Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

24 Anesthesia and Pain Control > techniques of mandibular injections > Flashcards

techniques of mandibular injections Flashcards

1
Q

what is the second most frequently injection used after infiltration?

A

IA block

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

what nerves are anesthetized with the IA block?

A

IA nerve
incisive, mental, and lingual nerves

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

the anatomic location of the lingula
at or below 1.0 cm above the mand occ. plan _____% of the time

A

84%

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

the anatomic location of the lingula
at or below 1.5 cm above the mand occ. plan _____% of the time

A

96%

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

the anatomic location of the lingula
_______% distally fo the mesiodistal length of the ramus

A

60%

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

where should you approach for the IA block?

A

from the contralateral premolars

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

T/F you shoudl be 1.0 cm above the mand occlusal plane and perpendicular to it

A

false: 1.5 cm above the mand occlusal plane and parallel to it

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

the needle endpoint should be _______% of the __________ length of the ramus, distally

A

60%, mesiodistal

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

T/f it is required that you hit the bone on the IA block

A

true

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

what gauge needle for the IA block?

A

25 gauge long needle

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

how far do you withdraw for the IA?

A

1mm

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

how much of the carpule of local anesthetic over how long?

A

3/4 of the carpule over 1-2 min
(inject 1/4 carpule, re-aspirate; inject 1/4, re-aspirate)

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

withdraw the needle 1/2 way (_______mm) during the IA block

A

~10-15mm

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

why will you withdraw during the IA block?

A

to slowly inject the lingual nerve

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

T/f you don’t need to save any anesthetic for the long buccal

A

false

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

what is the clinical failure rate for the IA block?

A

15-20%

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

what is a common issue with IA block?

A

wide variation in anatomy
-anesthetic too low, too anteriorly
limited access to IAN
accessory innervation
-mylohyoid nerve

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

T/f it’s ok to give bilateral IA blocks

A

False. can bite themselves etc

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

what are the complications of IA block?

A

syncopal episode
hematoma (bruise)
trismus (trouble opening)
transient facial paralysis

SHTT

20
Q

where does the long buccal block get numb?

A

soft tissue on buccal from just posterior to molars up to the premolar area (where mental nerve exits mental foramen)

21
Q

where is the long buccal block injection given?

A

distal and buccal to 2nd molar

22
Q

what’s the depth of penetration for long buccal block

A

2-3mm (bone contact)
~1/5th of carpule

23
Q

where will you give the lingual nerve block?

A

inserted distally and lingually to the 3rd molar area to the depth of ~5mm no bone contact

24
Q

what does the lingual n. block get numb?

A

lingual gingiva, mucosa, floor of the mouth, and anterior 2/3 of tongue

25
Q

where do you place incisive nerve block?

A

mental nerve and rub into foramend

26
Q

does the incisive nerve block give 100% profound pulpal anesthesia?

A

no

27
Q

what nerves get numb with incisive nerve block?

A

mental, incisive

28
Q

what do you do fi the conventional IA block is unsuccessful?

A

Gow-Gates nerve block

29
Q

what is the most important contraindication for Gow-gates nerve block?

A

pt’s who are unable to open their mouth wide? (e.g. trismus)

30
Q

T/F gow-gates is a true V3 nerve block

A

true

31
Q

what branches are numb with the gow-gates nerve block?

A

IA
lingual
auriculotemporal
mylohyoid
long buccal

32
Q

where do you want to inject for Gow-Gates?

A

the lateral aspect of the anterior portion of the condylar head

33
Q

how long must the pt remain wide open for ________ minutes after the injection for gow gates

A

1-2 min

34
Q

for gow gates you’re injecting just inferior to the insertion of the ________ pterygoid muscle

A

lateral

35
Q

where do you position the needle for gow-gates?

A

beginning form the contralateral canine, the needle is positioned for insertion at a level just inferior to mesiolingual cusp of 2nd molar

36
Q

what is the alternate approach for gow-gates?

A

puncture point is made approximately at the location of the distobuccal cusp of the 2nd molar

37
Q

what is the needle insertion depth of gow-gates?

A

25-30mm

38
Q

what’s the idea behind having the bone contacted during gow-gates?

A

prevents injection into the capsule of the TMJ

39
Q

what is the success rate of gow-gates?

A

> 95% when you’re proficient

40
Q

when do you use the akinosi block?

A

limited mandibular opening
inability to visualize landmarks for the IA block due to large tongue

41
Q

what nerves will be anesthetied with vazirani-akinosi block?

A

IA
incisive
mental
lingual
mylohyoid
(NOT long buccal)

42
Q

what are the disadvantages of vazirani-akinosi block?

A

-difficult to visualize the path of the path of the needle and depth of insertion
-no bony contact; depth of penetration somewhat arbitrary
-potentially traumatic if needle is too close to periosteum

43
Q

bevel orientation _________ from ramus with vazirani-akinosi block

A

away

44
Q

what is the depth of the vazirani-akinosi block?

A

25mm

45
Q

T/f with vazirani-akinosi block you’ll be perpendicular to the max occlusal plane

A

false. parallel

46
Q

where do you insert needle for vazirani-akinosi block?

A

into mucosa b/w medial border of mandibular ramus and the max tuberosity at the level of the cervical margin of the max molars

47
Q

what areas are anesthetized with vazirani-akinosi block?

A

-mand teeth to midline
-buccal mucoperiosteum and mucous membranes on the side of injection
-ant. 2/3 of tongue and floor of oral cavity
-lingual soft tissues and periosteum
-body ob mandible, inferior portion of the ramus
-skin over the zygoma, post portion of the cheek and temporal regions

24 Anesthesia and Pain Control (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions