Introduction to local anaesthetic Flashcards
Name some formulas of local anaesthetic
- Articaine 4% with epinephrine
- Bupivacaine 0.5% with epinephrine
- Lidocaine 2% with epinephrine
- Mepivacaine 2% with levonordefrin
- Mepivacaine 3% plain
- Prilocaine 4% with epinephrine or plain
What is the max dose of 2% lidocaine plain in mg/kg and no of cartridges
4.4 mg/kg
7 cartridges
What is the max dose of 2% lidocaine with adrenaline in mg/kg and no of cartridges
6.6 mg/kg
10 cartridges
What is the max dose of 4% Articaine with adrenaline in mg/kg and no of cartridges
7.0 mg/kg
5 cartridges
What is the max dose of 3% prilocaine with octapressin in mg/kg and no of cartridges
9.0mg/kg
18 cartridges
What is the max dose of 3% mepivicaine plain in mg/kg and no of cartridges
4.4 mg/kg
9 cartridges
What is the max dose of 2% mepivicaine plain in mg/kg and no of cartridges
4.4 mg/kg
14 cartridges
Which cranial nerve are we aiming to anaesthetise when administrating LA
Trigeminal nerve (V)
Name the 3 division of the trigeminal nerve
V1: Ophthalmic divison
V2: Maxillary division
V3: Mandibular division
Which of the divisions of the trigeminal nerves is the largest
The mandibular division
Describe the mandibular division of the trigeminal nerve
It conveys afferent sensory and efferent motor fibres
What do the motor fibres of V3 do
They innervate the:
- muscles of mastication
- Mylohyoid muscle
- Anterior belly of the digastric muscle
- Tenor veli palatini
- Tensor tympani muscle
What does V3 divide into
the anterior and posterior trunks
Describe the anterior trunk of V3
It is predominantly muscular
Describe the posterior trunk of V3
Mainly sensory
What does the anterior trunk of V3 give rise to
The motor branches supplying the masticatory muscles
Which key nerve originates fro the anterior trunk of v3
The long buccal nerve
Describe the path of the inferior alveolar nerve
- Branches from the mandibular nerve below the foramen ovale passing down between the lateral and pterygoid muscles
- Enters the mandibular foramen along with its artery
What is the mandibular foramen shielded by
By lingula
Describe lingula
Formed as a pointed and thin bony spicule
What is the lingula
It is the lower attachment point of the sphenomandibular ligament which extends from the sphenoid bone to the ramus.
What is the mandibular nerve supply
The pulps of all the teeth of its own side and part of the periodontal ligament
Name a key brach of the inferior alveolar nerve
Th mental nerve
Where does the metal nerve go after branching from the inferior alveolar nerve
Exits through the metal foramen
Where is the metal foramen located
Usually located at the apices of the premolars
What does the mental nerve supply
It supplies sensation to the skin of the chin, lower lip, mucosa of the lp and gingival attachment
Name the largest branch of the posterior trunk of V3
Lingual nerve
Where does the lingual nerve emerge from
Emerges from the between the 2 pterygoid muscles about 1cm in from of and medial to the inferior alveolar nerve
Talk through the path the lingual nerve takes
- Emerges from the pterygoid muscles
- After leaving the inferior alveolar nerve it is joined by chorda tympani
- Runs downwards across the medial ptergoid
- enters the mouth by passing under the lower border of the inferior constrictor of the pharynx
What does the lingual Neve supply
It is the sensory nerve to the:
- anterior 2/3rd of the tongue
- Floor of the mouth
- Lingual aspect of the mandible
What is the chorda tympani
It carries both the sensory from the geniculate ganglion and pregangionic parasympathetic nerve fibres
If we are going to carry out exodontia or minor oral surgery on mandibular teeth which nerves MUST we anaesthetise
- Inferior alveolar nerve or mental nerve
- Long buccal nerve
- Lingual nerve
