Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MicroBac > Oral Surgery Test Review > Flashcards

Oral Surgery Test Review Flashcards

1
Q

The following are associated with the extracellular space:

  • Na+
  • K+
  • Cl-
A

Na+

Is there more?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The following are associated with the Intracellular space:

  • Na+
  • Cl-
  • K+
A

Cl-

and

K+

??????

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

_______ _______ is where local anesthesia exert their pharmacological actions

A

Nerve membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

______ ______ ______: Local anesthesia bind to specific receptor on the
Na channel

A

SPECIFIC RECEPTOR theory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Nodes of Ranvier: Sodium channel is_______.

A

abundant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How Local Anesthesia Work?

A

• Decrease permeability of ion channels to Na

• Nerve block by local anesthesia is a
Non-depolarizing block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T/F: nerves have a quicker conduction than un-myelinated. AND….
Adelta and A Alpha (about 120 m/sec) are faster than C fibers (1.2 m/sec) .

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where does local anesthesia work at myelinated nerve?

A

the nodes of ranvier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Is local anesthesia hydrophilic or they like oily stuff?

A

Hydrophillic (injectable)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

t/f: only the free base form of LA can diffuse through the wall of the nerve.

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

t/f:

↑ pKa translate to slow onset

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

t/f:

↓ pKa will have faster onset

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

t/f: Extracellular pH determines the ease for nerve blockade

A

true:

So, since: RNH = RN+H+

does the higher pH (more H+ shift the equation to RNH which cannot cross neerve membrane like free base can. This results in less effective LA?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

t/f:

Greater lipid solubility relates to intrinsic potency

A

true – Nerve membrane is 90% lipid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

t/f:

Increased protein binding will increase duration

A

true – Nerve membrane is 10% protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lipid Solubility influences: _______

A

potency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

pKA influences: _______

A

onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Protein Binding influences: ________

A

Duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

↑ Tolerance to drug after repeated administration

A

Tachyphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the Different classes of local anesthesia

A

Ester and Amide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

______ most potent vasodilator

A

Procaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

_______ : the only local anesthetic with constrictor effect

A

Cocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

_____ ______ has greatest % of anesthetics

A

Skeletal muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do you calculate elimination half life?

A

Time needed for 50% reduction in blood level

  • 1st t ½ 50%
  • 2nd t ½ 75%
  • 3rd t ½ 87.5%
  • 4th t ½ 94 %
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
_______ local anesthetics cross blood-brain barrier, and placenta
ALL LA
26
How ______ metabolize in the body: - Hydrolyzed in plasma by pseudocholinesterase into paraaminobenzoic acid (PABA)
Ester Metabolism
27
How ______ metabolize in the body: - Primary biotransformation site is Liver - Liver function/ hepatic perfusion influence Pharmacology of Local Anesthesia Metabolism biotransformation – Relative contraindication for • ASA IV to V patient with liver dysfunction, heart failure
Amide Metabolism
28
Would CHF or Liver failure increase Ester availability, but decrease amide availability.
Please call or text me. I seriously have no clue.
29
_______ are primary excretory organ
Kidneys
30
Initial clinical signs/symptoms of CNS toxicity are________!
Excitatory
31
Further______ in toxicity leads to cessation of seizure activity:  respiratory depression  reparatory arrest
increase
32
What are the stages/ signs of local anesthesia over dose / toxicity?
– Numbness of tongue and circumoral region (symptoms) – Slurred speech, shivering, A/V disturbances, Disorientation, tremor.. (signs) – Luckily, lidocaine don’t have these s/s but mild sedation or drowsiness
33
the follow are examples of _____ _____:  Epinephrine  Norepinephrine  Dopamine
natural catecholamines
34
The following are examples of ______ ______:  Isoproterenol  Levonordefrin
synthetic catecholamines
35
the following are examples of ___-_____:  Amphetamine, Ephedrine, Methamphetamine
Non-catecholamines
36
All Cathecholamines work on adrenergic receptors with______ acting
direct
37
Adrenoceptors: ``` Vasoconstriction increased peripheral resistance increased BP mydriasis increased closure of internal sphincter of the bladder ```
Alpha 1
38
Adrenoceptors: inhibition of norepinephrine release inhibitiomn of insulin release
alpha 2
39
Adrenoceptors: tachycardia increased lipolysis increased myocardial contractility
beta 1
40
Adrenoceptors: vasodilatation slightly decreased peripheral resistance bronchodilation increased muscle and liver glycogenolysis increased release of glycogen relaxed uterine smooth muscle
beta 2
41
In a ratio for epinephrine dilution, 1: 100,000 the 1= ______ mg
1000 mg
42
do the following question: Epinephrine dilution: a) 1: 300,000 vs. b) 1: 200,000 Which one is more concentrated
a) 0.00333333333 mg/ml b) 0.005mg/ml B is more concentrated
43
_________: ``` Lack significant B2 actions • Intense vasoconstriction  Almost exclusive alpha action • Dramatic elevation of blood pressure  9X higher than epinephrine ```
norepinephrine
44
1) Blood pressure in excess of 200 mmHg systolic or 115 mmHg
Contraindication of vasoconstrictor
45
2) Uncontrolled hyperthyroidism
Contraindication of vasoconstrictor
46
3) Severe cardiovascular disease  a) Less than 6 months after myocardial infarction  b) Less than 6 months after cerebrovascular accident  c) Daily episodes of angina pectoris or unstable angina  d) Cardiac dysrhythmias despite appropriate therapy  e) Postcoronary artery bypass surgery (CABG), less than 6 months
Contraindication of vasoconstrictor
47
4) Undergoing general anesthesia with halogenated agents
Contraindication of vasoconstrictor
48
5) Patient receiving nonspecific B-blocker, MAOi, Tricyclic antidepressants
Contraindication of vasoconstrictor
49
Using the categories provided, which patients are considered ASA 4 risks and are not normally considered candidates for elective or emergency dental treatment in the office.  1) Blood pressure in excess of 200 mmHg systolic or 115 mmHg  2) Uncontrolled hyperthyroidism  3) Severe cardiovascular disease  a) Less than 6 months after myocardial infarction  b) Less than 6 months after cerebrovascular accident  c) Daily episodes of angina pectoris or unstable angina  d) Cardiac dysrhythmias despite appropriate therapy  e) Postcoronary artery bypass surgery (CABG), less than 6 months  4) Undergoing general anesthesia with halogenated agents  5) Patient receiving nonspecific B-blocker, MAOi, Tricyclic antidepressants
1-3d
50
Do patient OD if your exceed MRD?
yes
51
t/f: Maximum calculated drug dose should decrease in medically compromised, debilitated, or elderly persons
