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Intro to OS and Pain Management > The Armamentarium > Flashcards

The Armamentarium Flashcards

1
Q

what is the armamentarium of local anesthesia delivery system

A

syringe + needle + cartridge = delivery vehicle

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2
Q

what are the types of syringes

A
  • non disposable syringes
  • disposable syringes
  • safety syringes
  • computer controlled local anesthetic delivery system
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3
Q

what is breech loading

A

carpule loaded from side

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4
Q

what causes blood in cartridge

A

negative pressure

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5
Q

what does positive pressure cause

A

thumb ring forced solution through needle to patient

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6
Q

when is pressure syringe used

A

pulpal anesthesia of one isolated tooth in the mandibular arch

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7
Q

what is a jet injector

A
  • liquids forced through very small openings caleld jets at very high pressure can penetrate intact skin or mucous membranes
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8
Q

what is primary use for jet injector

A

topical anesthesia before needle insertion but you still need to do nerve block and infiltration

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9
Q

advatnages and disadvantages to disposable syringr

A

-A: disposable, single use. sterile. lightweight.
-D: does not take prefilled dental cartridges. difficult aspiration- need 2 hands

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10
Q

how should you care for needle instrument

A
  • wash syringe after each use
  • lubricate every 5 autoclaves
  • clean harpoon with brush after each use
  • replace piston and harpoon
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11
Q

what are the parts of the needle

A

-bevel
- shaft
- the hub
- cartridge penetrating end

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12
Q

what are the factors of the shaft

A

-diameter/guage
- length from tip to hub

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13
Q

the greater angle the bevel, the greater the degree of:

A

deflection

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14
Q

the smaller the guage number, the ____ the diameter

A

greater

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15
Q

advantages of larger gauge needle

A
  • less deflection
  • greater accuracy in injection
  • less change breakage
  • greater aspiration
  • no difference in patient comfort
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16
Q

what gauges are each color needle: red, yellow and blue

A

-red: 25
- yellow- 27- what we use
- blue: 30

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17
Q

where is the nondeflecting needle tip

A

in the center of the shaft

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18
Q

what is the average short needle

A

20 mm

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19
Q

what is the average long needle

A

32mm

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20
Q

where is the weakest portion of the needle

A

at the hub

21
Q

how should the needle be handled

A
  • never used on more than 1 patient
  • change after 3 or more tissue penetration
  • cover in protective sheath when not in use
  • scoop technique
22
Q

what are the most common bent needle procedures

A
  • inferior alveolar nerve block
  • posterior superior alveolar nerve block
  • intrapulpal injection
  • PDL injection and intraosseous injection
23
Q

what would cause pain on insertion

A

dull needle

24
Q

do not bend needle if to be inserted into ____mm soft tissue depth

A

> 5mm

25
Q

how much can a cartridge hold

A

2ml solution but US cartridges hold 1.8ml

26
Q

what is the cartridge made of

A

glass

27
Q

what is the stopper (plunger)

A

receives the harpoon of the aspirating syringe

28
Q

what does gold around cylinder mean

A

articaine

29
Q

what does red around the cylinder mean

A

lidocaine with epi

30
Q

what is the diaphragm of the cartridge

A
  • semipermeable membrane
  • where the needle penetrates into the cartridge
31
Q

what does the mylar plastic label wrap around glass cylinder do

A

protect doctor and patient in event of glass crack or shattering

32
Q

what are the cartridge contents

A
  • may have vasopressor
  • NaCl
  • distilled water
  • methylparaben
33
Q

what is the vasopressor

A

sodium bisulfite
- sodium bisulfite oxidize

34
Q

what are the problems with the cartridge

A
  • bubble in the cartridge- usually nitrogen gas
  • extruded stopper
  • corroded cap- if immersed in disinfecting solution
  • rust on cap
  • leakage during injection
  • broken cartridge
  • burning on injection
35
Q

what can cause burning on injection

A

pH, alcohol, heat, expiration date

36
Q

what are the topical anesthetics

A

-betadine
- chlorhexidine

37
Q

what are the most common psychogenic reactions

A
  • vasodepressor syncope
  • hyperventilation
38
Q

what are other common induced reactions

A
  • tonic clonic convulsions
  • bronchospasms
  • angina pectoris
39
Q

what do you avoid with bleeding problems

A

avoid techniques with increased chance of aspiration

40
Q

what would heart failure cause

A
  • CHF (ASA III or ASA IV) may cause decreased liver perfusion -> increased t 1/2 amide local anesthesia
41
Q

what does AIDS, hepatitis, A, A and jaundice cause

A

increased t 1/2 amide

42
Q

what can be the causes of seizures

A
  • stress/anxiety
  • hypoglycemia
  • hyperventilation
43
Q

when is local anesthesia contraindicated in pregnancy

A

during 1st trimester

44
Q

what does cimetidine cause

A
  • increase t 1/2 of circulating local anesthesia
  • H2 receptor blocker compete with lidocaine for hepatic oxidative enzyme
  • cimetidine + ASA III CHF = relative contraindication for amide local anesthesia
45
Q

what do tricyclic antidepressants do (TCAs)

A
  • enhance cardiovascular action to exogenously administered vasopressors
  • 5-10x increase with levonordefrin and nore-epi
  • 2x increase with epinephrine
46
Q

what does cocaine stimulate

A

nore-epi release and inihbit reuptake
- tachycardia/ hypertension -> increase myocardio O2 requirement -> cardiac ischemia -> MI
- 72 houes needed for cocaine clearance

47
Q

what are relative contraindications with local anesthesia

A

-malignant hyperthermia
- methemoglobinemia

48
Q
A

Intro to OS and Pain Management (9 decks)

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