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Dental Nursing 313 & 315 > Unit 313 > Flashcards

Unit 313 Flashcards

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1
Q

What are the components of a local anaesthetic cartridge?

A

Water - liquid volume
Buffering agent - maintains a neutral PH
Preservative - allows storage
Vasoconstrictor - constricts the blood vessels
Anaesthetic - blocks nerve signals to the brain

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2
Q

Usual ratio of adrenaline in local anaesthetic

A

1:80,000

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3
Q

What component of local anaesthetic should not be used for pregnant patients?

A

Felypressin - brings on labour

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4
Q

Nerve supply to the upper 1s, 2s and 3s

A

Anterior superior dental nerve

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5
Q

Nerve supply to the upper 4s, 5s and mesiobuccal root of the 6s

A

Middle superior dental nerve

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6
Q

Nerve supply to the upper distobuccal root of the 6s, 7s and 8s

A

Posterior superior dental nerve

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7
Q

Nerve supply to the front of the soft palate (1s, 2s and 3s)

A

Nasopalatine nerve

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8
Q

Nerve supply to the back of the palate (4s, 5s, 6s, 7s and 8s)

A

Greater palatine nerve

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9
Q

Nerve supply to the back of the hard palate (behind the teeth)

A

Lesser palatine nerve

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10
Q

Nerve supply to all lower teeth

A

Inferior dental nerve

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11
Q

Nerve supply to the floor of the mouth and 2/3 of the tongue

A

Lingual nerve

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12
Q

Nerve supply to the buccal of the lower 6s, 7s and 8s

A

Long buccal nerve

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13
Q

Nerve supply to the labial gingivae of the lower anterior teeth, lips and chin

A

Mental nerve

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14
Q

What is a foramen

A

A hole in the bone where the nerves and blood vessels can pass through

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15
Q

Signs of a partially blocked airway

A

Wheezing
Coughing
Red face

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16
Q

Signs of a fully blocked airway

A

Cyanosis
Collapsing
Grasping at the neck

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17
Q

Symptoms of a fully blocked airway

A

Panic

Unable to cough

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18
Q

What should you do if someone has a blocked airway

A

Encourage them to cough
If this does not work, administer 5 back blows and 5 abdominal thrusts
Call 999

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19
Q

Signs of anaphylactic shock

A

Swelling of the face
Rash
Rapid, weak pulse

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20
Q

Symptoms of anaphylactic shock

A

Breathing difficulty
Feeling faint
Nausea

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21
Q

What should you do if someone is in anaphylactic shock

A

Administer adrenaline 1:1000 and call 999

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22
Q

Signs of a grand mal seizure

A

Unconsciousness
Rigid limbs
Convulsions

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23
Q

Symptoms of a grand mal seizure

A

Possible aura beforehand

Halt in breathing

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24
Q

Signs of a petit mal

A

Dazed

In a world of their own

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25
Q

Symptoms of a petit mal

A

Daydreaming

Feeling spaced out

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26
Q

What should you do if someone is having an epileptic seizure

A

Time the seizure
Administer buccal midazolam
Call 999 if its been over 5 minutes, if it is their first seizure or if they fall in and out of seizures

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27
Q

What medication can cause gingival hyperplasia

A

Epanutin

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28
Q

What medication reverses midazolam

A

Flumazenil

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29
Q

Signs of an angina attack

A

Pale, clammy skin

Irregular pulse

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30
Q

Symptoms of an angina attack

A

Crushing pain in the chest and left arm

Unable to catch breath

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31
Q

What should you do if someone is having an angina attack

A

Administer GTN spray sublingually - 2 sprays - 0.4mg

Call 999

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32
Q

Signs of a myocardial infarction

A

Cyanosis
Grey pallor
Collapsing

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33
Q

Symptoms of a myocardial infarction

A

Severe pain

Vomiting

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34
Q

What should you do if someone is having a myocardial infarction

A

Try GTN spray
Administer aspirin 300mg
Call 999

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35
Q

Signs of cardiac arrest

A

No pulse
Loss of consciousness
No breathing

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36
Q

What should you do if someone is having a cardiac arrest

A

Call 999

Perform CPR

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37
Q

Signs of hypoglycaemia

A

Pale, clammy skin
Trembling
Slurred speech

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38
Q

Symptoms of hypoglycaemia

A

Sweating

Blurred vision

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39
Q

What should you do if someone is hypoglycaemic

A

Offer a sugary drink or tablet if conscious and administer glucogel
Administer glucagon 1mg injection if unconscious

