Local Anaesthetic Flashcards
What does the anterior superior alveolar nerve supply?
Upper 1-3 anterior teeth
Anastomoses with the adjacent side - corss over
What does the middle superior alveolar nerve supply?
Hard and buccal soft tissues of upper MB 6, 5 and 4
Not always present and innervation is past to the posterior superior alveolar nerve
What does the posterior superior alveolar nerve supply?
Hard and buccal soft tissue of upper 8, 7, 6 (+/- 5 and 4)
Anastomoses with mid sup alveolar if present
What does the nasopalatine nerve supply?
Palatine tissues of the premaxilla area
What does the greater palatine nerve supply?
Palatine tissue from the last molar to the first premolar/canine area
What does the buccal nerve supply?
Buccal soft tissues of lower 8-5 area
What does the lingual nerve supply?
Lingual gingiva of lower teeth and aspects of the tongue
What does the inferior alveolar nerve supply? and its exception?
Hard and soft tissues of the lower teeth except the buccal tissues of 8-6
What does the incisive nerve supply?
Extension of the IAN and ruins in canal and supplies the incisors and structures
What does the mental nerve supply?
Continuation of the IAN but exits canal at apices of premolar teeth to supply soft tissues of lower lip and chin
Which scenarios are best for the infiltration technique? what allows this?
All maxillary teeth and supporting teeth, both buccally and palatally
Mandibular anterior teeth and supporting tissues
Thin cortical plate allows diffusion
Which scenarios should you avoid an infiltration? but what is the exception? and what stops it?
Anything posterior to the lower premolar
except lower first molar using 4% articaine
This is due to the bone being very dense for adequate penetration
Where is the inferior alveolar nerve found and its course?
IAN passes between the lateral an medial pterygoid muscle, behind the lingual nerve via the mandibular foramen into the mandibular canal
Where is IAN block achieved?
Mandibular foramen located on the medial aspect of the ramus, before it enters the canal
Where to inject to achieve IAN block?
Through the lateral side of the mouth into the fat of the pterygomandibular space
What needle size and gauge is needed for a IAN block?
Long needle
27 gauge
How to place and manipulate the patient to achieve a successful IAN block?
Patient supine or semi recumbent
Mouth open wide
What are the clinical anatomical landmarks to remember to aid an IAN block?
Mandibular foramen
External oblique ridge at anterior aspect of ascending ramus
Pterygomandibular raphe (runs from the pterygoid hamulus down to a point on the mandible in the retromolar region)
Forms a V shape
Where should the thumb or finger palpate for an IAN?
At the ramus whilst the injection is given
Where should the needle be positioned before entry for an IAN?
Introduced from premolar area of opposite side
Barrel of syringe parallel to lower occlusal plane
Where should the needle enter for an IAN?
Lateral to the pterygomandibular raphe
Medial to ramus of mandible
Within the V
Halfway up the thumb from palpating ramus