Local Anesthesia Techniques Flashcards

1
Q

What is the target of the inferior alveolar NB?

A

2mm superior to the md. foramen; midway between anterior and posterior border of ramus

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2
Q

What is the insertion point of the inferior alveolar NB

A

10mm above occlusal plain; 2mm lateral to pterygo md. raphe

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3
Q

What is the angle/landmarks of the inferior alveolar NB

A

parallel to occlusal plane; over contra-lateral premolars

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4
Q

What tissue is anesthetized with the inferior alveolar NB?

A

all teeth, buccal and lingual gingiva in quad except buccal to molars

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5
Q

What is the depth of the inferior alveolar NB?

A

2/3-3/4 needle length; contact bone

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6
Q

What is the length of needle used in the inferior alveolar NB?

A

long

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7
Q

What is the volume of anesthetic injected in the inferior alveolar NB?

A

2/3 at target; 1/4 half out

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8
Q

What are some comments about the inferior alveolar NB?

A

sit patient up afterwards; redirecting is common (rt side sit at 8oclock)

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9
Q

What is the target of the buccal NB?

A

buccal nerve; above periosteum, in connective tissue

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10
Q

What is the insertion point of the buccal NB?

A

buccal mucosa adjacent to DB cusp of last md. molar

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11
Q

What is the angle/landmarks of the buccal NB?

A

either low angle to slide under tissue or steep angle if tissue pulled up

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12
Q

What tissue is anesthetized with buccal NB?

A

buccal gingiva of molars

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13
Q

What is the depth of the buccal NB?

A

2mm; +/- contact bone

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14
Q

What length of needle is used in the buccal NB?

A

long

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15
Q

How much anesthetic is injected with buccal NB?

A

1/8 carpule

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16
Q

What are some comments regarding the buccal NB?

A

awkward to slide under the mucosa

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17
Q

What is the target of the infiltration technique?

A

periosteum over tooth apex

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18
Q

What is the insertion point of the infiltration tech?

A

height (or depth) of the buccal vestibule

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19
Q

What is the angle/landmarks of the infiltration tech?

A

parallel to long axis of tooth

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20
Q

What tissue is being anesthetized with infiltration?

A

target tooth and buccal gingiva; may anesthetize adjacent teeth

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21
Q

What is the depth of the infiltration tech?

A

approximately 3mm

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22
Q

What length of needle is used with infiltration

A

small

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23
Q

How much anesthetic is injected with the infiltration?

A

1/2 carpule

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24
Q

What are some comments about the infiltration tech?

A

not suitable for 1st max molar or md teeth (except incisors)

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25
Q

What is the target of the nasopalatine nb?

A

nasopalatine foramen (incisive foramen)

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26
Q

What is the insertion point of the nasopalatine nb?

A

at the base of the incisive papilla from either side

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27
Q

What is the angle/landmarks of the nasopalatine nb?

A

45 degrees to the long axis of the central incisors; in the plane of incisor inclination

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28
Q

What tissue is anesthetized with the nasopalatine nb?

A

lingual gingiva of all max incisors and cuspids

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29
Q

What is the depth of the nasopalatine nb?

A

until boney contact

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30
Q

What size of needle is used for the nasopalatine nb?

A

short

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31
Q

How much anesthetic is used for the nasopalatine nb?

A

1/8 of a carpule or until blanches just shy of a nickel size

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32
Q

What are some comments about the nasopalatine nb?

A

brace with opposing hand; bevel toward tissue; give at side toward you

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33
Q

What makes the nasopalatine nb different from any other injection?

A

it crosses the midline

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34
Q

What is the target of the Gow Gates NB?

A

anterior neck of the condyle

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35
Q

What is the insertion point of the Gow Gates NB?

A

about 10mm above IANB insertion; near pal cusp of max 2nd molar

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36
Q

What is the angle/landmarks of the Gow Gates NB?

A

from the opposite corner of mouth of tragus of ear; near mand canine

37
Q

What is the tissue anesthetized with the Gow Gates NB?

A

all teeth, buccal and lingual gingiva in quad; (may require buccal NB)

38
Q

What is the depth of the Gow Gates NB?

A

almost entire length of needle; boney contact

39
Q

What is the size of needle used for Gow gate NB?

A

long

40
Q

What is the volume of anesthetic used in the Gow Gate NB?

A

entire carpule

41
Q

What are some additional notes for the Gow Gates NB?

A
  • keep mouth open for 1 min after injection
  • target with finger on tragus
  • right side sit at 8oclock
42
Q

What is the target of the incisive NB?

A

mental foramen

43
Q

What is the insertion point for the incisive NB?

A

depth of buccal vestibule, between md. premolars

44
Q

What is the angle/landmarks of the incisive NB?

A

parallel to long axis of teeth (be cognizant of the flare of the mandible)

45
Q

What is the tissues anesthetized with the incisive NB?