true That’s correct. Disadvantaged people are slower in metabolizing these drugs. So you need to decrease the MRD on them
52
Which drug?  Onset of action: rapid (2-3 mins)  Anesthetic t ½ : 1.6 hours Maximum Recommended Dose (MRD)  4.4mg/kg (Council on Dental Therapeutics of the ADA and USP convention)  Absolute maximum 300mg  8 Cartridges will be the maximum # used on a patient  Healthy patient, maximum epinephrine is 0.2mg or 200mcg  Cardio patient , maximum epinephrine is 0.04mg or 40mcg
Lidocaine
53
Which drug?  Healthy patient, maximum epinephrine is 0.2mg or 200mcg  Cardio patient , maximum epinephrine is 0.04mg or 40mcg
lidocaine
54
Which Drug? Maximum Recommended Dose (MRD)  4.4mg/kg (Council on Dental Therapeutics of the ADA and USP convention)  Absolute maximum 300mg  8 Cartridges will be the maximum # used on a patient
lidocaine
55
which drug?  Onset of action: rapid (2-3 mins)  Anesthetic t ½ : 1.6 hours
Lidocaine
56
Which drug? ```  Onset of action: Rapid (1.5 to 2 mins)  Anesthetic t ½ : 1.9 hours  Maximum Recommended Dose ( MRD):  4.4mg/kg  Absolute maximum 300mg  5.5 cartridges will be maximum # used on a patient ```
Mepivacaine
57
Which drug?  Onset of action: Rapid (1.5 to 2 mins)  Anesthetic t ½ : 1.9 hours
Mepivacaine
58
Which drug?  Maximum Recommended Dose ( MRD):  4.4mg/kg  Absolute maximum 300mg  5.5 cartridges will be maximum # used on a patient
Mepivacaine
59
Which Drug?  Onset of Action: slightly slower (2-4 mins)  Anesthetic t ½ : 1.6 hours  Maximum Recommend Dose:  6.0mg/kg  Absolute Maximum 400mg  5.5 cartridges will be the maximum # used on a patient
Prilocaine
60
``` Which drug?  Onset of Action: Longer 6-10 mins  occasionally similar to lidocaine  Anesthetic t ½ : 2.7 hours (Long Duration)  Maximum Recommended Dose:  1.3mg/kg  Absolute maximum 90 mg  10 cartridges is the maximum # used on a patient ```
Bupivacaine
61
Which Drug?  Onset of Action: slightly slower (2-4 mins)  Anesthetic t ½ : 1.6 hours
Prilocaine
62
Which Drug?  Maximum Recommend Dose:  6.0mg/kg  Absolute Maximum 400mg  5.5 cartridges will be the maximum # used on a patient
Prilocaine
63
Which Drug? Which drug?  Onset of Action: Longer 6-10 mins  occasionally similar to lidocaine  Anesthetic t ½ : 2.7 hours (Long Duration)
Bupivacaine
64
Which Drug?  Maximum Recommended Dose:  1.3mg/kg  Absolute maximum 90 mg  10 cartridges is the maximum # used on a patient
bupivacaine
65
Which Drug?  Onset of Action:1-2 mins infiltration  Anesthetic t ½ : 0.5 hours  Maximum Recommended Dose:  7mg/kg
Articaine
66
Which drug?  Onset of Action:1-2 mins infiltration  Anesthetic t ½ : 0.5 hours
Articaine
67
Which Drug?  Maximum Recommended Dose:  7mg/kg
Articaine
68
Articaine is ____% concentrated
articaine is 4% concentrated
69
The following are contraindications to which drug?  Patient allergic to amide type anesthesia (few to none)  Sulfite sensitivity  Caution with hepatic disease  Patient with significant impairments in cardiovascular function  Children < 4 y/o is not recommended due to insufficient data
articaine
70
t/f: Articaine cannot be used on children 4 y/o and younger.
true
71
``` t/f:  After 55 years of clinical use, 2% lidocaine with 1:100,000 epinephrine is still the closest to the ideal intermediate-duration local anesthetic in dentistry. ```
true
72
t/f:  Healthy patient, maximum epinephrine is 0.2mg or 200mcg  Cardio patient , maximum epinephrine is 0.04mg or 40mcg
true
73
What is the most common cause of failure to acheive adequate anesthesia?
anatomical variation and faulty technique
74
t/f: the smaller the gauge the bigger the diameter of the needle
true
75
Can we use needle on more than one pt?
no
76
t/f: the needle should be covered with the protective sheath when not in use.
true
77
What technique do you use to recap the needle?
the scoop technique
78
are you ever to bend the needle?
no never
79
t/f: Larger gauge does not = higher gauge. higher gauge = smaller diameter. Larger gauge is wider diameter. super confusing. but high is not a size descriptor.
true
80
it is recommended to use 25- or at least 27-gauge needle. this reduces the chance of needle breakage.
true
81
Which bacteriostatic agent was removed from LA cartridge in 1984?
methylparaben
82
