Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Practice > LA all > Flashcards

LA all Flashcards

1
Q

what all needs to be in place/checked before local anesthetic can be carried out?

A
  • must be enrolled on GDC register
  • signed treatment plan from dentist
  • PMH checked
  • dentist must be on site if doing an IDB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what position should pts be in for LA and why?

A

semi recumbant

reduce chance of vaso vagal attack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

apply topical for how long?

A

2 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

why are infiltrations possible in maxillary teeth and mandibular incisors?

A

bone is thinner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

maxillary incisors and canines/buccal gingivae supplied by?

palatla gingivae?

A

anterior superior alveolar nerve

nasopalatine nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

maxillary premolars and buccal gingivae supplied by?

palatal gingivae?

A

superior plexus

nasopalatine and greater palatine nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

maxillary molars and buccal gingivae supplied by?

palatal gingivae?

A

posterior superior alveolar nerve

greater palatine nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what problems might there be with LIA at the maxillary molars?

A

zygomatic arch

mesial and distal infiltrations overcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

where do you give a palatal injection?

A

equidistant between median raphe and gingival margin above tooth requiring anaesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how do you know a palatal injection achieved?

A

blanching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

where to avoid when giving a palatal injection?

A

rugae and foramen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

why do the lower molars and premolars require an IDB?

A

thick lamina dura - LIA doesnt work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

when giving LIA at the lower incisor/canine region where should you ensure the needle is?

A

in contact with bone to prevent escape of agent into the tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how to anaesthatise the lingual nerve?

A

LIA below attached gingivae lingually

interpapillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how to give an interpapillary injection?

A

insert needle at centre of papilla near crest of bone/perio pocket level
small and slow injection
blanching indicates anaesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how quick should LIA anesthesia be established?

A

2 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

lidocaine and ep gives pulpal anaesthesia of how long?

A

approx 1 hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

do the soft tissues or the hard tissues stay anesthatised for longer?

A

soft tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are some reasons for LA failure?

A 
pts are different - some la might not last as long
IV - syncope
IM
too little LA
infection and injection site
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

why can an injection stop LA working?

A

infection sites tend to be acidic and LA works best in alkaline conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is LA?

A

the loss of sensation in a specific area by depressing excitation of nerve endings or inhibititng conduction processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the main aim of LA in dentistry?

A

loss of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what channels does LA block?

A

ion channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

where does inferior alveolar nerve pass through?

A

passes through the foramen ovale into the infratemporal fossa, between the lateral and medial pterygoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

where is the needle entered into?

A

the pterygomandibular space

26
Q

what are some contra indications to an IDB?

A

haemophilliacs
co agulation tx
co operation

27
Q

what anatomy is identified prior to IDB?

A

external oblique ridge at anterior aspect of ascending ramus

and V shape of pterygomandibular raphe

28
Q

where does the thumb palpate when doing an IDB?

and where is the needle advanced from?

A

palpate the ramus,
needle advanced from opposite premolars in line with lower occlusal plane
enters soft tissues at mid point of thum above last standing molar

29
Q

why might an IDB fail?

A 
too little LA
not enough time
inaccurate placement
different anatomy
inflammed tissues
30
Q

what complications can an IDB cause?

A 
facial palsy
nerve damage
ST damage
haematoma
IV
31
Q

what systemic effects might an IDB cause?

A

fainting
allergy
drug interactions
toxic reaction

32
Q

6 contents of LA?

A 
local anaesthetic agent
vasoconstrictor
reducing agent
preservative
fungicide
carrier solution
33
Q

details of lidocaine?

A

commonly in 2% solution dissolved in sol as hydrochloride salt
with ep gives longer anaesthesia

34
Q

details of prilocaine?

A

citanest
3% with octapressin
4% plain
less effective at haemostasis and vasoconstriction

35
Q

mepivicaine comes as?

A

2% with epinephring 1:100000

3% plain

36
Q

articiane details?

A

4% 1:100/200000

metabolised faster so is useful for repeat injections

37
Q

advantages of epinephrine?

A

more profound anaesthesia
longer lasting
hameostasis

38
Q

details of felypressin?

A

less effective at haemorrhage control

not as good a vasoconstrictor

39
Q

what trauma can LA cause?

A

IV
IM
needle
trauma to mouth while numb

40
Q

why is an IV injection dangerous?

A

enough LA agent to be of a toxic dose to the CNS of children and young adults
heart and brain susceptible to effects

41
Q

why may you think twice about LA and a pt with liver disease on PMH?

A

liver disease = impaired metabolism, could cause toxic effects

42
Q

what heart problems can contraindicate use of LA?

A

arrhythmia, unstable angina

43
Q

alternate LA for cardiac pts?

A

use felypressin max 3 cartridges and avoid epinephrine

44
Q

max lidocaine?

prilocaine?

A

lido plain - 11 max, ep - 6.8

prilo plain - 9, fely - 4

45
Q

be careful with use of LA agent and what drugs?

A

beta blockers - max of two with ep

calcium channel blockers

46
Q

be careful of what drugs and vasoconstrictors?

A

diuretics
antiparkinsons
calcium channel blockers
beta blockers

47
Q

what are some systemic diseases that are contra indicated in LA?

A 
leukaemia
anticoag tx
steroid tx
liver dysfunction
renal disease
rheumatic fever
uncontrolled diabetes
haemophilia
pregnancy
48
Q

what is gate control theory?

A

melzack and wall 1965

pain is modulated at the spinal cord and influenced by socio cultural factors/physiological and psychological factors

49
Q

what is the adult pain rating scale?

children?

A

mcGill

wong and baker

50
Q

what are some ways of distracting the pt?

A

shift attention
mental task
audio analgesia
visual distraction

51
Q

what component of LA gives haemostasis?

A

the vasoconstrictor

52
Q

what is the aim of analgesia?

A

haemostasis and elimination of pain

53
Q

what part of a nerve cell contributes to nerve conduction?

A

nodes of ranvier

end feet synapses

54
Q

how does analgesia work r.e nerve anatomy?

A

gains access to nerve at nodes of ranvier and blocks conduction

55
Q

what conditions can give rise to pain?

A

inflammation
trauma
necrosis
ischaemia

56
Q

what substances give rise to pain?

A

potassium
chlorine
sodium
calcium

57
Q

what is polarisation?

A

no pain

potassium in cytoplasm and sodium outwith

58
Q

what is depolarisation?

A

destruction of polarity
ionic exchange
sodium in cytoplasm and potassium outwith

59
Q

what is action potential?

A

change in membrane potential permeability
transfer or ions
potassium exchanges with sodium

60
Q

what is repolarisation?

A

sodium potassium pumo

reverts to polarised state

Clinical Practice (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions