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Pain & Anxiety Control > Module 12 > Flashcards

Module 12 Flashcards

1
Q

what is the principal sensory nerve to the orofacial complex

A

trigeminal

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2
Q

what are the 3 divisions that trigeminal nerve is composed of

A
  • ophthalmic
  • maxillary
  • mandibular
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3
Q

what are the major branches of V2 (maxillary)

A
  • Posterior Superior Alveolar (PSA)
  • Middle Superior Alveolar (MSA)
  • Anterior Superior Alveolar (ASA)
  • Greater Palatine (GP)
  • Nasopalatine (NP)
  • Infraorbital (IO)
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4
Q

what is the quantity of local anesthetic used for a PSA nerve block

A

0.9 - 1.8 cc

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5
Q

what is the quantity of local anesthetic used for a MSA nerve block

A

0.9 - 1.2 cc

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6
Q

what is the quantity of local anesthetic used for a ASA nerve block

A

0.9 - 1.2 cc

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7
Q

what is the quantity of local anesthetic used for a GP nerve block

A

0.25 cc

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8
Q

what is the quantity of local anesthetic used for a NP nerve block

A

0.25 cc

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9
Q

what is the quantity of local anesthetic used for a IO nerve block

A

1.2 cc

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10
Q

what is the quantity of local anesthetic used for a supraperiosteal infiltration

A

0.9 - 1.0 cc

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11
Q

what teeth does the MSA nerve innervate

A
  • 1st premolar
  • 2nd premolar
  • mesial of 1st molar
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12
Q

what tissues does the MSA nerve innervate

A

buccal gingiva in premolars / 1st molar region

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13
Q

when doing a MSA block what is the target area

A

slightly apical to the premolars either 1st or 2nd

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14
Q

where is penetration of the mucosa made in a MSA block

A

along the long axis at the apex of the premolar

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15
Q

what needle is used for a MSA nerve block injection

A

27 short

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16
Q

how much of the needle length is inserted into the mucosa

A

1/3 to half

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17
Q

does it matter which way the bevel is pointed?

A

YES - towards the bone!

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18
Q

how much the carpule do you use for a MSA block

A

about 1/2 carpule (0.9 - 1.0 cc)

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19
Q

why does it matter which direction the bevel is directed

A

if it is not directed towards the bone it can inflict pain on the patient

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20
Q

what teeth does the PSA nerve innervate

A
  • 3rd molar
  • 2nd molar
  • distal 1st molar
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21
Q

what tissue does the PSA nerve innervate

A

buccal gingiva in the molar region

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22
Q

what is the target area of a PSA injection

A

apical to the root of the 3rd molar

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23
Q

where is penetration of the mucosa made in a PSA nerve block

A

just lateral to the 2nd molar at a 45 degree angle to the long axis of the tooth and at a 45 degree angle approaching medially

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24
Q

what do you want to avoid in a PSA nerve block

A

Pterygoid Plexus

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25
Q

what needle is used for a PSA nerve block

A

27 short

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26
Q

how much of the needle is inserted into the mucosa in a PSA nerve block

A

half the needle length

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27
Q

how many carpules are used for this block

A

1/2 carpule (0.9 - 1.0 cc)

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28
Q

what teeth does the ASA nerve innervate

A
  • canines
  • lateral incisors
  • central incisors
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29
Q

what tissue does the ASA nerve innervate

A

labial mucosa & inner aspect of the lip to the midline

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30
Q

what is the target area of an ASA nerve block

A

apical and slightly distal to the canine

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31
Q

where is penetration of the mucosa made in a ASA nerve block

A

along the long axis of the canine to the target zone

32
Q

what needles is used for an ASA nerve block

A

27 short

33
Q

how much of the needle is inserted in an ASA nerve block

A

1/3 to half the needle length

34
Q

what is a specific instruction for giving an ASA nerve block

A

pull the lip tight

35
Q

how many carpules are used for an ASA injection

A

1/2 carpule (0.9 - 1.0 cc)

36
Q

which of the following provides pulpal innervation to the maxillary molars?

a - ASA
b - MSA
c - PSA
d - Inferior Alveolar Nerve

A

c - PSA

37
Q

what teeth does the GP innervate

A

NONE

38
Q

what tissues does the GP innervate

A

palatal soft tissue and bone from the distal of the canine to the junction of the hard and soft palate and medial towards the midline

39
Q

what is the target area for a GP nerve block

A

greater palatine foramine

40
Q

where is penetration of the mucosa made in a GP nerve block

A
  • just anterior to the greater palatine foramen
  • 1/2” medial to the disto-palatal cusp of the 2nd molar
41
Q

how is the needle positioned in a GP nerve block

A

nearly perpendicular to the mucosa

42
Q

what is a cotton tip applicator used for in a GP nerve block

A

to locate GP foramen since tissue is thicker there & to eliminate patient discomfort

