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Dental Hygiene > Dental Meds/LA Test 1 > Flashcards

Dental Meds/LA Test 1 Flashcards

1
Q

What is the largest/thickest cranial nerve?

A

Trigeminal (V)

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2
Q

The trigeminal nerve provides the majority of ? innervation of the teeth, bone, and soft tissue.

A

sensory

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3
Q

What are the two roots that the trigeminal nerve are composed of?

A

small motor root and large sensory root

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4
Q

pulpal anesthesia

A

from the inside out

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5
Q

infiltration/local anesthesia

A

surrounding soft tissue

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6
Q

What branch/division of the trigeminal nerve is sensory from muscles of forehead?

A

V1- Opthalmic

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7
Q

What branch/division of the trigeminal nerve is sensory from lower eyelids, zygoma, and upper lip?

A

V2- Maxillary

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8
Q

What branch/division of the trigeminal nerve is sensory from lateral scalp, skin anterior to ears, lower cheeks, lower lips, and anterior aspect of mandible?

A

V3- Mandibular

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9
Q

What branch/division of the trigeminal nerve is both sensory and motor?

A

V3- Mandibular

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10
Q

What branch/division of the trigeminal nerve is motor to muscles of mastication (temporalis, masseter, medial and lateral pterygoid, tensor veli palatine, and tensor tympani)

A

V3- Mandibular

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11
Q

Sensory root (3 branches) supplies the skin of the entire face and oral cavity except for what?

A

pharynx and base of tongue

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12
Q

Muscles of mastication

A

Masseter, temporalis, medial and lateral pterygoid

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13
Q

Motor root innervates

A

muscles of mastication, mylohyoid, anterior belly of digastric, Tensor (tympani, veli palatini)

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14
Q

What do the tensor muscles do?

A

pick up uvula and help you swallow

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15
Q

V1 exits where?

A

superior orbital fissure

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16
Q

V2 exits where?

A

foramen rotundum

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17
Q

V3 exits where?

A

foramen ovale (largest one)

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18
Q

What innervation? Skin (middle portion of face, lower eyelid, side of nose, upper lip) mucous membrane (nasopharynx, maxillary sinus, soft palate, hard palate, tonsil) , maxillary teeth and periodontal tissues.

A

V2- maxillary

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19
Q

V2 branches…pterygopalatine fossa

A

Nasopalatine nerve
Greater palatine nerve
Posterior superior alveolar nerve (PSA)

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20
Q

V2 branches…infraorbital canal

A

Middle superior alveolar nerve (MSA)

Anterior superior alveolar nerve (ASA)

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21
Q

infiltrations

A

right above tooth you want numb…one thing

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22
Q

PSA, MSA, ASA

A

nerve blocks…up higher

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23
Q

What innervation? Skin (temporal region, auricula, external auditory meatus, cheek, lower lip. chin region) Mucous membrane (cheek, tongue-anterior 2/3, mastoid cells) mandibular teeth and periodontal tissues, bone of mandible, TMJ, parotid gland (facial nerve runs thru)

A

V3 mandibular

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24
Q

IA injection..what nerves…posterior branch

A

lingual nerve, inferior alveolar nerve (mental and incisive), mylohyoid nerve

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25
Q

numbness happens from injection site where?

A

forward

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26
Q

osteology/properties of maxilla

A

cancellous bone - more porous, some areas paper thin, more vascularity…infiltrations work well

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27
Q

osteology/properties of mandible

A

largest/strongest bone, dense cortical bone

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28
Q

Inferior alveolar nerve enters where?

A

mandibular foramen

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29
Q

Height of mandibular foramen

A

about 1-19mm above level of occlusal plane

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30
Q

Types of non-disposable syringes

A

breech loading, metallic, cartridge-carpule type (aspirating or non-aspirating) and pressure type

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31
Q

Most common syringe used

A

breech loading, metallic, cartridge type - aspirating

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32
Q

silicone rubber stopper…aka

A

bung

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33
Q

positive pressure

A

applied to thumb ring, forces local anesthesia into needle lumen and into tissue

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34
Q

negative pressure

A

blood enters cartridge if needle tip is in lumen of vessel (aspiration test)

