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Pain Management 1 > Local anesthesia Four > Flashcards

Local anesthesia Four Flashcards

1
Q

____ -_____ : cartridge is inserted into the syringe from the side

A

Breech-loading:

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2
Q

______ :

 with harpoon, it engages thick silicone rubber stopper
at the tail end of the cartridge
 Negative pressure will cause blood (if there) to be
visible in the cartridge

A

Aspirating

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3
Q

____ ____: Thumb ring forces solution through needle to patient

A

Positive Pressure

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4
Q

It is important for the clinican to be aware of the ____ _____ coming off of the syringe.

A

Needle adaptor

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5
Q

WIth the ____ _____ it is Possible to achieve consistently reliable
pulpal anesthesia of one isolated tooth in
the mandibular arch

A

pressure syringe

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6
Q

t/f: 1947 Figge and Scherer introduced “needle-less” injection

A

true

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7
Q

What is the basis of the Jet injector?

A

 Liquids forced through very small openings called jets, at very high pressure can penetrate intact skin or mucous membrane

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8
Q

t/f: One still need nerve block and infiltration with a jet injector.

A

true

Jet injector is NOT an adequate substitute for needle
and syringe.

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9
Q

What are the advantages of a disposable syringe?

A
  • single use
  • sterile until opened
  • lightweight
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10
Q

What are the disadvantages of a disposable syringe?

A

does not accept prefilled dental cartridges

difficult aspiration (usually need to hands

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11
Q

With a ______-______ ____ _____ ______ _____, there is Constant flow rate of
local anesthesia, and Controlled rate of fluid
administration =
reduced pain
perception

A

Computer-Controlled Local Anesthesia Delivery System

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12
Q

t/f: One should do the following while taking care of your instruments:
1 Wash the syringe after each use
2 Dismantle and lubricate every 5 autoclavings
3 Clean Harpoon with brush after use
4 Replace piston and harpoon on regular basis

A

true

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13
Q

T/f: with the bevel of the stainless steel needle, the Greater angle the bevel, greater the degree of deflection.

A

true

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14
Q

_______ =Diameter of the lumen of the needle

A

gauge

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15
Q

t/f: Smaller the gauge #, Greater the diameter.

A

true

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16
Q

t’f: Patients feel the same regardless of gauges of needle.

A

true

it has been demonstrated that patient is unable
to differentiate among 23-, 25-, 27-, and 30-gauge
needle.

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17
Q

(His wording is so confusing)

What are some advantages of larger gauge needle (smaller gauge number)

A 
 Less deflection, as needle advances
through tissues
 Greater accuracy in injection
 Less chance of needle breakage
 Easier aspiration
 No perceptual difference in patient comfort
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18
Q

_____ -gauge needles should be used when there is a

greater risk of positive aspiration

A

Larger-gauge

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19
Q

Red:

A

25- gauge

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20
Q

Yellow:

A

27- gauge

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21
Q

Blue:

A

30- gauge

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22
Q

_______ becomes important when needle

must penetrate a greater thickness of tissue

A

Deflection

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23
Q

With a ____ ___ _____ the Needle tip is at the lower edge of the needle shaft

A

Conventional Dental Needle

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24
Q

With a __________ ______ the tip of needle is at the center of the shaft

A

Nondeflecting Needle

25
Q

__________ ____ _____:

Rotate handpiece or
needle in a back-and-
fore rotational
movement while
advancing the needle
A

Birotational Insertion Technique

26
Q

t/f:

Average short needle is 20mm

Average long needle is 32mm

A

true

27
Q

What is the weakest portion of the needle?

A

the hub

28
Q

t/f: Needles should not be inserted into tissues to their hub unless it is
absolutely necessary for the success of the injection

A

true

29
Q

______ _ _____:

 Never used on more than one patient
 Change after 3 or more tissue penetration
 Must cover in protective sheath when not
use
 Pay attention to the position of uncovered
needle tip
 Proper disposal is necessary
 Recapping using “Scoop” technique

A

handling of needle

30
Q

What can cause pain upon insertion?

