Extra werid panic revision!!!!! Flashcards
Cranial nerves
olfactory
optic
occluotor
trochlear
trigeminal
abuducens
facial nerve
vestibuchoclear
glosspharyngeal
vagus
accesory nerve
hypoglossal nerve
Olfactory
test by sense of smell
optic nerve
test reactivity of pupils - vision
Occulomotr nerve
eye moevement
trochlear
superior oblique eye movement
Trigeminal nerve
sensory - press on each side of face in the 3 divisions
motor - clench teeth - palpate (masseter and temporalis), openand close jaw (lateral and medial pterygoid)
coroneal relfex test
Abuducens
lateral rectus eye movement
Facial nerve
eyes shut
blinking eyes
purse lips
smile
raise eyebrows
Vestibuchoclear
hearing
Glossopharygeal nerve
taste to posterior 1/3rd of tongue
ahh and soft palate look
Vagus
soft palate, pharynx and larynx
vocal cord movement
Acessroy
trapezius and sternocloediomastoid muscle
shurg shoulders, move head to side with resistance, tip chin down towards chest
Hypoglossal
stick tongue out - control movement of tongue
Factors for oral cancer
betal quid
scoecionic satus
smokers
alcohol
Common sites ofr oral caancer
FOM
lateral border of tongue
HP
SP
Buccal mucosa
gingivae
Early symptoms of oral cancer
hoarseness of voice
non healing ulcers
red and white patches
rough/lumpy areas
crustted non healing lesionson limp
persistent soreness
Cohesive front on oral cancer
tissue extending at same pace - metastasis to lymph nodes unlikely
Non conhesive front for oral cancer
tissues not extending at same pace - more likly for metasisi spread to lymph nodes
Warts
HPV 2and 4
Stage
Tumour size - 1<2cm, 2=2-4cm, 3=>4cm, 4= >4cm and local invasion
Nodal spread - 0=none, 1=<3cm single, 2a) 3-6cm one single, 2b = <6cm on one side, 2c) <6cm on both sides, 3= >6cm
Metasiasis - 0 = none, 1=spread
Clincal stages of cancer
size
site
spread
tx options
multiple primaries
Features when grading tumour
does it resemble the same function as tissue of origin
resembles of cells to the tissue orign
Squamous cell papilloma
HPV 6,11,14
non malginaincy, benign tumour
cauliflower appearance
Histo of squamous cell papilloma
finger like projectin - attached stalk process
epithelium - hyperplastic and keratinsied
no invasion or atypia
kolicytes present
pedunculatated/sessile - pink appearnace
Biopsy for squamous cell papilloma
excisional biopsy
Addisions’s disease signs and sympomts
weight loss
anorexia
body hair loss
hyerpigmentation
postural hypertension
weakness
lethargy
What is addisons disease
disorder of the adrenal gland
it affects the production of cortisol and aldsoterone
cortisol - regulates bp, glucose and muscle stregnth
aldosterone - regulates sodium and fluid balance
tx for adrenal insufficency
hydrocortisone and glucosteriod
20 -30mg per day
Dental tx and addison’s diseases
Minor -scale and polish - take morn dose as norm and addiontal dose1hr beforehand and continue normal afterwards
Minor oral surgery - take nomral dose in morn and double dose 1hr ebforetx to max of 20mg and then double dose for 24hrs after tx
Major tx - managed in secondary care - IM or IV hydrocortisone before tx and double after tx
Adrenal crisis signs and stmptoms
nasuea
vominting
loss of consciousness
shock
confusion
BLS and monitor
oxygen
50-100mg of hydrocrtisone IMand reeat every 6hrs
Cushings syndrome
when the body has too much cortisol
weight gain and fat, decreases in sexual drive, easy bruishing and purple stretch marks, depression, weakness
tx - remove sterios slowly or if casued by tumour them remove that
Conn’s syndrome
overporoduction of aldosterone - high BP and low potassium #excessive thrist, fatigue, urniation, muscle cramps, visual issues
Tx - with meds and chagne in lifestyle adn diet
Infective endocariditis
inflammation of the lining of the heart that often involves the heart valves
streptocci or staphlyoccci bacteria
Specific heart problems
hx of infective endocairiditis
cogentital heart disease - atrial septal defect, ventricular septal defect
replascement heart valve therapy
diseases affecting the heart valves - stenosis, regurtitiation
hypertropic cardiomyopathy
NICE guidlines state
there is no antiobitc prohylaxis rouninely given for dentalprocedures
uncertain if antibiotic prophylaixis works
antibiotic reisitance on increase
taking antibiotics carries its own risks
Antibiotics prophylaxis tx
3g of amoxicillin oral powder sachet 60mins before procedure
or
clinmydacin capsules 300mg x2 60 mins before procedure
IE sympomts
cough
shortness o fbreath
tiredness
muscle pain
petachie
fever and chills
heart murmur
Hypercementosis
overproduction of cementum on the tooth root and is asymptomatic
occurs more in mandible and molars
Casues of hypercementosis
fracture of teeth
occlsuion
root fracture repair
occlusal truama
pulp or perio disease
systemic - paget’s disease, goitre, gardner’s syndrome, RF, acrmegagly
Symptoms of hypercementosis
bulbous roots and spcae of perio membrane
Complications of hypercementosis
difficult xla due to fusion of roots with adj teeth
pulpal necrosis - due to blocking of apical formane
tooth section may be required to remove the tooth
Constituents of LA
type - ester or amide
perservatives - bisulphite
vasocontritor - fleypressin or adrnealine
How does La work
LA works by blocking nerve conduction by blocking volgate gated sodium ion channels
The LA is deposited and binds to the voltage gated sodium channels and prevents an influx of sodium ions
This blocks the action potential generation and propagtion
The block will continue as long as sufficent number of sodium ion channels are blocked
To block the action potential the la needs to work on serveal nodes of ranvier
Alternatives to an idb
Gow’s Gate
Akonisi technique
Maxiallry division of the trigeminal nerve
foramen rotundum
Mandiblaur division of the trigeminal nerve
foramen ovale
How La works
LA works by blocking nerve conduction by blockig the volgated gated sodium channels
La bigs to the sdoium ions
The la block the sodium ion channels and prevents an influx of sodium ions
the blocks action potentional generation and propgation
The block wil last as long as the sodium channels are blocked
The action otentials are blocked depending on number of noes of ranvier the la works with
