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Week 36 > Taylor: ANS > Flashcards

Taylor: ANS Flashcards

1
Q

ANS:

A
  • Automatic, not voluntary
  • has both afferent and efferent fibers
    • receives input from afferent fibers
    • efferent fibers respond to changes from afferent
    • Reflexes
  • Regulates
    • cardiovascular and digestive systems
    • body temp
    • glandular secretions
    • metabolism
  • Protects and/or maintains homeostasis
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2
Q

Autonomic nervous system innervates:

A
  • smooth muscle
  • cardiac muscle
  • exocrine galnds
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3
Q

3 classification schemes for ANS:

A
  • Anatomical
    • Preganglionic fibers
    • Postganglionic fibers
  • Actions:
    • Trophotrophic (nutritive)
    • Ergotrophic (work related)
  • Chemical:
    • Primary Neurotransmitter
      • Actylcholine (Cholinergic)
      • Norepinephrine or Epinephrine (noradrenergic/adrenergic)
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4
Q

Anatomical Classification:

A

Preganglionic vs Postglanglionic fibers

  • Parasympathetic:
    • Long preganglionic fibers
      • most innervate ganglia in the walls of the tissue
      • some innervate ganglia located outside organs
      • derived from craniosacral origin
        • sacral spinal cord (S2-S4)
        • Cranial N-3, 7, 9, 10
    • Short postganglionic fibers located near or in tissues
      • discrete innervation
  • Sympathetic:
    • Short preganglionic fibers from interomedial lateral cell column of spinal cord
      • most innervate ganglia distant from effector tissue in paravertebral chains that run down both sides of vertebral column
      • Origin: Thoracolumbar origin (T1-L2)
    • Long Postganglionic fibers
      • single fiber
        • exits ganglia and innervates many cells in many tissues
          • 1 fiber: 100s of cells
      • Distribuation innervatin pattern
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5
Q

List all Cranial Nerves

A

Oh Oh Oh To Touch And Feel A Girls Vagina, Ah Hell

  1. Olfactory
  2. Optic
  3. Occulomotor
  4. Trochlear
  5. Trigeminal
  6. Abducens
  7. Facial
  8. Adutiory (Vestibulocochlear)
  9. Glossopharyngeal
  10. Vagus
  11. Accessory (spinal accessory)
  12. Hypoglossal
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6
Q

Actions Classification:

A

Trophotrophic (Nutritive) vs Ergotrophic (Work related)

  • Trophotropic Action=PNS
    • accumulation and storage of energy reserves
    • “feed and breed, Rest and Digest” or “Rest and Repair”
    • No wide spread Activation
    • Functions on organ-specific basis
    • Activities:
      • SLUDGE
        • Salivation, Lacrimation, Urination, Defecation, GI motility, and Erection
      • DUMBBELLS
        • Diarrhea, Urination, Miosis, Bradychardia, Bronchospasms, emesis, Lacrimation, Salivation, & Seizures
  • Ergotrophic- Sympathetic
    • energy expenditure system
    • “Fight, Fright, or Flight”
    • wide spread activation
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7
Q

Chemical Classification:

A

Chemical: Primary NT

  • Cholinergic Neurons
    • NT: Acetylcholine
      • released from
        • somatic motor nerve endings
        • autonomic ganglia
        • parasympathetic postganglionic nerve endings
        • sympathetic neurons innervating sweat glands
  • Adrenergic or Noradrenergic Neurons
    • NT: Norepinephrine
      • released from sympathetic postganglionic nerve endings
        • except: Sympathetic neurons that innervate sweat glands=cholinergic=Ach
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8
Q

ANS: Dual Innervation

A
  • Both Parasympathetic and Sympathetic NS innrvate same organ
  • Work in opposition w/each other in:
    • cardiovascular system
    • salivary glands
    • urinary bladder
    • Bronchial Tree
  • Net effect depends on:
    • innervation present
      • Blood vessels, spleen, piloerector muscles, and sweat glands=ONLY Sympathetic
        • NT= NE except Ach for sweat glands
    • Predominant Tone (Central activation)
    • Receptor Present
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9
Q

Parasympathetic Receptors:

A

Cholinergic Neurons

  • NT: Ach
    • somatic motor
    • all autonomic ganlia
    • all parasympathetic postganglion
    • sympathetic sweat glands
  • Muscarinic Receptors:
    • M1, M3, M5
      • Gq–> PLC–>DAG & IP3–> Increase in intracellular Ca2+, Activation of PLD2 and PLA2
      • Autonomic Nerve depolarization
      • Smooth m. contraction (Bladder)
    • M2, M4
      • Gi–> inhibits adenylyl cyclase–>Decrease cAMP–>opening of inward rectyifying K+ channels, inhibition of voltage-gated Ca2+ channels
      • Hyperpolarization, Decrease HR, Decreased ganglion NT release, SM contract
      • M2 linked directly to the opening of K+ channels
  • G-Protein coupled receptors
  • Location
    • M1: Autonomic ganglia
      • modify effects of nicotinic receptor activation\
    • M2: Heart
    • M3: Glands & SM
    • M4/M5: unknown
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10
Q

Sympathetic receptors

A
  • Adrenergic/Noradrenergic
    • Norepinephrine (E)
      • sympathetic postgangliionc nerve endings except SWEAT glands
  • a1
    • a1a, a1b, a1d
    • Gq=same as M1,M3, M5
  • a2
    • a2a, a2b, a2c
    • Gi=same as M2, M4
      • Not always: BV–>Increase Ca2+
    • beta/gamma subunit of g protein–Hyperpolarizes heart
  • A2
    • Postganglion
      • primarily actived by epinephrine
    • Preganglion=Autoreceptor
      • presynatpic inhibtion
      • bound on adrenergic and cholinergic nerve terminals
        • inhibit release of Ach from muscarinic
      • activated by NE or agonist
      • Decrease release of NT
      • If you block a2 receptor
        • enhance NE release
  • B
    • B1, B2, B3
    • B2=always relaxation
      • low affinity for NE
      • adrenal glands release E and activates
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11
Q

Eye:

A
  • Iris:
    • radial m. (dilator m.); Tone=A
      • SNS-contrct=a1
      • PNS=n/a
    • circular m. (Sphincter m.); Tone=C
      • SNS: n/a
      • PNS: contract= M3
  • Ciliary M.; tone=C
    • SNS: relax=B2
    • PNS: contract=M3
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12
Q

Lacrimal Glands

A
  • Tone=C
    • SNS: secretion; a
    • PNS: secretion: M3
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13
Q

GI Tract:

A

ALL TONE C

  • Motility & Tone:
    • SNS: relax-a1, a2, B1, b2
    • PNS: contract: M3
  • Sphincter:
    • SNS: Contract=a1
    • PNS: relax: M3
  • Secretion:
    • SNS: n/a
    • PNS: increase-M3
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14
Q

Repiratory Tract:

A
  • Bronchiole SM: Tone C
    • SNS: Relaxtion, but NO INNVERVATION=B2
    • PNS: Contract=M3
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15
Q

Salivary Glands

A

Dual innervation

  • SNS: secretion: a1
  • PNS: secretion M3
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16
Q

Sweat Glands:

A
  • Actionable=Sympathetic, but release Ach
  • Tone: C
  • Local Secretion:
    • SNS: a1
  • General secretion:
    • PNS: M3
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17
Q

Blood vessels

A
  • sympathetically innverate ONLY
  • have muscarinic receptors that live in endothelial cells-release nitric oxide
  • B2=coronary artery, SKM, pulmonary a. veins
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18
Q

Heart

A

Tone=All C, but ventricle

  • SA node:
    • SNS: increase-B1
    • PNS: decrease-M2
  • Atria:
    • SNS: increase-B1
    • PNS: decrease-M2
  • AV Node
    • SNS: increase=B1
    • PNS-Decreaes-M2 (AV block)
  • His-Purkinje System (Conduction system)
    • SNS: Increase-B1
    • PNS: little effect-M2
  • Ventricle: TONE=A
    • SNS: increase-B1
    • PNS: slight decrease-M2

Parasympathetic affects primarily rate and conduction

Sympathetic affects rate, conduction, and force of contraction

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19
Q

What is the most difficult phase of endodontic treatment?

A

Access cavity prep

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20
Q

Access Cavity Preparation: Objectives

A
  • Remove the roof of the pulp chamber
  • Remove all coronal pulp tissue
  • Locate all canals
  • establish straight line access
  • conserve tooth structure
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21
Q

Rubber dam

A
  • do not begin access until rubber dam places
    • exceptions:
      • teeth tipped, rotated, extremely calcified
  • is the standard of care
  • 53% do not use
  • seal around clamp with cavit or oraseal to prevent leaks=contamination
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22
Q

26N clamp

A

Displaces the dam

minimal interferance with radiographs

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23
Q

What if there is not enough tooth to hold clamp?

