Module 13 Flashcards
what are the three branches of V3
- undivided nerve
- anterior division
- posterior division
what is involved in the undivided nerve of V3
- medial pterygoid branch
- dura mater branch
what is involved in the anterior division of V3
- lateral pterygoid branch
- masseter muscle branch
- temporal muscle branch
- LONG BUCCAL NERVE
what is involved in the posterior division of V3
- auriculotemporal branch
- LINGUAL NERVE
- mylohyoid nerve
- INFERIOR ALVEOLAR NERVE
- MENTAL NERVE
- incisive nerve (terminal branches)
what are the 4 MAJOR branches of V3
- inferior alveolar nerve
- lingual nerve
- long buccal nerve
- mental nerve
what are examples of mandibular injections
- conventional mandibular block
- Gow-Gates mandibular block
- Uni-linear mandibular block
- Vazirani-akinosi mandibular block
- mental nerve block
- mylohyoid nerve block
ALL mandibular nerve blocks use a full carpule EXCEPT __
mental & mylohyoid nerve blocks –> use 1.0 cc
what is the most challenging area of the orofacial complex to anesthetize
inferior alveolar nerve
why is the inferior alveolar nerve so difficult to anesthetize
- structural complexity of V3
- entire division is freely movable along with the mandibular structures which it innervates
- bone is more compact so local infiltration is NOT effective
what does the inferior alveolar nerve provide sensation to
- mandibular teeth
- body of the mandible, inferior portion of the ramus
- buccal mucoperiosteum, mucus membrane anterior to the mental foramen
the inferior alveolar nerve descends __ and __ across the pterygoid space
inferiorly & laterally
what are the 2 branches that the inferior alveolar nerve forms
anteriorly = lingual nerve
posteriorly = mylohyoid nerve
the inferior alveolar nerve enters the mandible through the ___ and transverse beneath the roots of the mandibular teeth to the ___
- mandibular foramen
- mental foramen
at the mental foramen the inferior alveolar nerve splits into two branches, what are these two branches?
- exiting the foramen = mental nerve
- remaining in the mandible = incisive nerve
the incisive nerve can cross the ___ to the opposite ___ and possibly the opposite ___
- midline
- incisors
- mandibular foramen
the lingual nerve descends ___ and ___ between the ramus and medial pterygoid muscle
inferiorly & medially
the lingual nerve runs anterior and slightly medial to the ___ & just distal and medial to the ___
- inferior alveolar nerve
- third molar
the lingual nerve extends inferiorly to the ___
tongue
what does the lingual nerve provide sensation to
- anterior 2/3 of tongue
- floor of mouth
- lingual gingiva
the long buccal nerve branches off of ___
anterior division of V3
the long buccal nerve descends parallel to the ___ and ___
- lingual nerve
- inferior alveolar nerve
at the ___ the long buccal nerve swings laterally and fans up and out over the area of the buccal mucosa
retromolar pad
what does the long buccal nerve provide sensory information to
- buccal gingiva of molar/premolar area
- skin of the cheek
NO innervation of the lip
in order to accomplish restorative and surgival procedures involving the tissues of the MANDIBULAR DIVISION –> the following nerves and their respective branches must be anesthetized USING ONE CARPULE
- inferior alveolar nerve
- lingual nerve
- long buccal nerve
which nerve provides pulpal innervation to the mandibular teeth?
a - long buccal nerve
b - inferior alveolar nerve
c - lingual nerve
d - nerve to mylohyoid
b - inferior alveolar nerve
T/F blocking the mandibular division nerve is subject to a high percentage of success
false - failure
due to dynamic nature of target zone and difficulty in visualization
what are the two target zones for the conventional mandibular block
- posterior zone
- anterior zone
what is included in the posterior zone of the conventional mandibular block
- inferior alveolar nerve
- lingual nerve
what is included in the anterior zone of the conventional mandibular block
- long buccal nerve
- targeted in separate injection
what is the posterior target area
retromolar triangle
what is the medial border of the retromolar triangle
pterygomandibular raphe
what is the lateral border of the retromolar triangle
anterior border of the ramus of the mandible
what is the superior border of the retromolar triangle
hamular notch
what is the posterior target area characterized by
a dimple / depression found roughly in the center of the triangle
what are the 3 parameters to consider with a conventional mandibular block
1 - height = 6 - 10 mm above occlusal plane
2 - 3/4 of A-P distance from the CORONOID NOTCH back to the deepest part of the PTERYGOMANDIBULAR RAPHE
3 - bone contact = 2/3 - 3/4 of needle length
what needle is used in the conventional mandibular block
25 long
how much of the needle is inserted in the conventional mandibular block
2/3 - 3/4 of needle length until BONE CONTACT