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40
Q

Signs of a vasovagal syncope

A

Pale, clammy skin

Weak, thready pulse

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41
Q

Symptoms of a vasovagal syncope

A

Nausea
Tunnel vision
Tiredness

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42
Q

What to do if someone is having a vasovagal syncope

A

Lay them back with their feet higher than their head - restore blood flow to the brain
Give a sugary drink or tablet if conscious
Administer glucogel

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43
Q

Name of oral cancer

A

Squamous cell carcinoma

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44
Q

Signs of clinical shock

A

Pale, clammy skin

Rapid pulse

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45
Q

Symptoms of clinical shock

A

Nausea

Confusion

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46
Q

What to do if someone is in clinical shock

A

Call 999

Do not let them eat or drink

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47
Q

Premalignant patches

A

Leukoplakia (white)

Erythroplakia (Red)

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48
Q

Herpes labialis

A

Cold sores

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49
Q

Herpes varicella

A

Chicken pox

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50
Q

Zoster virus

A

Shingles

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51
Q

Non premalignant white patches

A

Lichen planus

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52
Q

What is mumps caused by

A

Parotitis - swelling of the parotid salivary gland

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53
Q

What is a mucocele

A

Minor salivary gland cyst

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54
Q

What are analgesics

A

Pain killers

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55
Q

What are antibiotics

A

Treat bacterial infections

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56
Q

What are anticonvulsants

A

Control epileptic fits

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57
Q

What are sedatives

A

Reduce anxiety/depression

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58
Q

Systolic number for a health adult

A

120 - pressure of the blood leaving the heart

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59
Q

Diastolic number for a healthy adult

A

80 - pressure of the blood in the arteries when the heart is not beating

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60
Q

Masseter - origin and insertion points

A

Originates at the zygomatic arch

Inserts at the ramus

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61
Q

Temporalis - origin and insertion points

A

Originates at the temporal bone

Inserts at the coronoid process

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62
Q

Medial pterygoid - origin and insertion points

A

Originates at the back of the maxilla - medial pterygoid plate
Inserts at the angle

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63
Q

Later pterygoid - origin and insertion points

A

Originates at the back of the maxilla

Inserts at the condyle neck

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64
Q

Muscles of facial expression

A

Orbicularis oris - encircles the mouth
Orbicularis oculi - encircles the mouth
Buccinator - pushes food onto the posterior teeth

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65
Q

What are the components of saliva

A

98% water
Proteins
Enzymes
Inorganic ions

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66
Q

What duct does the submandibular gland secrete saliva through

A

The whartons duct

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67
Q

What duct does the parotid gland secrete saliva through

A

The stensons duct

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68
Q

What duct does the sublingual gland secrete saliva through

A

18-22 ducts - Rivinus ducts

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69
Q

What are the two signs that should prompt a rescuer to begin BLS?

A

Unconsciousness and abnormal breathing

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70
Q

What does asystole mean?

A

The heart has stopped beating

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71
Q

What does fibrillating mean?

A

The heart is beating in effectively

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72
Q

What is an increased rate of respiration?

A

Faster than 20 breaths per minute

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73
Q

What is an increased heart rate?

A

Faster than 100 beats per minute

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74
Q

What is a falling blood pressure?

A

Systolic reading below 90

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75
Q

What is the ABCDE approach?

A

Airway, breathing, circulation, disability, exposure

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76
Q

What is the aim of BLS?

A

To maintain the flow of oxygenated blood around the casualty’s body until they recover, specialists arrive, the rescuer is too exhausted or the death of the casualty

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77
Q

After how long will the brain cells suffer irreversible damage without oxygen?