A
  • slit dam
  • clamp to soft tissue
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24
Q

Krasner Paper

A

Anatomy of Pulp-Chamber floor

  • Pulp chamber always in the center of tooth at CEJ
  • pulpal floor-darker
  • pulpal roof-yellowish/white
  • orifices of the root canals always located at th jxn of the wall and pulpal floor
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25
Q

Deutsch

A
  • Roof of the pulp chamber was found at CEJ in maxillary and mandibular molars=97-98%
  • Maxillary and mandibular molars
    • 7mm from cusp tip to middle of pulp chamber
  • Maxillary premolars
    • 7mm from cusp tip to the roof of pulp chamber
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26
Q

Lee paper

A
  • Anterior teeth
    • 4.5-6mm from lingual surface to pulp chamber
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27
Q

estimated depth of acces

A
  • Distal from reference point to the roof of pulp chamber
  • used to use burr against radiograph
    • now its digital
  • Do not explore with a bur
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28
Q

Length of 557 bur tip

A

4 mm

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29
Q

Length of #4 round bur shank

A

6 mm

30
Q

Round burr #2 vs #4

A
  • 2
    • define access shape in anterior and premolar
  • 4
    • define access in molars
31
Q

Endo-Z bur

A
  • Non-cutting TIP
    • won’t perforate floor
32
Q

Maxillary Central Incisor

A
  • Triangle outline
  • 1 canal always
33
Q

Why we need to do coronal modification

A
  • reduces the stress on the instrument as it proceeds toward the apex
    • dentin shelf
34
Q

Maxillary Lateral Incisor

A
  • Triangle outline
  • 1 canal
  • Curved distal and palatal
  • Dens invaginatus
    • common developmental defect
    • pulp necrosis
35
Q

Maxillary canines

A
  • 1 root
    • 1 canal (not true)
  • Ovoid outline form
36
Q

Apex Locator

A
  • Determine working length
    • helps find pulp chamber/canal
    • must be confirmed by radiographs
  • used:
    • objects that obstruct vision of apex
      • prosthetic devices or metal bar on maxilla
    • gag reflex
    • medical problems so can’t hold sensor
  • 4 parts:
    • lip clip
    • file clip
    • acutal instrument
    • cord connecting the cliips with the instrument
37
Q

Maxillary Premolar

A
  • Ovoid outline
    • half way up buccal and lingual cusp
  • 1st premolar
    • 2 canals (sometimes 3=upside down triangle-6%)
  • 2nd premolar
    • 1 canal (sometimes 2)
38
Q

Weine classificatioin

A

Canal types:

  • 1
    • 1 canal at orific
    • 1 canal at apex
  • 2
    • 2 at orifice
    • 1 at apex
  • 3
    • 2 at orifice
    • 2 at apex (2 foramina)
  • 4
    • 1 at orifice
    • 2 at apical (last 1/3 of canal system)
39
Q

Maxillary 1st molars

A
  • Trianglular outlineform
    • mesial half of the tooth
      • upside down triangle
  • 3 roots
    • 4 canals (60%
    • 3 canals (40%)
40
Q

Maxillary 2nd molar

A
  • Trianglular outline form
    • mesial half of the tooth
    • upside down triangle
  • 3 roots
    • 4 canals (60%
    • 3 canals (40%)
41
Q

Mueller Burs

A

help with visualization

42
Q

Mandibular Incisors

A
  • 1 root
    • 1 canal
      • Ovoid or ribobon-shape
    • 2 canal (more common)
43
Q

Mandibular canals

A

*

44
Q

How to remember which tooth:

A
  • mark tooth with thomson stick
  • Notch tooth before rubber dam placed
  • clamp or foil placed on tooth to take x-ray
45
Q

Radix Entomolaris

A

3rd DL root curves first to lingual then to buccal

  • asians, hispanic, native americans
46
Q

Canal instrumentation: objectives

A
  • Canal negotiation
  • Working length determination
  • Straight line access
  • secure glide path
  • irrigation
47
Q

Canal negotiation

A
  • Explore canal for patency with small pre-curved stainless stell file
    • always use lubricant or irrigation
    • Pre-curve exploration files
      • # .06, .08. 010
      • help bypass obstruction
  • watcch winding motion to push file
    • do not screw
    • do not force
48
Q

