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Dental Science > Landmarks for Local Anesthia- Part of CUM FINAL > Flashcards

Landmarks for Local Anesthia- Part of CUM FINAL Flashcards

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1
Q 
type of injection that
anesthetizes a small area—one or two
teeth and associated structures—when the
local anesthetic agent is deposited near
terminal nerve endings
A

Local infiltration

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2
Q

type of injection that
anesthetizes a larger area than a local
infiltration because the local anesthetic is
deposited near large nerve trunks

A

Nerve block

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3
Q

abnormal sensation from an

area such as burning or prickling

A

Paresthesia

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4
Q

Bones involved in Local Anesthia are

A

maxilla
palatine
mandible

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5
Q

Soft tissues will serve as ____ _____,
but due to variation among patients, you
must learn to rely mainly on visualization
and palpation of hard tissues

A

initial landmarks

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6
Q

The clinician must never progress the needle
through an area with an ______ ________ ________ to prevent spread of dental
infection. Effectiveeness is greatly reduced in areas administered

A

abscess, cellulitis, or

osteomyelitis

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7
Q

Why is local anesthia of the maxilla more successful than the mandible ?

A
  • Bone over facial surface of max teeth is less dense than that of the mandible
  • Less variation of anatomy of the maxillary and palatine bones with respect to landmarks than the mandible
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8
Q 
PSA
MSA
ASA
IO
NP
AMSA
A

Maxillary nerve anesthesia

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9
Q

Maxillary molar teeth and associated buccal tissues

A

PSA

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10
Q

Maxillary premolars and mesiobuccal root of 1st molar, and associated buccal tissues

A

MSA

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11
Q

Maxillary canine and incisors and associated facial tissues

A

ASA

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12
Q

Maxillary anterior and premolar teeth and associated facial tissues

A

Infraorbital IO

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13
Q

Palatal tissues distal to maxillary canine

A

GP

greater palatine

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14
Q

Palatal tissues between the right and left maxillary canines

A

NP

nasopalatine

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15
Q

The only injection that crosses the midline

A

Nasopalatine

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16
Q

Pulpal and soft tissue anesthia of large area covered by ASA, MSA, GP and NP

A

Anterior Middle Superior Alveolar AMSA

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17
Q

PSA Target Area

A

PSA nerve as it enters the maxilla through the posterior superior alveolar foramina on the maxilla’s infratemporal surface

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18
Q

PSA penetration site

A

Height of the mucobuccal fold at the apex of the maxillary second molar, distal to the zygomatic process of the maxilla

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19
Q

In some patients, the MB root of the first molar is not innvervated by the PSA, but by the ___ , a second injection may be necessary

A

MSA

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20
Q

PSA must avoid injecting into the

A

pteryoid plexus

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21
Q

MSA Target Area

A

MSA nerve at the apex of the maxillary second premolar

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22
Q

Penetration site of MSA

A

-Penetration site: Height of mucobuccal fold at the
apex of the maxillary
second premolar ž

-Needle is inserted
until its tip is located
superior to the apex of
the maxillary second
premolar without
touching the bone
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23
Q

Possible complications of MSA

A

Over-insertion complications such as a

hematoma are rare with the MSA

24
Q

ASA target area:

A

ASA nerve at the apex of the maxillary canine

25
Q

Penetration site ASA

A

Penetration site: tissues at the height of the mucobuccal fold at the apex of the maxillary canine, just anterior to and parallel with the canine eminence.

26
Q

Possible complications of ASA

A

over insertion with complications like a hematoma are rare with the ASA

27
Q 
-Anesthetizes MSA
and ASA nerves
(max. premolars,
canine, and incisors
and supporting
structures) ž

-Ta r g e t a r e a :
infraorbital foramen.

A

IO

28
Q

IO penetration site:

A

height of the mucobuccal fold tissues at the apex of the maxillary first premolar.

29
Q

IO possible complications

A

May get a hematoma across lower eyelid and tissues between it and the infraorbital foramen

30
Q

GP/Greater Palatine Target Area

A 
anterior to where the
nerve exits the
greater palatine
foramen, at the
junction of the
alveolar process and
hard palate
31
Q

GP penetration site:

A

anterior to depression created by the greater palatine foramen. The depression can be palpated about midway between the palatine raphe and the lingual gingival margin.