A

3-4 minutes

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78
Q

What does DRSABC stand for?

A

Danger, response, shout for help, airways, breathing, circulation

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79
Q

What does ACVPU stand for?

A

Alert, confused, verbal, pain, unresponsive

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80
Q

When should you not perform head tilt, chin lift?

A

If the casualty is suspected of having a spinal/neck injury

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81
Q

How long do you assess a casualty’s breathing for?

A

10 seconds

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82
Q

What is the normal rate of breathing?

A

12-20 breaths per minute

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83
Q

What does gasping or stridor (high pitched inspirations) indicate?

A

Upper airway is blocked

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84
Q

What does snoring indicate?

A

Semi conscious or unconscious casualty who is laying flat due to the tongue falling back

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85
Q

What does gurgling and rattling indicate?

A

Presence of fluid in the airway

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86
Q

What does wheezing indicate?

A

Narrowed bronchi and bronchioles (often during an asthma attack)

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87
Q

What is the log roll technique?

A

Rolling a casualty with suspected spinal/neck injury onto their back keeping their head in line with their neck

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88
Q

How many chest compressions per minute should be carried out?

A

100

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89
Q

How deep should the chest be compressed during BLS?

A

4-5cm

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90
Q

How much oxygen is in expired air?

A

16%

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91
Q

What is the most common problem during rescue breathing?

A

The chest does not lift when the breath is being given

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92
Q

What is being done if the abdomen is rising during a rescue breath?

A

The breath is too forceful or prolonged

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93
Q

How long should a lone rescuer perform BLS for before going to call for specialist help for a child?

A

1 minute

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94
Q

What side should an unconscious pregnant woman be laid on?

A

Left side

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95
Q

What blood vessels are squashed when a pregnant woman is laying on her back?

A

Inferior vena cava

96
Q

Why should you place someone into the recovery position?

A

So that the tongue does not fall to the back of the mouth and any liquids can drain out of the mouth

97
Q

Why are the maxilla bones hollow?

A

They would be too heavy to lift the head if they were solid

98
Q

What is the name of the region where the two halves of the maxilla meet?

A

The intermaxilliary suture

99
Q

What is the back end of each alveolar process called?

A

The maxillary tuberosity

100
Q

When can the maxillary tuberosity be fractured?

A

During difficult upper wisdom tooth extractions

101
Q

What is the name of the area where the 2 halves of the mandible join?

A

The mental symphysis

102
Q

What is the vertical section of the mandible called?

A

The ramus of the mandible

103
Q

What is the horizontal section of the mandible called?

A

The body of the mandible

104
Q

What is the junction called where the body and ramus meet?

A

The angle

105
Q

What type of joint is the TMJ?

A

A hinge joint

106
Q

Where does the TMJ and the mandible meet?

A

At the head of the condyle

107
Q

What does the alveolar process do?

A

Supports the lower teeth

108
Q

Where does the condyle rest when the mouth is shut?

A

In the glenoid fossa

109
Q

What does the front edge of the glenoid fossa form into?

A

The articular eminence

110
Q

What disc prevents the two bones grating against eachother?

A

The meniscus disc

111
Q

What is subluxation?

A

When the meniscus slips in front or behind it’s position causing clicking

112
Q

How does the mouth open?

A

The condyle slides from the glenoid fossa to the crest of the articular eminence

113
Q

What is trismus?

A

Involuntary painful contraction of the TMJ

114
Q

Other than the TMJ, what can cause trismus?

A

Pericoronitis, after surgical extraction of lower wisdom teeth and during mumps

115
Q

What do the suprahyoid muscles do?

A

Allow mouth opening and swallowing

116
Q

What is trigeminal neuralgia?

A

A condition affecting the sensory nerves of the maxillary or mandibular divisions of the trigeminal nerve

117
Q

What is Bells Palsy

A

Temporary paralysis of the facial nerve

118
Q

What is a combination nerve?

