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OS & Pain Management > Local Anesthesia pt. 8 > Flashcards

Local Anesthesia pt. 8 Flashcards

1
Q

Buccal Nerve
Between

A

Lateral Pterygoid Heads

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2
Q

Buccal Nerve
Sensory to (2)

A

Cheek Area
Molar Buccal Gingiva

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3
Q

Buccal Nerve Block
Injection – (3)

A

Injection – 25 Gauge Long Needle
Injection – Stretch Tissue
Injection – Contact Periosteum

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4
Q

Buccal Nerve Block
Tissues Anesthetized
(4)

A

•Gingiva buccal to molars
•Retromolar pad mucosa
•Buccal mucosa in molar area
•NO hard tissues anesthetized

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5
Q

Buccal Nerve Block
Indications

A

•When buccal soft tissue
anesthesia is required

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6
Q

Buccal Nerve Block
Advantages
(3)

A

•High success rate
•Easy injection to administer
•Atraumatic

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7
Q

Mandibular Nerve
Posterior Division
(5)

A

•Primarily sensory
•Auriculotemporal nerve
•Lingual nerve
•Inferior alveolar nerve
•Mylohyoid nerve

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8
Q

Auriculotemporal Nerve
Areas Innervated
(5)

A

•Skin over areas supplied by VII
•Skin over helix and tragus of ear
•Skin of external auditory meatus
•Posterior part of TMJ
•Skin over temporal area

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9
Q

Lingual Nerve
(3)

A

Second Branch of Posterior Division
Innervates Anterior 2/3 of Tongue
Innervates Lingual Mucosa

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10
Q

Lingual Nerve Blocked With:
(5)

A

•Inferior Alveolar Block
•Mandibular Block
•Gow-Gates Mandibular Block
•Vazirani-Akinosi Block
•Infiltration in lingual sulcus

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11
Q

Lingual Nerve Blocked With:

A

Infiltration in lingual sulcus

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12
Q

Inferior Alveolar Nerve
steps (probs skip)

A

Largest Branch of Posterior Division
Sphenomandibular Ligament
Mandibular Foramen
Syringe at Level of Coronoid Notch
Syringe Directed Across Arch
Needle Penetrates Buccinator
Muscle
Penetration Lateral to
Pterygomandibular Raphe
Drying the Injection Site
Apply Topical Anesthetic
Wait One to Two Minutes
Finger on Notch Retracts Cheek and
Determines Height of Injection
Note Site of Needle Insertion
Barrel of Syringe in Corner of Mouth
Aspirate, Inject 1.5 ml over 60 Sec.
Insert~25mm to Contact Bone
Withdraw Halfway, Deposit 0.1 ml at
Lingual Nerve

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13
Q

Inferior Alveolar Nerve Block
Nerves Anesthetized
(4)

A

•Inferior alveolar
•Incisive
•Mental
•Lingual (usually)

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14
Q

Inferior Alveolar Nerve Block
Indications
(3)

A

•Wide area requires anesthesia
•Buccal tissue anesthesia is needed
•Lingual soft tissue anesthesia is
needed

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15
Q

Inferior Alveolar Nerve Block
Contraindications
(3)

A

•Infection in area
•Acute inflammation in area
•Patient a potential lip-biter

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16
Q

Inferior Alveolar Nerve Block
Advantages
(2)

A

•Provides wide area of anesthesia
•Minimizes anesthetic dose

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17
Q

Inferior Alveolar Nerve Block
Disadvantages
(4)

A

•Wide area anesthetized
•Unsuccessful in 15 to 20%
•Inconsistent oral landmarks
•10-15% positive aspiration

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18
Q

Inferior Alveolar Nerve Block
Alternatives
(5)

A

•Mental nerve block
•Incisive nerve block
•Gow-Gates block
•Vazirani-Akinosi block
•Intraosseous or intraseptal
injection

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19
Q

Terminal Branch of Inferior Alveolar

A

Mental Nerve

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20
Q

Mental Nerve Block
steps (5)

A

Palpate the Mental Foramen
Determine Site of Injection
Dry the Area and Apply Topical
Orient Needle Bevel Facing Bone
Insert into Tissue Over Foramen

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21
Q

Insert into Tissue Over Foramen
Deposit — ml over —
seconds.