32
Q

KEYS for greater palatine injection

A 
ž Because overlying tissue is firmly
adhered to the palatal bone, use
pressure anesthesia posterior to the
injection site to blanch tissues and
reduce discomfort. ž Deposit the anesthetic SLOWLY!
33
Q

Possible Complications of GP

A

soft palate may be
inadvertently anesthetized, which is
harmless, but may be uncomfortable for
patient who may gag

34
Q

During the GP injection which nerve may be anesthetized causing soft palate anesthia

A

Lesser palatine/feels like cant swallow

35
Q

Nasopalatine Block Target area

A 
b o t h
the right and left NP
as they exit the
incisive foramen,
beneath the incisive
papilla
36
Q

NP Block Injection Site

A

palatal tissues
lateral to the incisive
papilla

Pressure anesthesia
is also applied, from
the contra lateral
side

37
Q

Possible complications of NP

A

Complications such as a hematoma are extremely rare

38
Q

AMSA
Anterior Middle Superior Alveolar Block
Target Area

A

Tissues of the hard palate between the apices of 1st and 2nd premolars

39
Q

Anterior Middle Superior Alveolar Block AMSA Injection Site

A 
an
area bisecting the
apices of the
maxillary
premolars,
midway between
lingual gingival
margin and
median palatal
raphe
40
Q

Possible complications of AMSA

A 
blanching will be noted
after the AMSA block.  If blanching is
excessive, there may be postoperative
tissue ischemia and sloughing.  Other
complications are rare.
41
Q 
Inferior Alveolar Block (IA)
Buccal Block (Long Buccal)
Incisive Block 
Mental Block
Gow Gates

These are all for

  1. Maxillary Nerve Anesthesia
  2. Mandibular Nerve Anesthia
A

Mandibular nerve anesthia

42
Q

Target Area for Inferior Alveolar Block

A 
slightly
superior to the entry
point of the IA nerve into
the mandibular foramen ž ***LA must be acurately
deposited within 1mm of
the target area to
achieve anesthesia*** ž Mainly hard tissues are
used as landmarks,
such as the coronoid
notch and occlusal
plane of mandibular
teeth
43
Q

When giving an IA the anesthetic must be acurately deposited within __ mm of the target areas to achieve anesthia

A

1mm

44
Q

IA injection iste

A

Pterygomandibular space = portion of infratemporal space between medial pterygoid muscle and ramus

45
Q

Possible Complications of IA

A

possible transient facial paralysis (if
facial nerve is mistakenly anesthetized—incorrect
injection of anesthetic into parotid gland); hematoma;
muscle soreness; paresthesia—usually from trauma to
the lingual nerve (rare)

46
Q

Possible lingual shock can come from

  1. IA
  2. AMSA
  3. NP
A

IA

47
Q

Buccal Block- Long Bucval Target Area:

A 
buccal
nerve located on the
anterior border of
the mandibular
ramus
48
Q

Long Buccal Block Penetration site

A

buccal tissues that are distal
and buccal to the most distal molar tooth in the
arch

49
Q

Complications of Buccal are

A

rare

50
Q

Incisive Block and Mental Block Target Area:

A 
a n t e r i o r
to the depression
caused by the
mental foramen,
usually located at
the height of the
mucobuccal fold
between the apices
of the mandibular
first and second
premolars
51
Q

Incisive Block and Mental Block

Penetration Site:

A 
height of
the
mucobuccal
fold tissues,
between
apices of first
and second
premolars
The difference:  Pressure is applied after the injection to force more LA into the foramen, anesthetizing both the shallow mental, and deeper incisive.
52
Q

Complications of Mental and Incisive Blocks

A

RARE

53
Q

Gow-Gates Target Area

A 
anteromedial border
of the mandibular
condyle neck, just
inferior to the
insertion of the
lateral pterygoid
muscle
54
Q

Gow-Gates Penetration site

A 
soft tissues just distal
to the maxillary second molar; vertical
height of the injection is established
using the height of the mesiolingual
cusp of max 2nd molar; use an extraoral
line for guidance (intertragic notch to
ipsilateral labial commisure of the lip)
55
Q

Possible Complications of Gow-Gates and disadvantages

A
  • Complications: anesthesia of the lower lip (can lead to
    trauma) ž

-Disadvantages: LA takes longer to take effect;
injection lasts longer, and a larger volume of anesthetic
may be necessary; trismus is possible

-Trismus = spasm of muscles making it difficult to open

56
Q

Your patient needs a filling on #6.
Which of the following injections is most
appropriate?

A

ASA

57
Q

SRP you need to anesthetize

a. Pulp
b. Soft tissue

A

BOTH

Dental Science (27 decks)

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