A

A nerve carrying both sensory and motor fibres

119
Q

What are the major arteries carrying oxygenated blood to the head and neck called?

A

Common carotid arteries

120
Q

What does the external carotid artery supply?

A

The outside of the cranium including the face and oral cavity

121
Q

What does the internal carotid artery supply?

A

The inner cranial structures including the brain and the eyes

122
Q

Why is it easier for localised infections to spread to the head and neck?

A

Because the flow of deoxygenated blood is not always in one direction due to the veins not having a one way valve system

123
Q

What arteries supply blood to the teeth?

A

The carotid arteries

124
Q

What arteries supply blood to the tongue?

A

The lingual artery

125
Q

What artery supplies blood to the upper teeth?

A

The maxillary artery

126
Q

What artery supplies blood to the lower teeth?

A

The inferior alveolar artery

127
Q

Where is the lining membrane found?

A

The inner surfaces of the checks and lips, floor of the mouth, underside of the tongue and soft palate

128
Q

Where is the masticatory membrane found?

A

Covering the gingivae, topside and edges of the tongue and the hard palate

129
Q

Where is the specialised membrane found?

A

Interspersed throughout the masticatory membrane on the top side and edges of the tongue

130
Q

What does the lining membrane do?

A

Provides a physical barrier between anything entering the mouth and the deep structures of the oral cavity

131
Q

What does the masticatory membrane do?

A

Provides a hard wearing surface that prevents traumatic damage from food, chemicals etc

132
Q

What does the specialised membrane do?

A

Provides taste sensation

133
Q

What does the soft palate do?

A

Seals off the oral cavity from the nasal cavity during swallowing

134
Q

Correct term for swallowing

A

Deglutition

135
Q

Why are drugs often administered sublingually?

A

It has a thin lining epithelium of mucous membrane

136
Q

What is the correct term for inflammation of the tongue?

A

Glossitis

137
Q

What causes glossitis?

A

Iron and vitamin B deficiency

138
Q

What does glossitis look like?

A

Smooth, red glazed appearance of the tongue

139
Q

What is dysphagia?

A

Difficulty swallowing

140
Q

Name of mineral crystals and percentage of them in enamel

A

96% calcium hydroxyapatite

141
Q

What happens to the enamel when it comes into contact with fluoride?

A

Hydroxyapatite crystals turn into fluorapatite crystals - more resistant to acid attacks

142
Q

Name of mineral crystal and percentage of them in dentine

A

80% calcium hydroxyapatite crystals

143
Q

What are the nerve endings called in dentine?

A

Fibrils

144
Q

Name of mineral crystals and percentage of them in cementum

A

65% calcium hydroxyapatite crystals

145
Q

Number of cusps on premolars

A

2

146
Q

Number of cusps on permanent first molars

A

5 (palatal cusp of carabelli)

147
Q

Number of cusps on permanent second molars

A

4

148
Q

Number of cusps on deciduous first molars

A

4

149
Q

Number of cusps on deciduous second molars

A

5

150
Q

Name of the outer surface of the alveolar bone

A

Lamina dura - hard and compact

151
Q

Name of the inner surface of the alveolar bone

A

Cancellous bone - soft and spongy

152
Q

What is the gingiva called which is attached to the bone?

A

The mucoperiosteal layer

153
Q

What is the interdental papilla?

A

Gingival tissue between each tooth

154
Q

What are the periodontal ligament fibres made of?

A

Collagen

155
Q

Inflammation of the periodontal ligaments

A

Periodontitis

156
Q

Where is the parotid salivary gland located?

A

Between the ramus and the ear

157
Q

Where is the submandibular salivary gland located?

A

In the posterior area of the floor of the mouth, beneath the mylohyoid muscle

158
Q

Where is the sublingual salivary gland located?

A

In the anterior area of the floor of the mouth, above the mylohyoid muscle

159
Q

What microorganism causes mumps?

A

Paramyxovirus

160
Q

What salivary gland is most commonly associated with benign and malignant tumours?

A

The parotid gland

161
Q

What salivary duct is most likely to become blocked by salivary stones?