Taper

A

increase in diameter from the tip of the file to a point farther from the tip

  • usually constant
  • usually 16 mm from tip
49
Q

Size 20 with .04 taper. What is D0-D16

A
  • D0=.2
  • D1=.24
  • D2=.28
  • etc
50
Q

D0 vs D16 in general

A

D0-tip diameter in 100ths of a mm

D16=16 mm from file tip

51
Q

Color sequence

-hand files

A
  • Files 6,8,10 on handle
    • pink gray purple
    • Red/orange band
      • White=15
      • Yellow=20
      • red=25
      • blue=30
      • green=35
      • black=40
  • Dark red
    • white=45
    • yellow=50
52
Q

Working length determination

A
  • process begins with x-ray
  • From x-ray
    • tooth length is calculated from reference point to the root apex
    • use digital imaging program
53
Q

Estimated working length determination

A
  • Calculated after length of tooth is calculated
  • Length of tooth - 1mm
54
Q

Corrected working length

A
  • Determined by placing a file into the tooth (min size 10) at the estimated working length
  • take x-ray
  • largest file should be used
  • distance from the tip of the file to the apex is calculated
    • rounded to nearest 0.5mm

Determined based on studies of apical anatomy, morphology and prognostic data

55
Q

What to use to measure files?

A
  • Endoruler
  • Endoring
56
Q

Apical foramen

A

main apical openiing of the canal

57
Q

Apical constriction

A
  • apical portion of root canal that has narrowest diameter
  • usually 0.5-1mm from center of foramen
58
Q

Dummer:apical anatomy: values

A
  • apical Foramen usually doesnt exit from tip, but 0,5 mm away
  • avg apical constriction distance=0.9
    • 95% of consrictions were between 0.5-1mm from apex
  • Types:
    • A=Traditional single constriction
    • B: Tapering constriction
    • C: multiconstricted
    • D. Parallel constriction
59
Q
A
60
Q

Straight line access

A
  • allows unimpeded placement of instruments to the corrected working length or in a curved canal -to the first curvature
    • remove dentin shoulder/triangle
  • use:
    • gates glidden drills-small to large
      • 2-3-4
61
Q

Gates-glidden drills

A
  • come in different lengths
  • Are brushes
    • cut in an upward and outward stroke
    • cut toward line angle
  • Removes dentin shoulder/triangle
  • notches determine number
  • # 2
    • 2 notches (Green)
    • .70
  • # 3
    • 3 notches (white)
    • .90
  • 4
    • 4 notches (red)
    • 1.10
62
Q

Danger zone

A

stay away frrom furcation wall

63
Q

glide path

A

prepares the canal for safe use of rotary files

  • prepared with:
    • hand files
    • orifice openers
    • gates-glidden drills
    • rotoary files=pro glider
64
Q

Proglider files

A
  • Rotary glid path files
  • 0.16mm tip
  • heat treated M wire alloy
  • progressive taper
    • 2% (0.02) at tip to 8% (0.08) at end of flutes
      • gets flattter
    • preliminary preflaring of middle and coronal prortions of canal
    • opens up middle and coroanl 1/3 of canal system
  • square cross section
  • 18mm cutting surface
  • Settings
    • 300 rpm
    • 2.0 N-cm
65
Q

Proglider vs Pro glider: glide path

A
  • progliders=more efficent
    • reduce stress in canal shaping
66
Q

Irrigation

A
  • effect on:
    • biofilm
    • dentin (Collagen)
    • stem cells
  • Sodium Hypochlorite (3%)=NaOCl
    • mechanically removes debris
    • organic tissue solvent
    • anti-microbial
    • lubricant
    • bleaching aciton
    • hemostatic agent
  • Adverse effects:
    • oxides and hydrolyzes proteins
    • RBC hemolysis
    • tissue necrosis
    • skin ulceration
    • corneal burns
  • No standard concentration today
67
Q

Chlorhexidine

A
  • first used as antiseptic cream
  • used in perio
  • persistent broad spectrum antimicrobial
    • persists upt ot 12 weeks
  • Problem: Toxic to stem cell
  • effective against E. Faecalis biofilm
  • can be absorbed by hydroxyapatite and tooth structure
    • does not dissolve smear layers
  • concentration dependent
68
Q

EDTA

A
  • Colorless, water soluble slid
  • demineralizes dentin (soften)
  • can help:
    • negotiate tight canals
    • calcified canals
  • FOUND IN ENDOGEL
  • MOA: on bacteria
    • can help eliminate bacteria in canal
  • does not remove organic portionof smear layer
    • removes smear layer in 1 min
  • usual conc. 17%
  • self limiting
  • USE LAST
69
Q

What happens if you use NaOCl last

A

Erode dentin and might contribute to vdrtical root fracture

*

70
Q

Qmix

A

EDTA

CHX

detergent

Water

Week 36 (4 decks)

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