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35
Q

Aspirating syringe metallic: advantages

A

visible cartridge, aspiration with one hand, autoclavable, rust resistant, long lasting

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36
Q

Aspirating syringe metallic: disadvantages

A

weight (heavier than plastic), syringe is large, possibility of infection with improper care

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37
Q

MIltex petite syringe

A

reduced thumb ring, flared base on ring handle, shortened harpoon rod, wider wings

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38
Q

Pressure syringes

A

introduced 1970’s, pulpal anesthesia-isolated tooth mandibular arch…PDL, ILI

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39
Q

Plastic reusable aspirating syringe: advantages

A

kinder looking, lightweight, cartridge visible, easy to aspirate, rust resistant, long lasting, lower cost

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40
Q

Plastic reusable aspirating syringe: disadvantages

A

size may be too large for small hands, possibility of infection with improper care, deterioration of plastic with repeated autoclaving

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41
Q

Metallic self aspirating syringe: advantages

A

cartridge visible, easier to aspirate with small hands, autoclavable, rust resistant, long lasting, PISTON scored to indicate volume of LA administered

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42
Q

Metallic self aspirating syringe: disadvantages

A

weight, feeling of insecurity, finger MUST be moved

43
Q

Self-aspirating syringe…

A

utilize elasticity of the rubber diaphragm in anesthetic cartridge to obtain negative pressure for aspiration

44
Q

syringe complications…leakage

A

when reloading 2nd cartridge make sure needle penetrates middle of diaphragm.

45
Q

syringe complications…broken cartridge

A

can result from bent harpoon, applying too much pressure, MOST common cause is cartridge damaged during shipping

46
Q

bent harpoon

A

causes off-center puncture-cause plunger to rotate as it moves down

47
Q

disengagement of harpoon during aspiration

A

harpoon dull, too much pressure applied

48
Q

common needle material

A

stainless steel and disposable

49
Q

Bevel/slant of needle

A

end of needle where anesthetic exits, can be long, medium, or short…

50
Q

The greater the angle of the bevel with long axis of needle = ?

A

the greater degree of deflection as needle passes through soft tissue

51
Q

Needles can be used up to ? times on same pt. before changing

A

3-4 tissue penetrations

52
Q

Larger gauge needle = ?

A

less deflection, greater accuracy, less chance of breakage, easier aspiration

53
Q

Dot on the hub of needle indicates ?

A

bevel placement - bevel towards nerve

54
Q

Shaft/ shank of needle

A

tip of needle, through the hub, and penetrates cartridge

55
Q

Hub of needle

A

plastic or metal piece that attaches to syringe, pre-threaded or self-threading

56
Q

Weakest part of the needle

A

hub - NEVER insert, most rigid, receives greatest stress

57
Q

needle gauge

A

diameter of lumen… smaller the number greater the diameter

58
Q

Aspiration test and needle gauge

A

100%- 25, 87%- 27, 2%- 30

59
Q

needle length

A

20mm (hub to tip) short, 32mm (hub to tip) long

60
Q

Problems- needle breaks

A

elastic properties of tissue allow rebound- covers/buries needle, if 5mm or more is visible use hemostats to remove

61
Q

Problems- needle bending

A

fatigues needle, no reason to bend to properly administer

62
Q

How many ml of anesthetic in cartridge?

A

1.8 ml

63
Q

If aluminum cap of carpule is distorted then?

A

throw away

64
Q

LA cartridge storage

A

room temp, don’t immerse in disinfectant, warmers not recommended

65
Q

Bubble in cartrige

A

nitrogen gas. 1-2m normal…larger indication of freazing and exansion

66
Q

Burning upon injection

A

normal response to pH of drug, cartridge contains bisulfate

67
Q

Additional armamentarium

A

topical anesthetic, applicator sticks, cotton gauze, hemostats

68
Q

topical anesthetic

A

prior to needle penetration, benzocaine = most common, lidocaine, ointment/sprays

69
Q

what happens when topical left to long?