A

The Wharton’s duct from the submandibular gland

162
Q

What condition is associated with xerostomia?

A

Sjogrens syndrome

163
Q

What is ptyalism?

A

Excess salivation

164
Q

What drug can be taken during oral surgery to reduce saliva flow?

A

Atropine

165
Q

Usual bacteria associated with caries

A

Streptococcus mutans
Streptococcus sanguis
Lactobacilli

166
Q

What food group is turned into acid by bacteria?

A

Carbohydrates

167
Q

What are cariogenic foods?

A

Capable of causing caries

168
Q

What are intrinsic sugars?

A

Sugars found naturally within the cell structure of foods

169
Q

What are extrinsic sugars?

A

Sugars added to foods in manufacturing or cooking, some can occur naturally such as honey and lactose in milk

170
Q

Most damaging NME (free) sugars

A

Sucrose and glucose (dextrose)

171
Q

What type of sugar is lactose?

A

Milk extrinsic

172
Q

What type of sugar is fructose?

A

Intrinsic

173
Q

How long does an acid attack last?

A

20 minutes

174
Q

How long does bacteria take to turn carbohydrates into acid?

A

A minute or 2

175
Q

What are the most common stagnation areas?

A

Interproximal and occlusal areas

176
Q

What does a remineralised spot on the tooth look like?

A

A brown spot lesion

177
Q

How does pulp necrosis occur?

A

The pulp cannot swell therefore pressure builds up and compresses the blood vessels which will stop the blood supply to the tooth

178
Q

How does an alveolar abscess occur?

A

The dead pulp tissue drains through the apical foramen into the surrounding alveolar bone and cause the tissue to inflame

179
Q

How does an acute abscess form into a chronic abscess?

A

Pus drains through the sinus, relieving pressure and symptoms

180
Q

What enzyme in saliva digests carbohydrates?

A

Ptyalin (amylase)

181
Q

What is term for tooth loss due to extrinsic acid on the enamel?

A

Erosion

182
Q

What medical conditions can cause tooth erosion?

A

Bulimia, reflux and stomach ulcers

183
Q

What tooth surfaces are particularly affected by erosion?

A

Labial and palatal of upper incisors and occlusal of the lower molars

184
Q

What is the term for tooth loss due to excessive forces (like brushing)?

A

Abrasion

185
Q

What type of patient is more likely to have abrasion cavities?

A

Smokers - using abrasive smokers toothpaste or brushing harder to remove stains

186
Q

What is the most common surface to see an abrasion cavity on?

A

The cervical area of the tooth on the buccal or labial surface

187
Q

What is the term for tooth loss due to tooth on tooth contact?

A

Attrition

188
Q

Other than tooth loss, what can bruxing cause?

A

Face pain and TMJ problems

189
Q

What surface does bruxing affect the most?

A

Occlusal

190
Q

What is the term for tooth loss due to shearing forces in a single standing tooth?

A

Abfraction

191
Q

What is the difference between abrasion and abfraction?

A

Abrasion happens over time, abfraction happens suddenly

Abfraction also affects the lingual and palatal surfaces, as well as the buccal and labial

192
Q

What tooth is most likely to be affected by abfraction?

A

Single standing premolars

193
Q

What is the difference between periodontitis and gingivitis?

A

Gingivitis is the inflammation of the gingiva alone, periodontitis is the inflammation of all supporting structures

194
Q

What are iatrogenic factors?

A

Factors caused by imperfect dentistry

195
Q

What is the specialist gingiva called at the junction where the neck of the tooth and gingiva meet?

A

Junctions epithelium

196
Q

How does gingivitis turn into periodontitis?

A

The toxins soak through micro-ulcers and penetrate the deeper tissues, destroying the periodontal ligaments and alveolar bone

197
Q

What virus causes acute herpetic gingivitis?

A

Herpes simplex

198
Q

What group of patients is most commonly affected by acute herpetic gingivitis?

A

Infants

199
Q

What does acute herpetic gingivitis show as in the oral cavity?

