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cranio exam 2 > Local Anesthetic Technique > Flashcards

Local Anesthetic Technique Flashcards

1
Q

MSA nerve in V2 is present —% of time

A

28%

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2
Q

ASA of V2 provides pulpal innervation to

A

central and lateral incisors
canine
PDL, buccal bone, mucous membrane of teeth

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3
Q

3 major types of local anesthesia

A
  1. local infiltration
  2. field block
  3. nerve block
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4
Q

where is the foramen rotundum?

A

pterygopalatine fossa

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5
Q

landmark for posterior superior alveolar nerve block

A
  • mucogingival sulcus
  • maxillary tuberosity
  • zygomatic process of maxilla

*insert needle at height of vestibule (16 mm depth)

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6
Q

PSA nerve block anesthetizes what?

A

maxillary molar tooth pulps
mesiobuccal root of 1st molar in 72%
buccal periodontium and bone

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7
Q

advantages of PSA nerve block

A
  • atraumatic
  • success rate >95%
  • minimal volume of anesthetic
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8
Q

PSA nerve block disadvantages

A
  • disfiguring hematoma risk
  • mesiobuccal root of 1st molar missed in 28%
  • aspiration rate about 3%
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9
Q

MSA anesthetizes what area

A

alveolar mucous membrane of premolars
mesiobuccal root of first molar 28% of time
buccal periodontium and bone

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10
Q

MSA nerve block landmark

A
  • depth of mucogingival sulcus above the maxillary second premolar
  • inject above premolar apices
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11
Q

anterior superior alveolar nerve areas anesthetized

A

through infraorbital nerve foramen

  • maxillary central through canine
  • premolars
  • mesiobuccal root of first molar in 28% of patients
  • buccal periodontium and bone
  • lower eyelid, side of nose, upper lip
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12
Q

indications of ASA nerve block

A
  • procedures on two or more teeth
  • inflammation or infection
  • dense cortical bone making supraperiosteal injections ineffective
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13
Q

maxillary labial bone is —

A

porous

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14
Q

supraperiosteal injection indications

A
  • procedures on one tooth

- soft tissue surgery in small area

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15
Q

advantages of local infiltration

A

simple

high success rate

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16
Q

disadvantages of local infiltration

A

not as useful in setting of abscess

slightly more volume needed to treat multiple teeth

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17
Q

in order to do a greater palatine nerve block, you have to —

A

contact bone

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18
Q

landmarks of greater palatine nerve block

A
  • greater palatine foramen

- junction of maxillary alveolar process and palatine bone adjacent to the maxillary first molar

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19
Q

areas anesthetized by greater palatine nerve block

A
  • posterior portion of hard palate
  • overlying soft tissues
  • no anesthesia of teeth
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20
Q

greater palatine nerve block indications

A
  • when palatal soft tissue anesthesia is needed –extractions, subgingival rest
  • putting on rubber dam for restoration
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21
Q

landmarks for nasopalatine nerve block

A
  • central incisors

- incisive papilla (lateral to papilla)

22
Q

areas anesthetized by nasopalatine nerve block

A
  • anterior portion of hard palate
  • both hard and soft tissues
  • no anesthesia of teeth
23
Q

indications of nasopalatine injection

A
  • when palatal soft tissue anesthesia is needed
  • pain control during periodontal or oral surgery
  • application of rubber dam
24
Q

buccal nerve is sensory to

A

molar buccal gingiva

25
Q

buccal nerve block landmarks

A
  • mandibular molars

- mandibular buccal vestibule/mucogingival sulcus

26
Q

tissues anesthetized by buccal nerve block

A
  • gingiva buccal to molars
  • retromolar pad mucosa
  • buccal mucosa in molar area
  • NO hard tissues anesthetized
27
Q

largest branch of posterior division of mandibular nerve

A

inferior alveolar nerve

28
Q

landmarks for inferior alveolar nerve block

A
  • coronoid notch
  • pterygomandibular raphe
  • occlusal plane of the mandibular posterior teeth
29
Q

for inferior alveolar nerve block, place the syringe at the level of?

A

coronoid notch across arch

30
Q

inferior alveolar nerve block—penetration lateral to –>

A

pterygomandibular raphe

31
Q

nerves anesthetized by inferior alveolar nerve block

A
  • inferior alveolar
  • incisive
  • mental
  • lingual
32
Q

disadvantages of inferior alveolar nerve block

A
  • wide area anesthetized
  • unsuccessful in 15-20% of pts
  • inconsistent oral landmarks
  • 10-15% positive aspiration
33
Q

alternatives to inferior alveolar nerve block

A
  • mental nerve block
  • incisive nerve block
  • gow-gates block
  • vazirani-akinosi block
  • intraosseous or intraseptal injection
34
Q

landmarks of mental nerve block

A
  • mandibular premolars

- mandibular vestibule

35
Q

areas anesthetized by mental nerve block

A
  • mucosa anterior to foramen
  • skin of lower lip
  • chin
  • anterior mandibular teeth (incisive branch of IAN)
36
Q

incisive nerve supplies–

A

incisors, canine, premolars

37
Q

incisive nerve block areas anesthetized

A
  • mucosa on buccal
  • lower lip
  • skin of chin
  • premolars, canines, incisors
38
Q

indications of incisive nerve block

A
  • procedures on anterior teeth
  • when inferior alveolar block is not indicated
  • to avoid bilateral mandibular blocks
39
Q

advantages of incisive nerve block

A
  • provides pulpal and hard tissue anesthesia without lingual anesthesia
  • high success rate
40
Q

disadvantages of incisive nerve block

A
  • no lingual anesthesia

- may be sensory overlap and midline (rare)

41
Q

lingual nerve innervates —

A

anterior 2/3 of tongue

42
Q

lingual nerve blocked with:

A
  • inferior alveolar nerve block (halstead)
  • gow-gates mandibular block
  • vazirani-akinosi block
  • infiltration in lingual sulcus
43
Q

gow gates nerve block

A

true mandibular nerve block

needle contacts neck of condyle

44
Q

landmarks for gow gates nerve block

A

-extraoral: lower border of tragus (intertragic notch)
corner of mouth
-intraoral: height of injection established by placement of needle tip just below the mesiopalatal cusp of maxillary second molar

45
Q

nerves anesthetized by gow gates nerve block

A

-inferior alevolar
-lingual
-mylohyoid
auriculotemporal
buccal

46
Q

disadvantages of gow gates nerve block

A
  • longer onset, >5 mins

- no intraoral landmarks

47
Q

vazirani-akinosi nerve block landmarks

A
  • mucogingival junction of maxillary third (or second) molar
  • maxillary tuberosity
  • coronoid notch on mandibular ramus
48
Q

height of vazirani-akinosi nerve block

A

in between gow gates and standard
at maxillary muco-gingival line
directly parallel to ramus

49
Q

depth of vazirani-akinosi nerve block

A

25 mm

50
Q

nerves anesthetized by vazirani-akinosi nerve block

A
  • inferior alveolar
  • lingual
  • mylohyoid
51
Q

advantages of vazirani-akinosi nerve block

A
  • atraumatic
  • no need to open mouth
  • aspiration rate < 10 %
52
Q

disadvantages of vazirani-akinosi nerve block

A
  • difficult visualization
  • no bony contact
  • arbitrary insertion depth

cranio exam 2 (11 decks)

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