 No manufacturer claim of sterility about exterior surface of the cartridge  Bacterial culture tested fail to produce any growth  Cannot withstand extreme temperature  No autoclaving especially plastic cartridge  When heated, vasopressors are destroyed  Store in room temperature in a dark place  Study showed no benefit of using cartridge warmer  Do NOT soak cartridge in alcohol or “cold sterilizing solution”  Semipermeable diaphragm permits diffusion of these solution  Read the drug package insert
Care and Handling of Cartridge
83
t/f: never soak cartridge in sterlizing solution
true
84
t/f: Most common psychogenic reactions  Vasodepressor syncope  Hyperventilation
true
85
Cimetidine + ASAIII CHF = ______ | contraindication for amide local anesthesia
relative contraindication
86
 Epinephrine-impregnated gingival retraction cord is ______ contraindicated in the cocaine abuser  Postpone dental treatment, if suspected cocaine usage within 24 hours
absolutely conraindicated
87
_______ Contraindication with local anesthesia  Malignant Hyperthermia  Methemoglobinemia (to Prilocaine)
Relative Contraindication
88
``` _____ ______ with local anesthesia  Malignant Hyperthermia  Methemoglobinemia (to Prilocaine)  Cimetidine + ASAIII CHF = relative contraindication for amide local anesthesia ```
Relative Contraindication
89
Where does the ophthalmic (v1) branch go through?
superior orbital fissure
90
where does the maxillary branch (v2) go through the skull?
foramen rotundum
91
where does the mandibular (v3) branch of the trigeminal nerve pass through?
the foramen ovale
92
One of the branch of V2 (trigeminal nerve), upon exiting cranial base, make a quick 180 degree turn back into cranium. This nerve provides sensory innervations to the dura mater. Its_____________ nerve.
ophthalmic (v1)
93
the ______ branch of the trigeminal nerve is both sensory and motor.
mandibular (v3)
94
psa stand for?
posterior superior alveolar
95
PSA Nerve Block Areas Anesthetized;
 Maxillary molar tooth pulps  MB root of 1st molar in (NOT ALWAYS slide says 72%)  Buccal periodontium and bone
96
Which Maxillary injection procedure is described here: 1. Insert needle at the height of vestibule 2. This insertion is 45 degrees upward, backward and in. 3. insert to 16mm depth 4. ASPIRATE 5. if - aspiration, then Inject 0.9ml-1.8ml 6. if + aspiration, remove slightly and reposition. we want - aspiration
Posterior Superior Alveolar Nerve Block
97
t/f: you always aspirate with PSA nerve block
true
98
t/f: a disadvantage of PSA nerve block is the disfiguring hematoma risk
true
99
``` Which Nerve Block?  Present in some patients  Premolars  MB root of 1st molar in 28%  Buccal periodontium and bone ```
Middle Superior Alveolar Nerve block
100
Which Nerve Block technique is described? 1. insert the needle with the bevel facing the bone well above the premolar apices 2. apsiration is optional? 3. inject 0.9-1.2 ml
Middle Superior Alveolar Nerve Block (MSA)
101
``` Which Nerve Block? Areas Anesthetized  Maxillary central through canine  Premolars  MB root of first molar in 28% of patients  Buccal periodontium and bone  Lower eyelid, side of nose, upper lip ```
Anterior Superior Alveolar Nerve (ASA) aka Infraorbital Nerve Block
102
1. Locate the Foramen by Palpation 2. Foramen ~ 16 mm Above Vestibule 3. Insertion Depth ~ ½ Long Needle 4. insertion for this nerve is almost always in line with the pupils. 5. Orient Needle Bevel Towards Bone 6. Insert Gently Until Bone Contacted this is the roof of the infraorbital foramen 7. Aspirate and Inject 0.9 to 1.2 ml 8. Maintain Pressure During Injection 9. Maintain Pressure One Minute After Injection
ASA anterior superior alveolar Nerve block
103
``` Which injection? Areas Anesthetized  Tooth  Buccal periodontium and bone  Labial or buccal mucosa ```
Supraperiosteal Injection (Local Infiltration)
104
Which local infiltration is described below: 1. Insert Superior to Root Apex 2. Orient Needle Bevel Towards Bone 3. Inject 0.6 ml of anesthetic
Supraperiosteal injection
105
``` Which Nerve Block ? Areas Anesthetized  Posterior portion of hard palate  Overlying soft tissues  No anesthesia of teeth ```
Greater Palatine Nerve Block
106
``` Which nerve block Areas Anesthetized  Anterior portion of hard palate  Both hard and soft tissues  No anesthesia of teeth ```
Nasopalatine Nerve Block
107
