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Terms in this set (121)
What nerve was damaged if the anterior 2/3 of the tongue has a loss of sensation
facial or lingual?
What is the volume of LA anesthetic solution in 2 cartridges of Lidocaine?
What type of injection would be used to achieve hemostasis
Where are used needles disposed
Burning feeling from injection can be caused by what?
Lowered pH, experienced more by an older cartridge than a fresher one because once sodium bisulfite is oxidized, it turns to sodium bisulfate, it has an even lower pH.
Needle gauge for infiltration
Why would you use caution with Amides and a patient who has Cirrosis?
Amides are metabolized in the liver
Which component of LA is an antioxidant
Sodium (Meta) Bisulfite
Sequence of disappearance of sensation
Pain, Temperature, Touch, Proprioception, Motor
Adverse effects on CNS
CNS Depression, Convulsions
4.5-7micrograms/mL Epinephrine will induce
Euphoria, sweating, vomiting
10 micrograms and up Epinephrine will induce
Seizures, Decreased HR, BP, and respirations
A cartridge of .5% contains how much LA
A cartridge of 2% contains how much LA
A cartridge of 3% contains how much LA?
A cartridge of 4% contains how much LA
Close proximity to nerve trunk
The maxillary division passes through which foramen
The mandibular division passes through which foramen
Treatment for Hematoma
Hematoma is the effusion of blood into extravascular spaces and can result from nicking a blood vessel, artery or vein. Apply pressure for atleast 2 minutes, Ice the area immediately, and then use warm moist towels 4-6 hours after to area, rinse with salt water
Primary reason for needle breakage
Weakening of the dental needle by bending it before it's insertion into the pt.'s mouth. 2nd reason is pt. movement.
How is topical anesthetic best described
absorbed through mucousal tissue
How far are you into tissue when you first hit bone on the IA block choices: 1/4 inch 1/2in, 3/4in, 1in?
Amides VS Esters and allergic reation
Less allergies with Amides
Which tissue is least effected by topical
Which injections to scale maxillary molars
PSA and GP
When do you use a long needle
How much epi in a 1:100,000 cartridge of LA
How much epi in a 1:50,000 cartridge of LA
How much epi in a 1:200,000 cartridge of LA
How much epi in a 1:20,000 cartridge of LA
How much LA to deposit on a Lingual injection
What is the shelf life of a cartridge of LA
the expiration date on the cartridge
Where do you inject the nasopalatine injection
How much epi for a cardiac pt.
How much epi for a healthy pt.
.20mg ( there was no .2 choice)
Are maxillary nerves motor and sensory
Pt reports pain on opening the next day after an injection...what is the pt experiencing
trismus. Prolonged tetanic spasm of the jaw muscles by which the normal opening of the mouth is restricted (lock jaw).
Before using a cartridge you should wipe it with disinfectant, soak it in alcohol, autoclave it and or sterilize it
NONE of the above
Foramen and various nerves that enter and exit: rotundum, ovale, mandibular, incisive, mental
rotundum- maxillary nerve
mandibular- IA nerve
incisive- incisive nerve
mental- mental nerve
Which Topical Anesthetic is NOT absorbed systemically?
What Injection would numb the lower lip?
How far do you insert the needle on an IA injection? What would happen if you were to insert it to the hub of the neddle?
2.5 cm/1in/25.4mm. If the needle is inserted to the hub it has a greater chance of breaking because the point at which the needle shaft meets the hub is the least flexible and weakest part.
What happens during depolarization?
reverse polarity = sodium in and potassium out
Which type of nerve transmits impulses faster - Mylinated, or unmylinated?
How do you safely recap a needle?
use the one handed scoop method, lay cap on table and with one hand scoop up the cap with the needle.
How do you orient the bevel of a needle before insertion?
Bevel toward bone
When do you aspirate?
before injection of anesthetic
What increases blood preassure
What part of the syringe indicates it is an aspirating syringe?
What LA is metabolized by pseudocholinesterase?
Which antiseptic should NOT be used?
Landmark for IA injection
What is a possible cause of pain upon removal of the needle?
