Mandibular Anaesthesia Flashcards
Give the lateral border of the pterygomandibular space
the ramus
Give the medial border of the pterygomandibular space
the medial pterygoid muscle
Give the superior border of the pterygomandibular space
the lateral pterygoid muscle
Give the anterior border of the pterygomandibular space
the buccinator muscle
Give the posterior border of the pterygomandibular space
the parotid gland
Name the branches of V3
Long Buccal Nerve Lingual Nerve Inferior Alveolar Nerve Incisive Nerve Mental Nerve
What does the long buccal nerve numb when anaesthetised?
Posterior buccal tissues
What does the lingual nerve numb when anaesthetised?
Lingual soft tissues
What does the inferior alveolar nerve numb when anaesthetised?
Mandibular teeth
What does the mental nerve numb when anaesthetised?
Labial soft tissues
What does the incisive nerve numb when anaesthetised?
Mandibular incisors
Name the 3 main techniques of local anaesthesia
Topical; infiltration; nerve block
Name the supplementary local anaesthesia techniques
Intraosseous; intrapapillary; intraligamentary; intra-pocket
What is the traditional IANB technique
Halsted technique
What is the aim of the Halsted technique?
To deposit local anaesthetic within 1mm of the inferior alveolar nerve before it enters the mandible at the mandibular foramen
What are the 2 main landmarks for IANB?
pterygomandibular raphe and coronoid notch
What type of needle is used for IANB?
35 mm (long), 27 gauge
What sort of anaesthetic solution is used for IANB?
2mm of 2% Lidocaine Hydrochloride with 1:80,000 adrenaline
Describe the Halsted technique for IANB
Mouth open wide Identify pterygomandibular raphe Place thumb in coronoid notch Identify injection point Insert needle until bone is touched Retract slightly and aspirate Inject slowly - 1ml per minute
What is the injection point for the Halsted technique?
Midpoint of thumb nail; midpoint of medial border of pterygomandibular raphe; barrel of needle over contralateral premolars; occlusal plane of molars.
What is the key sign for successful anaesthesia of IANB?
Numb lower lip
What type of needle is used for a lingual nerve block?
35mm (long), 27 gauge
What sort of anaesthetic solution is used for lingual nerve block?
2.2ml of 2% lidocaine hydrochloride with 1:80,000 adrenaline
What is the key sign for successful anaesthesia of lingual nerve block?
numb ipsilateral tongue
Why are blocks not reliable for the incisor teeth?
due to cross over of innervation from contralateral side