43
Q

what is a specific technique for administering the GP nerve block

A
  • apply pressure to the cotton tip perpendicular to the bone until tissue blanches
  • keep pressure on the applicator during penetration and first couple of drops
  • ease pressure as anesthetic is delivered
44
Q

what needles is used for the GP nerve block

A

27 short

45
Q

how much of the needle is inserted in a GP nerve block

A

needle is inserted until BEVEL IS BURIED

46
Q

how is the bevel positioned in a GP nerve block

A

laterally towards the soft tissue

47
Q

how much of the carpule is administered in a GP nerve block

A

1/4 carpule (0.25 cc) or until the tissue blanches

48
Q

what teeth are innervated by the NP nerve

A

NONE

49
Q

what tissues are innervated by the NP nerve

A
  • palatal soft tissue and bone anterior to the portion of the hard palate from distal of one canine to the distal of the other canine
50
Q

what is the nasopalatine nerve block also called

A

incisive nerve block

51
Q

what is the target area of the NP nerve block

A

incisive foramen

51
Q

where is penetration of the mucosa in NP nerve block

A
  • just lateral to the incisive papilla toward the posterior portion of the papilla
  • at a 45 degree angle to the palatal bone
51
Q

what is the specific technique for NP nerve blocks

A
  • apply pressure to cotton tip on incisive papilla until tissue blanches
  • keep pressure on applicator during penetration and first couple of drops
  • ease pressure as anesthetic is delivered
52
Q

what needle is used for a NP nerve block

A

27 short

53
Q

how much of the needle is inserted in a NP nerve block

A

until bevel is buried

54
Q

how much of a carpule is used in a NP nerve block

A

1/4 carpule (0.25 cc) or until tissue blanches

55
Q

the greater palatine nerve innervates the following teeth:

a - 1-3
b - 4-5
c - 6-8
d - the greater palatine nerve provides no pulpal innervation

A

d - the greater palatine nerve provides no pulpal innervation

56
Q

what teeth does the IO nerve innervate

A
  • canine
  • incisors to midline
  • 75% premolars + part of 1st molar
57
Q

what tissue does the IO nerve innervate

A

buccal gingiva associated with teeth affected

58
Q

what does the IO nerve innervate in addition to the teeth and tissue

A

the skin of the lower eyelid, upper lip, and lateral aspect of the nose

59
Q

what is the target area of the IO nerve block

A
  • near infraorbital foramen
  • inferior to the orbital rim
60
Q

where does penetration of the mucosa occur in IO nerve block

A
  • parallel to the 1st premolar
  • angled toward the infraorbital foramen
61
Q

what needle is used for an IO nerve block

A

25 long or 27 short

62
Q

in an IO nerve blcok insertion is made until ___

A

bone is contacted (about half the needle length)

63
Q

how much of a carpule is used in an IO nerve block

A

3/4 carpule (0.9 -1.2 cc)

64
Q

what is the superperiosteal injection used for

A
  • pulpal anesthesia of 1-2 teeth
  • soft tissue anesthesia of limited area
65
Q

what is the target area of a supraperiosteal injection

A

apical region of the tooth to be anesthetized

66
Q

where is penetration of the mucosa in a supraperiosteal injection made

A

along the long axis of the maxillary tooth to the target zone

67
Q

what needle is used for a supraeriosteal injection

A

27 short

68
Q

where is the supraperiosteal injection insertion made

A

at the height of the mucogingival fold with the needle advancing to the apical region of the tooth

69
Q

how much of a carpule is used for a supraperiosteal injection

A

1/3 carpule (0.6 cc)

70
Q

when giving a PSA block you should use a 25 gauge long needle

a - true
b - false

A

b - false

27 short, a long needle is too long and is more likely to encounter the pterygoid plexus and increase the risk of hematome

71
Q

needle re-capping has to be done with __

A

one hand

72
Q

how do you prepare a syrnige

A

engage the harpoon into the stopper with gentle but firm pressure on the thumb ring until the harpoon is FLUSH with the rubber

73
Q

how do you unload a syringe

A
  • take re-capped syringe to sharps container
  • unscrew needle to remove while holding the cardboard
  • discard needle ONLY in sharps container by pushing capped end through cardboard
  • retract piston by pulling back on the thumb ring
  • remove carpule & dispose in sharp container
74
Q

what do you do if the syringe needle adaptor remains on the hub

A

remove it with cotton pliers, do NOT use your fingers

75
Q

what do you do if the rubber stopper remains on the harpoon

A

remove it with cotton pliers, do NOT use your fingers

Pain & Anxiety Control (12 decks)

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