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Pain Management > Final > Flashcards

Final Flashcards

1
Q

3 lengths of needles

A

long
short
ultra short

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2
Q

long needle length

A

between 30-35

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3
Q

short needle length

A

20-25u

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4
Q

ultra short needle length

A
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5
Q

what are the gauge options for needles and their color codes

A

30 blue
27 yellow
25 red

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6
Q

what are the 2 chemical classifications of dental anesthetics

A

ester
amide

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7
Q

ester anesthetic undergo biotransformation where

A

blood plasma

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8
Q

amide anesthetic undergo biotransformation where

A

liver

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9
Q

what is the most commonly used topical anesthetic

A

benzocaine or lidocaine

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10
Q

what is the most commonly used dental anesthetic in the US

A

2% lidocaine

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11
Q

what anesthetic provides the longest duration

A

.5% bupivicaine (marcaine)

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12
Q

which anesthetic is classified as an amide but metabolized more like an ester

A

articaine (septocaine)

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13
Q

what is a vasoconstrictor

A

a substance that causes vasoconstriction, which is the narrowing of blood vessels (increased BP)

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14
Q

what are the effects of adding a vasoconstrictor

A

prolongs anesthetic
reduces toxicity
decreases blood loss

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15
Q

what are the two types of vasocontrictors

A

epi (adrenaline)
levonordefrin (neo-cobefrin)

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16
Q

what is the anesthetic most likely used without a vasocontrictor

A

topical - benzocaine

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17
Q

what is the safe dose of epi for a healthy adult

A

.2mg

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18
Q

what is a safe dose of epi for a cardiac patient

A

.04mg

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19
Q

how much solution is in a catridge of local anesthetic

A

1.8mL

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20
Q

what is in a cartridge of anesthetic

A
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21
Q

what is aspiration and why is it done

A

its pulling back the needles once inserted, looking for blood

its used to verify that the needle is not in a blood vessel or any vasculature

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22
Q

what happens if you inject into a blood vessel

A

it can travel to the heart and cause heart palpitations

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23
Q

what are the 3 branches of the trigemenial nerve

A

V1=opthalmic
V2=maxillary
V3 = mandibular

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24
Q

where does v1 exit

A

superior alveolar fissure

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25
Q

where does v2 exit

A

foramen rotundum

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26
Q

where does v3 exit

A

foramen ovale

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27
Q

what is the nerve that innervates the face

A

trigeminal

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28
Q

what is the largest branch of the trigeminal nerve

A

mandibular

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29
Q

what branch of the trigeminal nerve caries both sensory and motor nerves

A

mandibular

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30
Q

Know the PSA, nerves and what teeth they provide pulpal innervation to in the maxilla.

A

second molar

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31
Q

Know the MSA, nerves and what teeth they provide pulpal innervation to in the maxilla.

A

second premolar

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32
Q

Know the ASA, nerves and what teeth they provide pulpal innervation to in the maxilla.

A

canine

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33
Q

Know the GP, nerves and what teeth they provide pulpal innervation to in the maxilla.

A

palatine tissue appx 1-2mm slightly anterior to the GP foramen

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34
Q

Know the NP, nerves and what teeth they provide pulpal innervation to in the maxilla.

A

the opening of the incisive foramen and its incisive papilla

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35
Q

IA nerves and provides innervation to in the mandible

A

anesthetizes IA nerve & its mental and incisive nerve branches as well as the lingual nerve

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36
Q

buccal nerves and provides innervation to in the mandible

A

long buccal, anesthetizes (long) buccal nerve & associated buccal periodontium/gingiva of
mand molars

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37
Q

mental nerves and provides innervation to in the mandible

A

anesthetizes mental nerve & associated facial periodontium/gingiva of mand anterior teeth and premolars to midline, as well as tissue of ipsilateral lower lip/chin

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38
Q

Landmarks: IA/lingual

A

lingual nerve with IA; mandibular plane of occlusion, pterygomandibular raphe, coronoid
notch of mandible; 5-10mm above mandibular plane of occlusion opposite side of arch at canine/first
premolar