A

0.6
20

22
Q

Mental Nerve Block
Areas Anesthetized
(3)

A

•Mucosa anterior to foramen
•Skin of the lower lip
•Chin

23
Q

Mental Nerve Block
Indications
(3)

A

•Soft tissue anesthesia
•Suturing lip lacerations
•Biopsies of lip tissue

24
Q

Mental Nerve Block
Contraindications
(2)

A

•Infection in the area
•Acute inflammation

25
Q

Mental Nerve Block
Advantages
(3)

A

•High success rate
•Technically easy
•Usually entirely atraumatic

26
Q

Mental Nerve Block
Disadvantages
(2)

A

•Hematoma
•Positive aspiration 5.7 %

27
Q

Terminal Branch of Inferior Alveolar

A

Incisive Nerve

28
Q

ncisive Nerve
Supplies (3)

A

Incisors, Canine,
Premolar(s)

29
Q

Incisive Nerve Block
(2)

A

Identical to Mental Block With
Pressure Maintained 2 Minutes
Trans-Papilla Injection for
Lingual Anesthesia

30
Q

Incisive Nerve Block
Areas Anesthetized
(4)

A

•Mucosa on buccal
•Lower Lip
•Skin of the chin
•Premolars, canines,
incisors

31
Q

Incisive Nerve Block
Indications
(3)

A

•Procedures on anterior teeth
•When inferior alveolar block is not
indicated
•To avoid bilateral mandibular
blocks

32
Q

Incisive Nerve Block
Contraindications
(2)

A

•Infection
•Acute inflammation

33
Q

Incisive Nerve Block
Advantages
(2)

A

•Provides pulpal and hard
tissue anesthesia without
lingual anesthesia
•High success rate

34
Q

Incisive Nerve Block
Disadvantages
(3)

A

•No lingual anesthesia
•May be sensory overlap at
midline (rare)
•Positive aspiration 5.7 %

35
Q

True Mandibular Nerve Block

A

Gow-Gates Nerve Block

36
Q

Gow-Gates Nerve Block
Needle Contacts

A

Neck of Condyle

37
Q

Gow-Gates Nerve Block
Two Extra-oral Landmarks (2)

A

Intertragic
notch
Corner of mouth

38
Q

Gow-Gates Nerve Block
Wide Opening, Condyle Moves

A

Forward

39
Q

Gow-Gates Nerve Block
Needle Puncture Point Dictated by

A

Intra-oral Landmarks

40
Q

Gow-Gates Nerve Block
steps (2)

A

Advance Until Bone Contacted
Withdraw 1 mm, Aspirate,
Inject 1.8 ml

41
Q

Gow-Gates Nerve Block
Nerves Anesthetized
(5)

A

•Inferior Alveolar
•Lingual
•Mylohyoid
•Auricolotemporal
•Buccal (in 75 %)

42
Q

Gow-Gates Nerve Block
Indications
(4)

A

•Multiple procedures
•Buccal anesthesia required
•Lingual anesthesia required
•Minimal dose of anesthetic

43
Q

Gow-Gates Nerve Block
Contraindications
(4)

A

•Infection in area
•Inflammation in area
•Potential lip-biter
•Restricted mouth opening

44
Q

Gow-Gates Nerve Block
Advantages
(4)

A

•95-99% success rate !
•Single injection
•Minimal aspiration rate
•Few complications

45
Q

Gow-Gates Nerve Block
Disadvantages
(2)

A

•Longer onset, >5 minutes)
•No intraoral landmarks

46
Q

Vazirani-Akinosi Nerve Block
(3)

A

Direct Parallel to Ramus
Insert to 25 mm Depth
Aspirate, Inject 1.5 to 1.8 ml

47
Q

Vazirani-Akinosi Nerve Block
Nerves Anesthetized
(3)

A

•Inferior Alveolar
•Lingual
•Mylohyoid

48
Q

Vazirani-Akinosi Nerve Block
Indications
(3)

A

•Limited mouth opening
•Multiple procedures
planned
•Landmarks poorly visible
for other injections

49
Q

Vazirani-Akinosi Nerve Block
Contraindications
(4)

A

•Infection in area
•Inflammation in area
•Potential lip-biter
•Inadequate access

50
Q

Vazirani-Akinosi Nerve Block
Advantages
(3)

A

•Relatively atraumatic
•No need to open mouth
•Aspiration rate <10 %

51
Q

Vazirani-Akinosi Nerve Block
Disadvantages
(3)

A

•Difficult visualization
•No bony contact
•Arbitrary insertion depth

OS & Pain Management (8 decks)

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