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DENT 1520 > mini assessment 3 > Flashcards

mini assessment 3 Flashcards

1
Q

Patient Assesment

A
  • history
  • exam
  • rad
  • assesment
  • treatment plan
  • treatment
  • prescription
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2
Q

Vital Signs

A
  • measure most basic body functions
  • BP, pulse, temp, resp rate
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3
Q

measuring BP

A
  • force on artery walls
  • look for anything that can cause orthostatic hypotension
  • change chair position slowly so they can get equilibrium
  • no clutter w/ easy exit and entrance
  • systole= contraction
  • diastole= dilation
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4
Q

BP devices
1-auscultatory
2-oscillometric
3-measuring BP

A

1-measures sounds—korotkoffs sounds (stethoscope and cuff)

2-measurement of vibrations—automatic inflation

3-cuff/stethoscope, finger measurement, wrist measurement

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5
Q

Seating Patient for BP

A
  • upright
  • go to bathroom before
  • factor in nervousness
  • feet on floor
  • arm at heart level—relaxed/supported
  • place cuff in front of elbow (antecubital)
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6
Q

BP errors
1-too narrow/short
2-too loose
3-patient raises arm
4-arm too low
5-arm too high
6-rapid deflation
7-congestion of arm

A

1-false high
2-false high
3-false high diastolic
4-false high
5-flase low
6-low SP/ high DP
7-low SP/ high DP

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7
Q

Contraindications of BP

A
  • lymphadema?—dont take BP on arm take on other arm
  • ask to see if had surgery that infects lymph flow

-no upper limits for BP

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8
Q

Normal BP vs others

A
  • normal bp= 120/80
  • high bp= 120-139/80-89 (prehyp)
  • mild bp= 140-159/90-99 (stage 1)
  • severe bp= 160/greater than 100 (stage 2)

symptoms= headache, dizziness, blurred vision, nausea, chest pain

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9
Q

Control BP

A
  • smoking cessation
  • lose weight
  • relax
  • decrease caffeine
  • exercise
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10
Q

oral side effect of antihypertensive drugs

A
  • dry mouth
  • mouth ulcers
  • enlarged gums bc of Ca channel blockers
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11
Q

Pulse—heart rate

A
  • radial artery (near wrist), carotid artery, or brachial artery
  • dont use thumb

newborns= 70-190
infants= 80-120
children= 70-130
10 and over= 60-100
athletles= 40-60

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12
Q

Respirations
1-newborns
2-less than 1
3-toddlers
4-3-6
5- 6-12
6- 12-17
7-adults

A

1-30- 40 bpm
2-30-40 bpm
3-23-35 bpm
4-20-30 bpm
5-18-26 bpm
6-12-20 bpm
7-12-20 bpm

-done surreptitiously

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13
Q

BG

A
  • inc pee
  • inc thirst
  • weight loss
  • blurred vision
  • older
  • fat
  • high BP
  • inc cholesterol

normal= less than 110: 65-104

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14
Q

Testing BG

A
  • glucometer
  • test strip—look at control #
  • retractable lancet
  • alc wipe
  • bandaid
  • insert test strip into glucometer w/ electrode up
  • make sure it shows control #
  • use finger not normally used
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15
Q

Recording in axium

A

-vitals—FORMS —> medical history

  • not intuitive
  • nothings erased
  • collected and analyzed
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16
Q

Slidematic Facebow

A
  • bitefork
  • reference point locator/pen
  • articulator index table
  • facebow
  • transfer jig assembly
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17
Q

Essential Features of Epidemiology

A
  • groups are the focus of the study
  • study people w/ and w/o disease
  • study of groups allow for valid estimates when looking for variation
18
Q

Uses of Epidemiology

A
  • see extent of disease in a community
  • find associations relating to a disease (risk factors)
  • test new preventative and therapeutic measures
19
Q

Periodontal Conditions that are Typically measured

A
  • amt of debris (plaque, calculus)
  • color + form of gingival tissue
  • bleeding on probing
  • clinical probing depth, gingival recession, mobility of teeth, furcation
  • radiograph marg. bone levels
20
Q

1-prevalence
2-extent
3-severity

A

1-proportion of diseased individuals

2-number of proportion of affected subunits (teeth, surfaces)

3-amt of attachment loss, depth of perio pockets

21
Q

Oral Hygiene Index —Greene/Vermillion

A

-Debris Index—DI: coronal extension of plaque score

  • 0= no debris/stain
  • 1=debris <1/3rd tooth surface
  • 2= between 1/3 and 2/3
  • 3= debris >2/3

-Calculus Index—CI: coronal extension of supragingival +/- extension of subgingival calc score

  • 0= no calculus
  • 1= supraign calc <1/3
  • 2=between 1/3= 2/3 and subgin calc
  • 3=supraign > 2/3 surface and band of subgin calc
22
Q

Oleary

A

Plaque Control Index—

PI= (# of sites w/ plaque/ # of sites evaluated) x 100

whole mouth view

23
Q

CDMI Plaque Control Index

A

-calculated as number of surfaces w/ plaque on 6 teeth divided by total number of tested surfaces (24)