A

causes tissue to sluff

70
Q

hemostats/cotton pliers

A

removal of broken needle

71
Q

Most common medical emergency in office with local anesthesia

A

5 minutes after administration - syncope

related to STRESS not the drug

72
Q

Three critical phases of injection

A

Penetration site
Deposition site
Aspiration

73
Q

Penetration site

A

tissue is barely penetrated…stop and hold

74
Q

Deposition site

A

Proceed to optimum deposition point and then stop and hold

75
Q

Aspiration

A

when you reach optimum depth and angle…announce positive or negative

76
Q

WREB critical errors

A

Anesthetic w/out epi
Check expiration date
Needle MUST NOT touch any extra or intra oral surface prior to insertion

77
Q

steps of initial procedure

A

position patient
dry tissue (optional)
topical anesthetic 1-2 min.

78
Q

three primary types of injection

A

local infiltration, field block, nerve block

79
Q

local infiltration

A

area flooded with anesthetic, smaller area, dependent on diffusion, tx in same area as injection

80
Q

field block

A

LA deposited near the larger terminal nerve branches, maxillary injections administered at apex of area to be treated, involves tissue in or around one or two teeth

81
Q

nerve block

A

LA deposited close to main nerve trunk, usually at a distance from the operative…PSA, MSA, ASA, IA

82
Q

MSA- penetration and deposition site

A

penetration: apical to second premolar, height of mucobuccal fold
deposition: apical to apex of 2nd premolar (1/2 to 2/3 of cartridge)

83
Q

PSA- penetration site

A

height of mucobuccal fold apical to second molar

84
Q

PSA- landmarks

A

mucobuccal fold, maxillary tuberosity, zygomatic process, DB root of maxillary 2nd molar, buttress of the zygoma

85
Q

PSA degrees and needle depth

A

45, 45, 45, and 1/2 long needle…3/4 short needle

86
Q

Greater palatine nerve block-penetration

A

anterior to greater palatine foramen

87
Q

Greater palatine nerve block landmarks

A

greater palatine foramen…junction between max. alveolar process and palatine bone…only need a few drops of anesthetic

88
Q

ASA- landmarks

A

mucobuccal fold, infraorbital notch, infraorbital foramen

89
Q

Anterior trunk of mandibular nerve

A

lateral pterygoid muscle, masseter muscle, temporalis muscle, buccal

90
Q

posterior trunk of mandibular nerve

A

auriculotemporal nerve, IA nerve (mental and incisive), lingual nerve (anterior 2/3 of tongue, mucosa floor of mouth, all mandibular, lingual gingiva

91
Q

Chorda Tympani nerve

A

joins lingual nerve (runs in bundle), submandibular and sublingual glands, taste- anterior 2/3 of tongue

92
Q

mandibular nerve descends down ? before entering ? canal gives off ? nerve

A

medial side of ramus, mandibular, mylohyoid

93
Q

when mandibular nerve enters mandibular canal it becomes?

A

inferior alveolar nerve…anesthesia to IA, mental nerve, incisive nerve, lingual nerve

94
Q

IA nerve exits? and remains?

A

mental foramen (mental nerve), alveolar bone (incisive nerve)

95
Q

Mandibular injection landmarks

A

lingula, pterygomandibular raphe, coronoid notch, angle of mandible, occlusal plane of mandibular post. teeth

96
Q

WREB mandibular injection site bordered:

A

medially by pterygomandibular raphe, laterally by internal oblique ridge, height of the coronoid notch

97
Q

angle and depth, barrel of syringe IA injection

A

long needle = 2/3, short needle = 4/5…syringe over premolar contralateral side…needle is parallel to occlusal plane of mandibular teeth.

98
Q

Buccal nerve block insertion

A

mucous membrane distal and buccal to most distal molar

99
Q

Buccal nerve block deposition

A

buccal nerve as it passes over the anterior border of ramus

100
Q

Buccal nerve block landmarks

A

mandibular molars and mucobuccal fold

101
Q

mental nerve only…areas anesthetized

A

buccal mucous membranes anterior to the mental foramen, to the midline and skin of the lower lip

102
Q

Mental nerve penetration site

A

mucobuccal fold- canine/first premolar

103
Q

incisive nerve (mental and incisive)…area anesthetized

A

buccal mucous membrane anterior to the mental foramen, lower lip and skin if chin, premolars, canine, and incisors, pulpal nerve fibers to premolars, cuspid, incisors

Dental Hygiene (2 decks)

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