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Dental Hygiene Local Anesthesia
Terms in this set (73)
Where mandibular nerve passes through in the skull
Where nasopalatine nerve passes through
Maxillary division of Trigeminal Nerve is
Nerve NOT associated with the mandibular nerve branch
Teeth that PSA innervates
1st, 2nd, and 3rd maxillary molars, but may not innervate MB root of the maxillary 1st molar
What injection is needed to anesthetize linguals of max anteriors
What injections are needed to anesthetize the entire palate on one side
Greater Palatine and Nasopalatine
How far do you insert the needle on an IANB?
20-25 mm or 3/4 the length of the needle
What happens during depolarization?
Sodium in and Potassium out
When do you aspirate?
Right before anesthetic is to be deposited
Which local anesthetic is metabolized by pseudocholinesterase?
Topical anesthetics are least effective on?
Which is true of topical anesthetics?
No systemic problems
Which has the highest occurrence of allergic reactions
Ester option; Benzocaine.
What is the significance of giving an amide anesthetic to a patient with cirrhosis?
Due to amide anesthetics being metabolized by the liver.
What is the landmark for the IANB injection?
No organic base for the pain
Max epi dose for cardiac & normal pt
What is trismus?
Limited opening of mouth
Management of hematoma
Cold compression and pressure to bleeding site
Management of trismus
Heat therapy, saline rinses, asprin and jaw exercises
Hematoma can occur if needle penetrates into the pterygoid plexus of veins during which injection?
What needle should be used for infiltration?
Volume of solution of a single cartridge of LA
Antioxidant preventing biodegration of LA by preventing oxidation of vasopressor by oxygen
Actions of vasopressors
Increase duration of LA, hemostasis, reduce chance of toxicity
What would cause a dry cornea?
Anesthetizing the facial nerve. The facial nerve can be anesthetized if bone is not contacted during the IANB and anesthetic solution is deposited into the parotid gland. Temporary bell's palsy would not allow the patients eyelid to blink or close, which would cause the dry eye.
How to calculate amount of epi in a solution
1% solution = 10 X 1.8 (or 1.7) = 18mg (or 17mg)
2% solution = 20 X 1.8 (or 1.7) = 36mg (or 34 mg)
3% solution = 30 X 1.8 (or 1.7) = 54 mg (or 51 mg)
Cause of burning upon injection
acidic pH of solution, injection too fast, cartridge being wiped with alcohol or sterilizing solution.
Cause of needle breakage
Bending needle, patient movement
Why would a patient receive an electric shock during delivery of anesthesia?
Needle touched the nerve sheath
Ongoing numbness of the anterior 2/3 of tongue is caused by which nerve being anesthetized?
What is the benefit of slow deposition rate?
Less pain, less complications
Location for the long buccal injection
Distal and buccal to the 2nd mandibular molar
Why does anesthesia fail to work near an abscessed tooth?
Infection causes lower pH which does not allow ionization of sodium molecules
Nerve that innervates the soft palate
Lesser Palatine Nerve
First sign of local anesthesia toxicity
Allergic reaction management
Epi for immediate, Benadryl for delayed
You just administered anesthetic to your patient, and within minutes a rash was forming on the patients neck. She complained of having difficulty breathing. What would you do?
If you want hemostasis what injection is best?
Decrease blood pressure
What part of the syringe indicates it is an aspirating syringe?
Antiseptic not to use
What is a poss cause of pain upon removal of the needle?
How a self aspirating syringe works
When let off pressure it aspirates
What causes a hematoma?
Injecting in the pterygoid plexus during a PSA injection
Needle gauge: which lumen is smallest?
Smaller number, larger the lumen
What sensation is lost first?
What function does sodium chloride provide in LA solutions?
Makes the solution isotonic
Local anes to avoid in patients with a sulfa allergy
If a patient receives 3 1.7 ml cartridges of 3% mepivicaine, how much drug did she receive?
=(1.7 x 30) x 3
=51 mg x 3
The answer is 153 mg.
What type of injection is local anesthesia
If you were going to anesthetize the maxillary incisors where would you inject?
Least preferable way to recap needle
2 hand method
Do myelinated nerves travel faster or slower than unmyeliated nerves?
Impulses travel faster than unmyelinated
What injection numbs lower lip?
What is the cause if patient has a lesion on the lower lip next day?
Why infiltration works better in maxilla than mandible?
Mandible more dense
Where is epi naturally found in body?
Adrenal gland, endocrine
Which anesthetic is not an amide?
Procaine (all amides have an "i" in prefix)
What is anesthetic suggested deposit rate?
Where to inject if infiltrating lingual of molars
5-10mm from the free gingival margin
Injection site if you want infiltrate #13 lingual?
apex of tooth
Expiration date for local anesthesia drug
When giving a IA injection at what point will the needle contact the bone?
2/3 way is when needle will contact the Ramus
When you are giving an injection the pt experience no pain until Anesthetic is deposited what happen?
IA goes through what foramen
#15 has a perio abcess, you've already given the PSA, what other injection will you need to numb the lingual?
A central Incisor has a periodontal defect on the lingual root surface, what injection would you use?
You are seeing a patient for SRPP and they have Cirrhosis of the liver, what complications could arise from using an amide local anesthetic?
Patient has complications metabolizing the drug
Where are you MOST likely use a long needle
Risk of hematoma
Cause of transient facial paralysis
IA injection~ introducing anes. into the parotid gland
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