24
Q

Loe & Silness

A

Gingival Index
0= normal gingiva
1= mild inflammation—slight color change, slight edema, no bleeding
2= moderate inflam—redness, edema, glazing, bleeding
3= severe inflamm—redness, edema, ulcerations, spont bleeding

25
Ainamo & Bay
Gingival Bleeding Index =(# of bleeding sites/#of sites evaluated) \* 100
26
Combined Indices
-systems combining assessment gingivits, periodontitis, plaque, calculus, and overhang restorations
27
Russell
Periodontal Index 0= normal gingiva= no inflamm nor loss of function bc of destruction 1= mild gingivitis= area of inflamm in free gingiva 2= gingivitis=inflam around whole tooth but no break in attachment 6= gingivitis w/ pocket formation---epithelial attachment broken but has pocket...mastication is normal 8= advanced destruction w/ masticatory loss---tooth is loose and drifted, depressible in socket
28
1-Combined: Russell 2-Combined Ramfjord
1- 1/2= localized circumf gingivitis, 6= periodontitis w/o impairment, 8= advanced periodontitis w/ impairment 2- 1/3= severity of gingivitis, 4/6= attachment loss uup to 3-7 mm
29
Community Periodontal Index of Treatment Needs
- divided into sextants - ainamo 0= health 1= BoP w/o pockets or calculus, overhangs 2=PD \< 3mm, plaque retentive factors= calculus 3= Pd 4-5 mm 4= Pd\> 6 mm
30
Prevalence of Gingivitis
- 40-60% of kids - 82% of adolescents and 50% of adults - peaks after puberty (bc of hormonal sometimes systemic) - more boys than girls
31
NHANES
- National Health and Nutrition Examination Survey - 1988–1994, a little over 1 in 5 Americans had such a condition, whereas in 1999–2004, only 1 in 10 fell in this category then goes back up **-partial mouth examinations significantly underestimated prevalence values**
32
NHANES 2009-2010
- half of american adults suffer from gum disease - 47% have periodontitis---mostly moderate. mild and severe= equal - high prevalence in low socioeconomic - high in mexican americans
33
Page & Schroeder Perio Paper
Initial Lesion- 2-4 days Early Lesion- 4-10 days has lymphochytes Established lesion- 2-3 weeks= inc plasma cells Advanced Lesion- bone loss and etc
34
molar not brushed for 24 hrs
-bacteria grow= immediate subclinical inflam response---cant be seen clincially
35
Stage 1- Initial Stage-Gingivitis
-Dilation of capillaries and inc in blood flow -inc gingival fluid flow, PMNs together w/ epithelial lining are first defense to protect host - collagen loss - 2-4 days - subclinical changes
36
Stage 2- Early Lesion
- prolif of capillaries - inc capillary loops between rete pegs - lymph (t-cell) predom - inc collagen loss - 4-7 days - erythema, edema, bleeding on probing - bacteria & virulence factors penetrate lining and enter CT---pro inflam cytokines are produced - in CT, interacting w/ host cells leads to release of pro inflamm mediators like TNFa, IL1, IL8, LRB4 and histamine
37
Stage 3- Established Gingivitis
- subging plaque extends and disrupts coronal junctional - PMNs fight - lymoho produce Ab - Immune sends more cytokines, PGE2, MMPS - destroy health CT
38
Stage 3 Established Lesion
- blood stasis---BV engorged & congested= blueish hue on red gingiva - inc rete pegs and atrophic areas - plasma cells predom - significant collagen loss by collagenase by PMNs - 14-21 days - visible redness, edema, & texture change - no attachment loss, no bone loss so is reversible affects all ages
39
1- Proinflammatory 2- Proresolution
1- Arachidonic Acid---Prostaglandin & Leukotriene & Arach to Lipoxin which is pro resolution 2-Eicosapentaenoic Acid---resolvin & protectin
40
Stage 4- Advanced Lesion
- plaque biofilm mature= inc gram neg, anaerobic, motile, late colonizers - overwhelmed via pathogens & collateral damage - dense inflamm cell infiltrate (plasma cells) - predom of PMN in pocket - bleeding w/ probing - collagen breakdown & destruction of PDL - presence and stimulation of osteoclasts= resorption of alveolar bone/bone loss (lesion no longer limited) - apical migration of epithelial attachment - inc clinical probing depths & attachment levels
41
Periodontitis---Advanced Lesion
-gingivitis before periodontitis but not always - lots of local factors - gingival inflammation - bleeding on probing (BOP) - perio pocketing - CAL - bone loss - mobility & furcation - tooth loss
42
Pseudopocket
- no clinical attachment loss but has a pocket because it is diseased - ex=edema in tissues and then expansion in tissue= gum space gets deeper - develops via apical migration of epithelial and then edema formation - gingival sulcus= healthy - gingival pocket= diseased

DENT 1520 (8 decks)

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