A

dull needle

31
Q

the following are the most common “____ ____” procedures:

 Inferior alveolar nerve block
 Posterior superior alveolar nerve block
 Intrapulpal injection
 PDL injection and Intraosseous injection

A

Bent needle

32
Q

t/f: “ there is no injection technique used in dentistry that
mandates that the needle be bent for the injection to be
successful”

A

true

33
Q

t/f: Don’t change direction of a needle when

its embedded in tissue, instead pull out and reinsert.

A

true

34
Q

t/f: Dr. Kao suggests always using a 27 gauge and long needles to prevent needle breakage

A

true

35
Q

U.S. dental cartridge contains_____ ml of local

anesthetic solution

A

1.8ml

36
Q

the ______ of the cartridge is made of silicon and Receives the harpoon of the aspirating
syringe

A

plunger

37
Q

the ____ of the cartridge is a Semipermeable membrane (latex rubber), and where needle penetrates into the cartridge.

A

diaphragm

38
Q

Calculate the mg of drugs in a 1.8 ml cartridge of 2% lidocaine.

A

2% = 20mg/ml and we have 1.8ml so

20 mg/ml X 1.8 ml = 36 mg

39
Q

some cartridges may contgain a ________. Examples include:

 Sodium bisulfite (antioxident)
 Sodium bisulfite oxidize to Sodium bisulfate

A

Vasopressor

40
Q

___ in the cartridge makes the solution isotonic with tissue

A

NaCl

41
Q

Contents of the cartridge:

A

medication
 May have Vasopressor
 NaCl
 Distilled water

42
Q

t/f: Store cartridges in room temperature in a dark place

A

true

43
Q

t/f: Do NOT soak cartridge in alcohol or “cold sterilizing

solution”

A

true

44
Q

the bubble in the cartridge is normally Nitrogen gas, but if there is a bubble larger than 2mm this could be a result of a _____ cartridge and is not normal.

A

frozen

45
Q

What can causes burning on patient injection?

A

pH, alcohol, heat, expiration date..

46
Q

 Dental cartridges must never be used on more
than one patient
 Cartridges should be stored at room
temperature
 It is not necessary to warm cartridges before use
 Cartridges should not be used beyond their
expiration date
 Cartridges should be checked carefully for
cracks, chips and integrity of the stopper and
cap before use

A

Recommendations for proper cartridge handling (good to know)

47
Q

t/f: Benzocaine > Lidocaine topical (reduced overdose potential)

A

true

48
Q

Most undesirable reaction to local anesthesia are______ to the act of drug administration

A

responses

49
Q

What are the most common psychogenic reactions

A

 Vasodepressor syncope

 Hyperventilation

50
Q

One should update medical history questionnaire every ___ months

A

6 months

51
Q

For patients with ______ the following is recommended:

Avoid techniques with ↑ chance of + aspiration

• Use supraperiosteal, PDL, Intraosseous

A

coagulopathies

52
Q

t/f: CHF with disability (ASA III or ASA IV) may demonstrate ↓ liver perfusion  ↑ t ½ amide
local anesthesia

A

true

53
Q

ASA ____ cardiovascular risk pt is not a candidate
for vasopressors or elective dental care

 Recent (< 6 months) or repeated MI increases risk
during dental care or local injection

A

ASA IX

54
Q

During what two stages of pregnancy is it contraindicated for LA?

A

1st and 3rd trimester

55
Q

t/f: Cimetidine + ASAIII CHF = relative contraindication for amide local anesthesia

A

true

56
Q

____ ____ can Enhance cardiovascular action to
exogenously administered vasopressors. This results in 5 -10 X increase with levonordefrin and Nore-epi, and 2 X increase with epinephrine. THIS CAN LEAD TO HYPERTENSIVE CRISIS= DEATH

A

Tricyclic Antidepressant (TCAs)

57
Q

__ hrs is needed for Cocaine clearance

A

72

58
Q

t/f: Epinephrine-impregnated gingival retraction cord is absolutely contraindicated in the cocaine abuser

A

true

Pain Management 1 (6 decks)

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