Mandibular Anaesthesia

Question 1

Give the lateral border of the pterygomandibular space

Answer 1

the ramus

Question 2

Give the medial border of the pterygomandibular space

Answer 2

the medial pterygoid muscle

Question 3

Give the superior border of the pterygomandibular space

Answer 3

the lateral pterygoid muscle

Question 4

Give the anterior border of the pterygomandibular space

Answer 4

the buccinator muscle

Question 5

Give the posterior border of the pterygomandibular space

Answer 5

the parotid gland

Question 6

Name the branches of V3

Answer 6

Long Buccal Nerve
Lingual Nerve
Inferior Alveolar Nerve
Incisive Nerve
Mental Nerve

Question 7

What does the long buccal nerve numb when anaesthetised?

Answer 7

Posterior buccal tissues

Question 8

What does the lingual nerve numb when anaesthetised?

Answer 8

Lingual soft tissues

Question 9

What does the inferior alveolar nerve numb when anaesthetised?

Answer 9

Mandibular teeth

Question 10

What does the mental nerve numb when anaesthetised?

Answer 10

Labial soft tissues

Question 11

What does the incisive nerve numb when anaesthetised?

Answer 11

Mandibular incisors

Question 12

Name the 3 main techniques of local anaesthesia

Answer 12

Topical; infiltration; nerve block

Question 13

Name the supplementary local anaesthesia techniques

Answer 13

Intraosseous; intrapapillary; intraligamentary; intra-pocket

Question 14

What is the traditional IANB technique

Answer 14

Halsted technique

Question 15

What is the aim of the Halsted technique?

Answer 15

To deposit local anaesthetic within 1mm of the inferior alveolar nerve before it enters the mandible at the mandibular foramen

Question 16

What are the 2 main landmarks for IANB?

Answer 16

pterygomandibular raphe and coronoid notch

Question 17

What type of needle is used for IANB?

Answer 17

35 mm (long), 27 gauge

Question 18

What sort of anaesthetic solution is used for IANB?

Answer 18

2mm of 2% Lidocaine Hydrochloride with 1:80,000 adrenaline

Question 19

Describe the Halsted technique for IANB

Answer 19

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

Question 20

What is the injection point for the Halsted technique?

Answer 20

Midpoint of thumb nail; midpoint of medial border of pterygomandibular raphe; barrel of needle over contralateral premolars; occlusal plane of molars.

Question 21

What is the key sign for successful anaesthesia of IANB?

Answer 21

Numb lower lip

Question 22

What type of needle is used for a lingual nerve block?

Answer 22

35mm (long), 27 gauge

Question 23

What sort of anaesthetic solution is used for lingual nerve block?

Answer 23

2.2ml of 2% lidocaine hydrochloride with 1:80,000 adrenaline

Question 24

What is the key sign for successful anaesthesia of lingual nerve block?

Answer 24

numb ipsilateral tongue

Question 25

Why are blocks not reliable for the incisor teeth?

Answer 25

due to cross over of innervation from contralateral side