Which nerve block is described? 1. apply topical for 2 min to the soft tissue covering the greater palatine foramen 2. Move Applicator Over Foramen – Apply Direct Pressure 30 Seconds 3. Place Needle Bevel Against Tissue and Bow the Needle 4. Administer a Few Drops of Local 5. Straighten and Advance the Needle, contact bone, but do not go into foramen 6. Aspirate, Deposit 0.45 to 0.6 ml
Greater Palatine Nerve Block
108
Which nerve block is described? 1. Apply Topical for Two Minutes 2. apply direct pressure 3. Contact Bone, Administer 0.45 ml
Nasopalatine Nerve Block
109
What is the name of the other approach to nasopalatine nerve block?
Transpapillary Approach
110
Which nerve block? 1. Apply Topical Lateral to Frenum 2. Blanching of Labial Tissue 3. Insert Through Papilla Towards Palate 4. Administer 0.3 ml Into Papilla
nasopalatine nerve block trans-papillary approach
111
t/f: the anterior branch of the mandibular nerve gives rise to the muscles of mastication.
true
112
t/f: the buccal branch is a branch of the anterior branch, and is in a league of its own. You really have to numb it if you want to take care of buccal tissue around mandibular molars
true
113
What are the two major branches from the posterior branch of the mandibular nerve?
inferior alveolar and the lingual
114
Which Mandibular nerve Block? ``` Tissues Anesthetized • Gingiva buccal to molars • Retromolar pad mucosa • Buccal mucosa in molar area • NO hard tissues anesthetized ```
Buccal Nerve Block
115
t/f: The injection site for the buccal nerve block is just buccal to the molars.
true
116
Which mand Nerve block is described? 1. find injection site: bust buccal to molars (looks like on occlusal plane 2. Injection – 25 Gauge Long Needle 3. during injections, stretch the tissue 4. contact periosteum
buccal nerve block
117
________ Innervates Anterior 2/3 of Tongue and Innervates Lingual Mucosa
lingual nerve
118
What is the largest branch of the posterior division?
inferior alveolar nerve (IA)
119
Which Mandibular nerve block is described? 1. Syringe at Level of Coronoid Notch 2. Syringe Directed Across Arch 3. needle penetrates buccinator muscle and lateral to the Pterygomandibular Raphe 4. dry injection site 5. apply topical 6. wait one or two minutes with topical 7. Finger on Notch Retracts Cheek and Determines Height of Injection 8. Barrel of Syringe in Corner of Mouth 9. Aspirate, Inject 1.5 ml over 60 Sec. 10. Insert~25mm to Contact Bone 11. Withdraw Halfway, Deposit 0.1 ml at Lingual Nerve
Inferior alveolar nerve block
120
Which nerves are Anesthetized with the Inferior Alveolar Nerve Block? * Inferior alveolar * Incisive * Mental * Lingual (usually) * All of the above
all above
121
areas Anesthetized with IA nerve block include: - entire quqadrant of dentition - entire quadrant of lingual mucosa - incisor to 2nd pm of buccal mucosa - 1/2 of tongue - all above
all above
122
which mand nerve block is described? 1. Palpate the Mental Foramen (xray) 2. site of injection is the depth of the vestibule 3. dry and apply topical 4. bevel to bone 5. Insert into Tissue Over Foramen. 6. Deposit 0.6 ml over 20 seconds.
Mental nerve block
123
Areas Anesthetized by ____ ____ _____ • Mucosa anterior to foramen • Skin of the lower lip • Chin
mental nerve block
124
In Gow-Gates nerve Block: the needles contacts ____ __ _____
neck of condyle
125
What are the two extra oral landmarks for the gow-gates nerve block?
corner of mouth | intertragic notch
126
Which mand Nerve block is described? 1. Wide Opening, Condyle Moves Forward 2. Needle Puncture Point Dictated by Intra-oral Landmarks (corner of mouth and the intratragic notch) 3. Advance Until Bone Contacted 4. Withdraw 1 mm, Aspirate, Inject 1.8 ml
Gow Gates
127
_________ Nerve Block Nerves Anesthetized | • Inferior Alveolar • Lingual • Mylohyoid • Auricolotemporal • Buccal (in 75 %)
Gow-Gates
128
Which mand nerve block is described? 1. Closed Mouth 2. Height of Injection: Maxillary Muco- Gingival Line 3. Direct parallel to ramus 4. Insert to 25 mm depth 5. Aspirate, Inject 1.5 to 1.8 ml
Vazirani-Akinosi Nerve Block
129
Vazirani-Akinosi Nerve Block Nerves Anesthetized: • Inferior Alveolar • Lingual • Mylohyoid - all above
all above
130
list the following in order of highest on the condyle? highest at top of list
gow gates Vazirani-Akinosi Nerve Block IA

MicroBac (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions