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BAMS > LA Symposium > Flashcards

LA Symposium Flashcards

1
Q

Define a nerve block anaesthesia and what it is used to anaesthetise

A

Anaesthetic deposited beside nerve trunk

Used to produce soft tissue anaesthesia
Used where bone is too thick to allow infiltration (mandible)

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2
Q

What LA type would you use to anaesthetise dental pulp in maxilla?

A

Buccal infiltration

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3
Q

What LA type would you use to anaesthetise buccal gingivae in maxilla?

A

Buccal infiltration

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4
Q

What LA type would you use to anaesthetise palatal gingivae in maxilla?

A

Palatal injection

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5
Q

What LA type would you use to anaesthetise dental pulp in lower molars (and second premolar)?

A

Inferior alveolar nerve block (IAN/IDB)

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6
Q

What LA type would you use to anaesthetise the pulp of lower premolars and canine?

A

Mental (incisive) nerve block

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7
Q

What LA type would you use to anaesthetise the pulp of lower canine and incisors?

A

Buccal/labial infiltration

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8
Q

What LA type would you use to anaesthetise buccal gingivae in lower molars and second premolar?

A

(Long) buccal infiltration

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9
Q

What LA type would you use to anaesthetise buccal gingivae in lower first premolar and canine?

A

IAN block or mental block

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10
Q

What LA type would you use to anaesthetise buccal gingivae in lower incisors and canines?

A

Buccal/labial infiltration

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11
Q

What LA type would you use to anaesthetise lingual gingivae in mandible?

A

IAN block, if given

Lingual infiltration

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12
Q

What tissues need to be anaesthetised for a restoration?

A

Pulp

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13
Q

What tissues need to be anaesthetised for an extraction?

A

Pulp and gingivae

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14
Q

What are the 2 types of needles used for LA in adults and give their lengths

A

Short- 25mm

Long- 35mm

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15
Q

Name 4 steps taken to prep patient for LA injection

A

Check medical history

Position in chair (dictated by type of treatment)

Dry mucosa

Apply topical (pea size on cotton wool)

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16
Q

What are the 5 steps in injection technique?

A

Stretch mucosa

Puncture quickly- use distraction

Position needle tip at target point

Aspirate

Inject slowly- no less than 30 seconds

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17
Q

What is the role of the bevel?

A

To provide a cutting surface, that offers little resistance to mucosa as the needle penetrates and withdraws from tissue

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18
Q

Name the 4 important landmarks when giving IAN

A

Coronoid notch on mandibular ramus
Posterior border of mandible
Pterygomandibular raphe
Lower premolar teeth on opposite side

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19
Q

Where is the site of anaesthetic deposition for IANs

A

In the region of the mandibular foramen

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20
Q

How much of needle should be visible during IAN when bony contact is made?

A

1cm

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21
Q

What 3 effects does LA have on CVS?

A
  1. Myocardial depression
    - decreased excitability
    - decreased force of attraction
  2. Vasodilation (arterioles)
  3. Inhibition of sympathetic system
22
Q

What are 2 adverse effects of LAs

A

Overdosage (toxic)

Allergy (rare)

23
Q

Name 3 ways overdosage can be avoided

A

Limiting volume
Aspirating
Slow injection

24
Q

What 4 effects does adrenaline have on heart, and what receptors involved?

A

Increased HR
Increased force
Increased CO
Increased excitability

β1 receptors

25
Q

What 3 effects does adrenaline have on blood vessels and what receptors are involved?

A

Coronary dilation
Skin contraction– α receptors
Muscle dilation– β2 receptors

26
Q

What effect does adrenaline have on BP?

A

Increased systolic
Decreases diastolic

Overall- little effect

27
Q

Name 7 symptoms of adrenaline overdose

A 
Fear/anxiety
Trembling
Weakness
Dizziness
Pallor/sweating
Palpitations
Headache
28
Q

What is the cause of fainting?

A

Lack of oxygenated blood to brain

29
Q

Name 6 clinical features of fainting

A 
Light headiness
Pallor
Beads of sweat
Bradycardia (slow pulse)
Nausea
Pupil dilation
30
Q

Name 4 ways to manage fainting

A

Lay flat and raise legs
Loosen neck clothing
Improve room ventilation
Sweet drink

31
Q

Define trismus

A

Inability to open mouth fully

32
Q

Cause of trismus

A

Probably damage to medial pterygoid

Injection too low, too forceful

33
Q

Cause of facial palsy

A

Local into parotid gland- infection too far posteriorly

34
Q

How would you diagnose palsy?

A

Test branches of facial nerve

35
Q

3 clinical features of IV injection

A

Skin blanching
Visual disturbance
Aural disturbance

36
Q

Define surface anaesthesia

A

Anaesthesia of the surface tissues I.e. Skin, mucous membranes

37
Q

3 uses of surface anaesthesia

A

Decrease pain of LA injection
Decrease discomfort of venipuncture
For superficial soft tissue manipulation

38
Q

2 types of surface anaesthesia

A

Physical (refrigeration anaesthesia)

Pharmacological (topical)

39
Q

4 types of topical anaesthetic application

A

Intraoral topical agents
Topical anaesthesias for skin
Controlled release devices
Jet injectors

40
Q

What are 2 advantages and 4 disadvantages of topical jet injectors?

A

Adv- allows anaesthesia upto 1cm
sole means achieving LA

Dis- could cause soft tissue damage if careless
Frightening sight and sound
Taste of solution
Expensive

41
Q

What are 4 contradictions for using lidocaine?

A

Heartblock and no pacemaker
Allergy to LA
Hypotension
Impaired liver function

42
Q

2 uses of intraligamentary LA

A

Supplement infiltration

May eliminate need for block

43
Q

What volume of LA is used for intraligamentary LAs

A

0.2ml per root

44
Q

How is intraligamentary LA given?

A

30° to long axis of tooth in mesio buccal gingival sulcus

45
Q

How would you give a mental block in child?

A

Advance needle in buccal sulcus towards region between apices of first and second primary molars

46
Q

One advantage and disadvantage of mental block in kid

A

Adv- v good soft tissue anaesthesia

Dis- not as reliable as ID

47
Q

5 steps to deal with treatment of toxicity

A 
Stop treatment
Provide BLS
Call for medical assistance
Protect patient from injury
Monitor vital signs
48
Q

6 late localised complications of LA

A 
Self-inflicted trauma
Oral ulceration
Trismus
Long lasting anaesthesia
Infection
Developmental defects
49
Q

What is Gow gates technique?

A

Open mouth technique
Patient lying flat
Aim for neck of condylar process

50
Q

What is the Akinosi technique?

A

Closed mouth technique

51
Q

Define an infiltration anaesthetic and what it’s used for

A

LA solution deposited around terminal branches of nerves

Used to anaesthetise soft tissues
Used to produce pulpal anaesthesia where alveolar bone is thin (maxilla, lower anterior teeth)

BAMS (9 decks)

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