A

all premolars and anterior teeth in quad and buccal gingiva (they are the last remaining teeth in the mouth as you get older)

46
Q

What is the depth of insertion with incisive NB?

A

approx 5mm

47
Q

What is the needle length of the incisive NB?

A

small

48
Q

What is the volume of anesthetic of the incisive NB?

A

2/3 carpule

49
Q

What are some additional notes on the incisive NB?

A

apply digital pressure for 1min
aspirate on 2 planes
rt and lft sit at 12 oclock

50
Q

What is the target of the PSA?

A

PSA foramina

be careful of the pterygoid plexus

51
Q

What is the insertion point of the PSA?

A

slight buccal to the height of the buccal vestibule; beside the second mx molar (7)

52
Q

What is the angle/landmarks of the PSA?

A
  • 45 degrees inward,
  • 45 degrees upward
  • 45 degrees backward
  • resting on retracting knuckle
53
Q

What is the tissue being anesthetized with the PSA?

A

mx molars and buccal gingiva in quad except MB root of 1st molar
(except in 28% of the population)

54
Q

What is the depth of the insertion with the PSA?

A

approx 2/3 of needle

55
Q

What is the length of needle with the PSA?

A

small (decreases risk of hematoma and is safer)

56
Q

What is the volume of anesthetic used in the PSA?

A

2/3 carpule

57
Q

What are any other notes to consider for the PSA?

A

get pt to partially close and relax jaw

  • aspirate in two planes 45 degree to the right
  • shift jaw toward the injection
  • lip will not be frozen
  • should you hit the pterygoid plexus - ice 24 hours, pressure followed by heat
58
Q

What is the target of the MSA?

A

periosteum 3mm superior to apices of mx premolars

59
Q

What is the insertion point of the MSA?

A

height of buccal vestibule between premolars

60
Q

What is the angle/landmarks of the MSA?

A

parallel to long axis of teeth

61
Q

What is the tissue anesthetized with the MSA?

A

premolars and buccal gingiva including MB root of 1st molar

62
Q

What is the depth of insertion with the MSA?

A

approx 5mm

63
Q

What is the needle length with the MSA?

A

small

64
Q

What is the amount of anesthetic needed with the MSA?

A

1/2 carpule

65
Q

What are any other additional notes to consider with the MSA?

A

as close as possible to the periosteum

66
Q

What is the target point of the ASA?

A

periosteum of the canine fossa (between lateral and canine)

67
Q

What is the insertion point of the ASA?

A

height of buccal vestibule between mx cuspid and lateral incisor (2&3)

68
Q

What is the tissue anesthetized of the ASA?

A

canine, lateral, and central incisors and assoc. buccal gingiva

69
Q

What is the angle/landmarks of the ASA?

A

parallel to long axis of teeth

70
Q

What is the depth of insertion with the ASA?

A

approx 5mm

71
Q

What is the length of needle in the ASA?

A

small

72
Q

What is the volume of anesthetic used in the ASA?

A

1/2 carpule

73
Q

What are any other notes to consider with the ASA?

A

as close as possible to the periosteum

74
Q

What is the target with the infraorbital?

A

infraorbital foramen

75
Q

What is the insertion point with the infraorbital?

A

height of the buccal vestibule adjacent to the 1st premolar (4s)

76
Q

What is the angle/landmark with the infraorbital?

A

parallel to long axis of the 1st premolar

*slightly more messiah than MSA

77
Q

What is the tissue anesthetized with the infraorbital?

A

all premolars and ant. teeth and assoc. buccal gingiva (also MB cusp of 1st premolar)
*same as ASA and MSA combined

78
Q

What is the depth of insertion with the infraorbital?

A

variable - depends on face height

79
Q

What is the length of needle used with the infraorbital?

A

long

80
Q

What is the volume of anesthetic used in the infraorbital?

A

1/2 carpule

81
Q

What are any additional notes to consider with the infraorbital?

A

target with finger/thumb on foramen; apply digital pressure for 1 min; rt side sit at 8oclock; open palm

82
Q

What is the target of the greater palatine?

A

greater palatine foramen

83
Q

What is the insertion point of the greater palatine?

A

half way between lingual margin of 2nd mx molar and midline raphe

84
Q

What is the angle/landmark of the greater palatine?

A

90 degrees to the palatal gingiva

85
Q

What is the tissue anesthetized with the greater palatine?

A

lingual gingiva of all mx. teeth in quad except incisors and cuspid

86
Q

What is the depth of insertion with the greater palatine?

A

until boney contact

87
Q

What is the length of needle with the greater palatine?

A

small

88
Q

What is the volume of anesthetic used in the greater palatine?

A

1/8 carpule or until tissue blanches

89
Q

What are some additional notes with the greater palatine?

A

do not insert in soft palate; brace with left hand

  • does not enesthetize any teeth
  • add pressure at site for Gate control