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39
Q

Landmarks: buccal

A

occlusal plane of mandible; buccal of mandibular teeth and 1-2mm above plane of occlusion;
mandible contacted within 2-5mm

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40
Q

Landmarks: mental

A

3-5mm; mandibular premolar; b/w mand. 1st and 2nd premolar

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41
Q

Gow-Gates injection

A

nerve block that anesthetizes the entire mandibular nerve w/in on mandibular quad

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42
Q

why use gow-gates

A

○ Highly recommended for quad dentistry or w/ lack of clinical effectiveness of an administered IA
block

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43
Q

Vazirani-Akinosi injection

A

Nerve block that has a large area of coverage of the mand nerve within one mand
quad (similar to IA block)

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44
Q

Why use vazirani-Ankinosi injection

A

used in a pt w/ severe trismus or when there is difficulty administering of IA block on
certain cases

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45
Q

what pressure anesthesia is in palatal injection

A

Pressure anesthesia is obtained by using pressure from the cotton tipped applicator while the injection is
administered

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46
Q

what direction of the bevel of the needle and window of the syringe when giving injections

A

always bevel to bone

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47
Q

how is nitrous oxide used

A

as an anxiolytic to relieve anxiety or fear

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48
Q

what are the most common fears

A

fear of the needle and drill
analgesic = insensitivity to pain w/o loss of conciousnes

49
Q

T/F: nitrous is a sub for anesthetic

A

no

50
Q

what is the color code for oxygen

A

blue

51
Q

what is the color code for nitrous

A

green

52
Q

what is the percentage that is used for nitrous oxide sedation

A

100% O2 for 3-5 minutes at the end of nitrous

53
Q

what are contraindications to No2 sedation

A

severe respiratory compromise or obstruction as

in severe asthma,

COPD,

emphysema

patients with eye surgery using intraocular gas.

for pregnant patients

history of stroke, hypotension and other cardiac condition

54
Q

What is difusion hypoxia

A

a lack of oxygen following sedation that gives the patient a ‘hungover” feeling
with headache, grogginess, nausea ect

55
Q

what is the best way to prevent medical emergencies

A

Implementation of a complete system of physical eval and medical health history could prevent up to 90%
of any medical emergency situations

56
Q

what are the AHA guidelines for antibiotic prophylaxis are needed for what tx

A

manipulation of the gum tissue or around the apex, penetration into the oral mucosa

57
Q

what patients need a prophylaxis before treatment according to the AHA

A

prosthetic heart valve
prosthetic material used for cardiac valves
history of bacterial endocarditis
cardiac transplate
cyanotic congenital heart disease
repaired heart defect

58
Q

ASA Class I

A

healthy patient

59
Q

ASA Class II

A

has a mild systemic disease but not functional limitations

60
Q

ASA Class III

A

has a mild systemic disease but functional limitations

61
Q

ASA Class IV

A

severe systemic disease that is not life threatening

62
Q

ASA Class V

A

Patient with life threatening disease that is unlikely to surve surgery

63
Q

ASA Class VI

A

brain dead organ donor

64
Q

what is tachycardia

A

increase HR>100bpm

65
Q

what is bradycardia

A

decreased HR <60bpm

66
Q

what is tachypnea

A

fast breathing >20bpm

67
Q

what is bradypnea

A

<20bpm

68
Q

Normal BP

A

120systolic/80

69
Q

Elevated BP

A

120-129/80

70
Q

hypertension I

A

130-139/ 80-89

71
Q

hypertension II

A

140+ systolic OR 90+ diastolic

72
Q

hypertensive crisis

A

180+ systolic OR
120+ diastolic

73
Q

a hypertensive crisis (BP) requires what

A

doctors consult

74
Q

what is the most common medical emergency in the dental office

A

syncope

75
Q

what is the cause of vasodepressor syncope

A

a sudden drop in blood pressure and heart rate that can be triggered by
a number of factors, including: intense emotion, such as fear, intense pain, sight of
blood or a needle, etc

