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Regional Anesthesiology > Midterm > Flashcards

Midterm Flashcards

1
Q

CNV originates from these 3 sensory nuclei in the midbrain:

A

mesencephalic, principle sensory, and spinal nuclei

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2
Q

Where do the sensory nuclei merge to form a sensory root?

A

pons

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3
Q

Where does the sensory root forms the trigeminal or Gasserian ganglion ?

A

middle cranial fossa, adjacent to the cavernous sinus

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4
Q

Mesencephalic nucleus is in this part of the brainstem:

A

midbrain

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5
Q

Trigeminal ganglion is in this part of the brainstem:

A

pons

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6
Q

spinal nucleus is in this part of the brainstem:

A

medulla

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7
Q

The ophthalmic division exits via:

A

superior orbital fissure

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8
Q

3 terminal branches of ophthalmic division:

A

Frontal, Lacrimal, and Nasociliary nerves

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9
Q

What carries postganglionic parasympathetic fibers does CN V carry?

A

fibers from the pterygopalatine ganglion (via facial nerve) which initially travel with the zygomatic branch of the maxillary division then join the lacrimal branch of the ophthalmic division

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10
Q

CN V innervates:

A

skin and mucous membrane derivatives of the frontonasal process: Forehead and scalp, Frontal and ethmoid sinuses, Upper eyelid and conjunctiva, Cornea, Dorsum of nose

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11
Q

These nn. supply the back of the head:

A

cervical

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12
Q

Nerves that supply the ear and neck under mandible:

A

superficial cervical plexus:

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13
Q

The maxillary division of the trigeminal nerve exits the skull via:

A

foramen rotundum

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14
Q

The maxillary division gives rise to 14 branches which innervate:

A

the skin, mucous membranes and sinuses that are derived from the maxillary prominence of the first pharyngeal arch

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15
Q

Does the maxillary division carry para?

A

Yes, to the lacrimal gland and the nasal glands

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16
Q

7 branches of maxillary division we need to be aware of:

A

Anterior, Middle and Posterior superior alveolar nerve, Infraorbital nerve, Nasopalatine nerve, Greater and lesser palatine nerves

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17
Q

Mandibular division, sensory or motor?

A

both

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18
Q

Sensory branches of CNV innervate:

A

the skin, mucous membranes and striated muscle derivatives of the mandibular prominence of the first pharyngeal arch

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19
Q

4 terminal branches of mandibular division:

A

Buccal, inf alv (mental nerve/ incisive nerve extension), auriculotemporal, lingual

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20
Q

mandibular division supplies sensory to:

A

Mucous membranes and floor of the oral cavity, External ear, Lower lip, Chin, Anterior 2/3 of the tongue with special taste sensation from the chorda tympani branch from the facial nerve, All lower teeth, gingiva and bone

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21
Q

Muscles of mastication:

A

Masseter, Temporalis, Internal/medial pterygoid, External/lateral pterygoid

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22
Q

8 m. pairs innervated by man branch:

A

mm. of mastication, ant belly of digastric, mylohyoid, tensor veli palatini, tensor tympani

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23
Q

This muscle often caries accessory sensory innervation to mandible:

A

mylohyoid

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24
Q

Infraorbital block:

A

Midline thru M2PM including the MB cusp of the Max1M and lip, etc.

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25
Q

Anterior superior alveolar block:

A

Midline thru canine and lip, etc.

26
Q

Middle sup alv block:

A

premolars, MB of 1st molar and later

27
Q

Pos sup alv block

A

molars except for the mb root of 1st molar and a little of the buccal gingiva

28
Q

Nasopalatine block:

A

only hard palate, triangle that includes canines

29
Q

Greater palatine block:

A

one side of hard palate only from the 1st premolar back

30
Q

Buccal block:

A

lateral to the molars, no teeth

31
Q

inf alv block:

A

entire quadrant except for the mucosa a lip surrounding the molars

32
Q

incisive block:

A

midline through premolars and lateral

33
Q

Nerve supply of ant sup alveolar nerve:

A

the pulp, investing structures and labial mucoperiosteum of anterior teeth

34
Q

Middle superior anterior alveolar nerve:

A

the pulp, investing structures and buccal mucoperiosteum of premolars and MB root of 1st molar

35
Q

Posterior superior alveolar nerve:

A

the pulp, investing structures and buccal mucoperiosteum of upper molars except MB root of 1st molar

36
Q

Greater (anterior) palatine nerve;

A

palatal mucoperiosteum of maxillary anterior teeth

37
Q

Closest surrounding structures to where man block is given:

A

medial pterygoid m., sphenomandibular ligament, medial surface of ramus, lingua nerve

38
Q

4 ways LA can interfere w excitation:

A

Alter the resting membrane potential, alter the threshold potential, decrease the rate of depolarization, prolong the rate of repolarization

39
Q

Action potential generation depends on these ions:

A

Na, K, Cl, Ca

40
Q

Primary moa of LA’s:

A

via specific receptor binding, and inactivation of, the Na channel, sites w/in or around the sodium channel

41
Q

2 theories as the moa of LA:

A

membrane swelling and channel blockade theories

42
Q

In which state do LA’s bind the Na channels?

A

resting, open, or inactivated

43
Q

Where does LA act?

A

w/in the channel itself

44
Q

snake venom acts here;

A

outer surface of channel

45
Q

scorpion venom acts here;

A

at the fast or slow sodium gates

46
Q

LA’s are classified by:

A

site of action

47
Q

Class A La:

A

receptor of external surface of membrane

48
Q

Class B La:

A

receptor on internal surface of membrane (venoms, not clinically usable)

49
Q

Class C La:

A

receptor independent

50
Q

class D:

A

combination of receptor dependent and independent mechanisms

51
Q

Class C La’s exist in this/these form(s)

A

only uncharged dissociated form

52
Q

Ex of Class C LA:

A

benzocaine

53
Q

Class D La’s exist in this/these form(s):

A

both the charged, undissociated and the uncharged dissociated forms

54
Q

Which form is responsible for most activity of the LA?

A

uncharged: 90%, charged: 10%, RNH+ vs. RN

55
Q

On what nerve channels can LA act?

A

only with sodium channels that are not insulated by myelin, only found in abundance at nodes of Ranvier

56
Q

Nerve channels per square micrometer of small, unmyelinated nerves:

A

35

57
Q

Sodium channels per square micromter at nodes of Ranvier:

A

20,000

58
Q

of adjacent nodes LA must block in order to work:

A

at least 3, up to 8-10mm

59
Q

Primary action of LA in terms of ion control

A

decrease permeability of sodium channel, slight decrease in K conductance (insignifiicant)

60
Q

Role of Ca in AP production:

A

Ca bound in the membrane is thought to have regularoty effect on the movement of Na ions across membrane

61
Q

Stopped at SLIDE 14 of 34

A

MOA

Regional Anesthesiology (3 decks)

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