A

Small painful ulcers (acute herpetic gingivo stomatitis)

200
Q

What antibiotic is commonly prescribed for ANUG?

A

Metronidazole

201
Q

What is an acute lateral periodontal abscess?

A

Pus is unable to drain through a pocket and therefore accumulates at the base of the pocket to form an abscess

202
Q

What areas are assessed during an oral health assessment?

A

Extra and intraoral soft tissues, dentition, occlusion and periodontal tissues

203
Q

What are the responses of an electric pulp tester?

A

Normal response - healthy pulp
Increased response - early pulpitis
Reduced response - pulp is dying
No response - pulp is dead

204
Q

Where is oral cancer most commonly seen?

A

Borders and underside of the tongue and the floor of the mouth

205
Q

What instruments would you set out for a tooth charting assessment?

A

Mouth mirror, angled probe, tweezers and a briault probe

206
Q

What teeth are most likely to be crowded?

A

Upper canines

Along with lower second premolars and lower third molars

207
Q

What should be done when a score of 3 is recorded?

A

Radiographs should be taken to record bone levels, plaque retention factors removed and patient given effective oral hygiene advice

208
Q

What should be done when a score of 4 is recorded?

A

Radiographs taken to see bone level, full pocket depths measured to see the problem areas and intensive periodontal treatment initiated

209
Q

What is grade 1 mobility?

A

Side to side movement of less than 2mm

210
Q

What is grade 2 mobility?

A

Side to side movement of more than 2mm

211
Q

What is grade 3 mobility?

A

Vertical movement

212
Q

What are the 3 things that can happen when taking an x ray?

A

X rays pass cleanly between atoms and are unaltered
X rays hit atoms and scatter, releasing energy as they do
X rays hit the atoms and are absorbed, releasing energy as they do

213
Q

What must consent be?

A

Informed
Voluntary
Capacity

214
Q

What act links to consent?

A

Mental capacity act

215
Q

What is a right angled probe used for?

A

To defect occlusal caries

216
Q

What is a briault probe used for?

A

To detect interproximal caries

217
Q

What is a sickle probe used for?

A

To detect residual caries

218
Q

What is a WHO probe used for?

A

BPE

219
Q

What is a Williams probe used for?

A

6 point pocket charting

220
Q

What are study models used for mainly?

A

Orthodontics

221
Q

What is an elastomer material?

A

Putty

222
Q

What is a silicone material?

A

Light body

223
Q

What do the periodontal ligaments connect?

A

The cementum to the socket - the lamina dura lining

224
Q

How does diabetes affect the salivary flow?

A

Reduce salivary flow - more prone to caries or perio

225
Q

How does HIV affect the oral cavity?

A

High risk of all diseases and hairy leukoplakia

226
Q

How will a patient suffering with a hernia affect the oral cavity?

A

Gastric reflux - acidic erosion

227
Q

How does pregnancy affect the mouth?

A

Pregnancy gingivitis - interdental papilla grow to cause epilis

228
Q

What can affect elderly patients more prominently than younger patients?

A

Gingival recession - root surface caries

229
Q

What can cause xerostomia?

A

Chemotherapy, salivary gland blockages and calculi

230
Q

What is lichen planus?

A

Inflammatory condition affecting the soft tissues, red swollen tissue, open sores or white Lacey patch

231
Q

Leukoplakia

A

White patches caused by trauma or possible site for oral cancer

232
Q

What should be noted when a patient is administered drugs and how long should this be kept for?

A

Expiry date and batch number - stored for a minimum of 2 years

233
Q

Symptoms of hyperglycaemia

A

Increased thirst

Ketone smell to breath

234
Q

What should you do if someone is suffering with hyperglycaemia?

A

Administer insulin

235
Q

What might a patient be treated for a stroke with?

A

Anticoagulants (blood thinners)

236
Q

What valve separates the right atrium and right ventricle?

A

The triscupid valve

237
Q

What valves separates the left atrium and left ventricle?

A

Mitral valve

Dental Nursing 313 & 315 (2 decks)

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