76
Q

what are symptoms of vasodepressor syncope

A

fainting, nausea, warmth, turning pale, getting sweaty palms, feeling dizzy or
lightheaded, blurred vision, sudden feeling of tiredness, yawning, slow pulse

77
Q

what is FBAO

A

foreign body airway obstruction

78
Q

what is the tx of partial airway obstruction

A

make a forceful cough

79
Q

what is the tx for a complete obstruction

A

heimlich
establish airway if pt goes unconcious

80
Q

what is status epilepticus

A

continuous epilectic seizure activity with incomplete neurological recovery for a period of 30min

81
Q

what is status astmaticus

A

most severe form of asthma
airway distress cannot be correction with albuterol

82
Q

most seizure last how long

A

1-2 minutes

83
Q

what is postural hypotension

A

when BP drops when you get up too fast from sitting down

84
Q

what is the age that postural hypotension is most common

A

elderly and in patients

85
Q

characteristics of type I diabetes

A

diagnosed at early age
insulin dependent
pancreas controls the synthesis of insulin

86
Q

what are characteristics of type 2 diabetics

A

non-insulin dependent
obese

87
Q

high glucose over a long period of time creates insulin _____ and defects in insulin secretion

A

resistance

88
Q

where is the thyroid gland located

A

in front of the next below the adams apple and below the trachea

89
Q

what are the thyroid hormones

A

T3 = thyroxine
T4 = triiodothyronine
calcitonin

90
Q

what is cretinism

A

deficiency of thyroid hormone (hypothyroidism) during fetal or early life can produce a clinical
syndrome known as cretinism in infants and children

91
Q

what is myxedema

A

severe hypothyroidism that develops in an adult is called myxedema and refers to the
appearance of non-pitting, gelatinous, mucinous infiltrates beneath the skin

92
Q

and is adrenal crisis

A

1 = addision’s disease = no cortisol production
2 = tumor or damage to pituitary gland
3 = steroids that cause adrenal gland to stop producing right levels of cortisol

93
Q

what is albuterol used for

A

asthma attack

94
Q

what is nitroglycerin used for

A

angina pectoris (chest pain) and MI (heart attack)

95
Q

what is ammonia capsules used for

A

syncope

96
Q

what is Diphenhydramine used for

A

allergic rxn

97
Q

what is cake icing used for

A

hypoglycemia

98
Q

what is an epi pen used for

A

anaphylatic shock

99
Q

what is the adult epi pen dose

A

.3mL

100
Q

what is the junior epi pen dose

A

.15mL

101
Q

what is naloxone

A

narcan

102
Q

what is narcan used for

A

opioid overdose

103
Q

where is the epi pen administered

A

lateral aspect of the thigh

104
Q

when do most allergic reactions occure

A

10-15min after injection

105
Q

what happens after 3 doses of nitroglycerin

A

its a heart attack
call 911
provide o2
get the AED

106
Q

what are the ABCs

A

airway
breathing
circulation

107
Q

CPR method is __:_

A

30:2 compression to breaths

108
Q

what is the most probably cause of hypoventilation

A

anxiety

109
Q

CVA is what

A

ischemic stroke

110
Q

what is an MI

A

heart attack

111
Q

what is ACT FAST in CVA

A

F- face drooping
A-arm weakness
S-speech impairment
T-time to call 911

112
Q

what is the most common cause of CVA

A

high blood pressure
when arteries carrying blood to the brain is blocked

113
Q

what is atherosclerosis

A

build up of cholesterol in the artery wall

114
Q

Trendelenburg position

A

feet above head
uncrossed legs
gets blood back to brain

115
Q

what two nerves would you use to anesthetize the infraorbital injections

A

IO block
also get ASA and MSA for one injections

116
Q

what is Diabetic Ketoacidosis

A

Complication of diabetes in which acids (ketones) build up in blood to levels that can become
life-threatening

117
Q

Diabetic Ketoacidosis is higher risk for what type

A

type i

118
Q

Diabetic Ketoacidosis is due to

A

missing an insulin dose

Pain Management (1 decks)

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