to produce a positive aspiration?

Which is most likely to produce hematoma?

Answer 13

IA

PSA

Question 14

What do you do with a positive aspiration?

Withdraw needle?

Answer 14

Change location

Yes if too much blood in cartridge and can’t see

Question 15

What is the challenge with Mandibular Infiltration?

What is the exception to this rule?

Answer 15

Dense Cortical Bone

Articaine (don’t know why this workd)

Question 16

Where is the Lingual n. in relation to the IA n.?

Answer 16

Anterior and Medial

*get as withdraw from IA block

Question 17

What is the reason for giving a Long Buccal?

Answer 17

Buccal soft tissues of Molars

Question 18

How much solution is administered for the IA (keeping in mind we have to give Long Buccal/Lingual on the way out)?

Answer 18

1.4 - 1.5 mL

3/4 cartridge

Question 19

Where is the Long Buccal n.?

2 data points

Answer 19

External Oblique Ridge

Cusps of the Mandibular Molars

Question 20

How far is penetration for the Long Buccal n.?

Answer 20

2-3 mm

*when touch bone

Question 21

Where is the barrel of the syringe when administering an IA?

Answer 21

Contralateral PM’s

Question 22

What is the depth of penetration for a PSA?

Answer 22

16 mm

Question 23

What is the depth of penetration for an IA?

If you contact bone too soon, you get no anesthesia and _____

Answer 23

20 - 25 mm

potentiate drug overdose

Question 24

What is a major contributor to missing the IA by going too deep?

*proper technique is contacting bone, backing out ___mm, depositing

Answer 24

Hand moves forward

1 mm

Question 25

What injection has the highest degree of failure?

Answer 25

IA

Question 26

What is the opening of the needle (not the bevel)?

How is it measured?

Answer 26

Lumen

gauge

*large means small

Question 27

How far above the Mandibular Occlusal Plane do we give the IA injection?

Answer 27

1.5 cm

15 mm

Question 28

How long is the Long Needle?

How long is the Short Needle?

Answer 28

32 mm

Question 29

What needle breaks?

Answer 29

30 gauge

sometimes the 27

Question 30

Why are Blocks better than Infiltrations?

Answer 30

Less injections, Less drug delivered

Question 31

What method of anesthetic delivery is prone to OD?

Answer 31

Infiltrations

*b/c give more

Question 32

Working on a Maxillary 1st Molar with a PSA, pt reports sensitivity - what did we most likely miss?

What injection can we give?

Answer 32

MB root

ASA Nerve Block (which is different from ASA)

*MSA is another option, but won’t be on test

Question 33

2 most used Maxillary injections:

Answer 33

Infiltration

PSA

Question 34

PSA gets Molars, buccal soft tissues, and supporting bone, but not…

Answer 34

Palatal Soft tissues/Bone

Question 35

PSA gets the MB root of the Mx 1M __%

Answer 35

72%

Question 36

ASA infiltration:

ASA Nerve Block:

Answer 36

Incisors - Canine

Infraorbital (Incisors - MB root Mx 1M)

Question 37

AMSA location:

Answer 37

halfway between mid-palatal suture and FGM

between PM’s

Question 38

Greater Palatine NB location:

*Also V2

Answer 38

halfway between mid palatal suture and FGM

5 mm Anterior soft palate

Question 39

Nasopalatal NB location:

What is unique about this injection?

P-ASA goes where?

Answer 39

PM level, lateral to Incisive Papilla

Only bilateral

Into Incisive Foramen

Question 40

Long buccal Penetration site is distal to the 3rd Molar and contacts bone at ____ mm

Answer 40

2-3 mm

Question 41

Gow Gates gets IA, lingual, auriculotemporal, mylohyoid, and log buccal nn. - it is inserted close to what?

Answer 41

toward head of condyle

Question 42

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

Answer 42

Trismus

Question 43

Difference between Mental and Incisive NB?

Answer 43

Incisive palpated

Question 44

PDL injections and Intraosseous anesthesia - won’t use much

Answer 44

True