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OSCE > oral surgery > Flashcards

oral surgery Flashcards

1
Q

what vasoconstrictors can be used in LA?

A
  • adrenaline
    -felypressin
    -none
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2
Q

what is the purpose of vasconstrictors in LA?

A

to increase the amount of time absorption occurs in the bloodstream

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3
Q

what vasconstrictor would you not give to a pregnant woman and why?

A

felypressin- induces labour

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4
Q

give two factors which affect which LA technique you would use

A
  • the nerve you are anaesthetising
  • the bone density
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5
Q

what is the difference between an infiltration and a block?

A

infiltration- LA deposited around terminal branches of the nerve
block- deposited beside nerve trunk

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6
Q

what is the bevel of the needle?

A

the point/tip of the needle

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7
Q

what is the gauge of the needle?

A

the diameter of the lumen
30-gauge has a smaller internal diameter than a 25-gauge needle

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8
Q

what is the length of a short needle?

A

25mm

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9
Q

what is the length of a long needle?

A

35mm

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10
Q

how much solution in a a typical LA cartridge?

A

2.2ml

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11
Q

describe lidocaine

A

HCl 2%
1:80,000 adrenaline
metabolised in liver and excreted in the kidney
rapid onset: 2-3 mins

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12
Q

describe Prilocaine

A

HCl 3%
contains felypressin

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13
Q

describe articaine

A

metabolised in liver and excreted in kidney
1:200,000 adrenaline

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14
Q

how long will anaesthesia last after a block with lidocaine HCl 2%?

A

pulp- 90 minutes
soft tissue- 3-5 hours

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15
Q

what is the max dose (mg/kg) of lidocaine?

A

5mg/kg

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16
Q

how many mg are in one cartridge of lidocaine?

A

44

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17
Q

what is the max dose (mg/kg) of articane?

A

7mg/kg

18
Q

how many mg are in one cartridge of articane?

A

88

19
Q

what is the max dose (mg/kg) of prilocaine?

A

8mg/kg

20
Q

how many mg are in one cartridge of prilocaine?

A

66

21
Q

what patients would u limit the use of adrenaline in?

A
  • cardiovascular disease
  • hyperthyroidism
  • hypertension
  • B-blockers
  • Tricyclic antidepressants
22
Q

what tissues does a lingual nerve block anaesthetise?

A
  • lingual gingiva
  • mucosa of anterior 2/3rds of the tongue
  • floor of the mouth
23
Q

what tissues does an inferior alveolar nerve block anaesthetise?

A

the mandibular teeth

24
Q

what post operative instructions would you give to a patient after an extraction? (in depth)

A
  • pain is normal; try and start analgesics before LA wears off
  • take pain killers you would normally use for headache
  • use regular analgesia for 1-3 days then as required
  • warn not to go over dose on packet
  • bleeding unlikely but is a possibility
  • don’t touch the socket with finger/toothbrush/tongue as it can disturb the clot
  • no exercise/ anything that will increase blood pressure rest of the day
  • avoid hot food/drinks until LA completely worn off
  • no hard food- can traumatise the socket
  • eat on opposite side of the mouth for a few days
    -no alcohol for 24 hours and no smoking for as long as possible
  • don’t rinse until the next day
  • start rinsing with warm salty water 4x daily
  • advise on bleeding
  • adjacent teeth may be sensitive
  • jaw might be sore for a few days- if it prevents eating call back
  • may be some facial swelling- if concerned, call back
  • can bruise
25
Q

what advice would you give a patient to prepare them for bleeding at home?

A
  • bite down on damp gauze for 20-30 mins
  • ensure it is damp but not soaking to stop it sticking
  • if not stopped, repeat for up to an hour
  • contact dentist/ out of hours if still not stopped
  • make sure you give a contact number
  • if cannot get to any dentist, go to A&E
26
Q

what advice would you give to a patient after an extraction? (basic)

A
  • painkillers
  • bleeding
    -no exercise, hot/hard food, alcohol, smoking
  • eat on opposite side of the mouth
  • rinsing instructions
  • sensitivity, bruising, swelling, jaw stiffness
27
Q

what advice would you give to a patient after a surgical extraction?

A
  • same as simple extraction but with additional info.
  • don’t touch sutures
  • if sutures fall out with no pain/bleeding, just leave them
  • if sutures become uncomfortable, come back to have them removed
  • tell patient if sutures are resorbable or not
  • advice on chlorhexidine- capful 2/3x daily
  • dilute with water if it causes discomfort
  • do not use just before/after eating or just after brushing
  • bruising and swelling common
  • use ice pack for swelling
28
Q

what is a periotome used for?

A

to remove a tooth or retained roots without damaging the alveolar plates or traumatising the soft tissue

29
Q

what is the difference between elevators and luxators?

A

elevators- less sharp, more curved blades that fit the shape of the tooth
luxators- sharp, flat-tipped blades that can penetrate into periodontal space

30
Q

name 3 types of elevator

A
  • couplands
  • cryer’s
  • warwick james
31
Q

name uses of elevators

A
  • to provide a point of application for forceps
  • to loosen teeth prior to using forceps
  • removal of retained roots
32
Q

what are the 3 basic actions of elevators?

A

wheel and axle
wedge
lever

33
Q

what are couplands elevators used for

A

Extracting retained roots

34
Q

what are cryer elevators used for

A

used in furcation area of molar teeth

35
Q

What are the Warwick James elevators used for

A

good to use for extracting wisdom teeth

36
Q

where would you stand to extract the lower right molar teeth

A

Behind the patient

37
Q

where would you stand to extract upper teeth

A

Infront of the patient

38
Q

Where would you stand to extract the lower left molar teeth

A

Infront of the patient

39
Q

what teeth would you extract using cowhorn forceps?

A

lower molars, especially broken down ones

40
Q

what teeth would you extract using bayonet forceps?

A

upper wisdom teeth

OSCE (11 decks)

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