Needle Barb from impaling bone.
How does a self-aspirating syringe work?
When you let off pressure it aspirates
Max. Dose of epi for a cardiac patient
Max. Dose of epi for a healthy patient
How do you determine gauge and lumen size of a needle?
Smaller number, larger the lumen
what function sodium chloride provides in LA solutions?
Makes the solution isotonic with the tissues of the body. Provides isotonicity of the solution.
What is the role of sodium bisulfite in LA?
antioxidant preventing oxidation of the vasopressor by oxygen which might be trapped in the cartridge by manufacture or diffuse through the semipermeable diaphragm after filling. Prevents biodegration of LA
action of vasodepressors in LA
increases depth and duration of anesthetic, decreases absorption of local anesthetic and vasopressor.
Maxillary and mandibular nerves, are they sensory, motor or both?
maxillary nerve- sensory
mandibular nerve- both
What are the causes of trismus and how do you manage it?
caused by trauma to muscles or blood vessels in the infratemporal fossa, injection of alcohol or sterilizing solution contaminated local anesthetic causing irritation to the tissues, hemorrhage, large volumes of anesthetic solution deposited in one area, or infection. exercise the area and apply a warm compress, or warm saline rinse.
What would cause a dry cornea?
IA injection not contacting bone and going into parotid gland-anesthesia to the facial nerve
What is the difference between a block and an infiltration?
nerve block- Close proximity to nerve trunk
infiltration- flooding area that you want numb
how much epi in on cartridge of 2% lidocane with 1: 100,000 epi?
Is laryngeal edema life threatening?
What happened when a patient receives electric shock during delivery of anesthesia
touched the nerve sheath
why does infiltration works better in the maxilla than the mandible?
issue of bone density
where is epinephrine naturally found in the body? Which system?
adrenal medulla, endocrine system
Which anesthetic is not an amide?
how long can you safely leave on a lidocaine patch
15 minutes with a concentration of 20%
most common anesthetic without epinephrine:
needle gauge for infiltration
27 or 30
which anesthetic is an ester?
if a patient has liver disease, you would use caution with an amide because
amide is metabolized/ biotransformation in the liver
what is the benefit of slow deposit rate
Less pain, less complications
location for buccal injection:
distal and buccal to the 2nd mandibular molar
After the infraorbital injection, the patients cheek turns white, what happened?
blanching, or vasoconstriction of the blood vessels in that area
why does anesthesia fail to work near an abscessed tooth?
Infection causes a lowered pH, infected area is more acidic which does not allow ionazation of sodium molecules
What causes a droopy eyelid?
Anesthesia to the facial nerve
Which root is not anesthetized by the PSA injection?
mesiobuccal root of the first molar
What would you use to manage an immediate severe allergic reaction and a delayed reaction?
Epinepherine for immediate severe
Benadryl for delayed reaction
Pain on injection is related to what?
careless injection technique, dull needle, Injecting too quickly can damage tissues, needles with barbs from impaling bone.
Why would a pt. experience burning upon injection?
lower pH from vasoconstrictor, rapid injection.
injection site for lingual infiltration of maxillary molars
5-10mm from the free gingival margin
if a patient is allergic to red wine due to a sulfite allergy what type of anest. would you not want to administer?
If a patient has an allergy to sulfite which anesthetic would be safe to administer?
Mepivacaine plain 3%(sulfite free) or Prilocaine plain 4%. The allergy to red wine is b/c of the sulfite preservatives put in it. Plain local anesthetics do not have preservatives(sodium bisulfite) in them, hence, safe for those with sulfite allergies. It is a sulfite allergy, not sulfa.
What is the first sign of an overdose?
Maxillary division of Trigeminal Nerve is:
Which Nerve is NOT associated with the mandibular nerve branch?
What injection needed to anesthetize ling of max anteriors?
What injections needed to anesthetize the entire palate on one side?
GP and Nasopalintine
Hematoma can occur if needle penetrates into the pterygoid plexus of veins during which injection?
What are the actions of a vassopressor?
increase duration of LA, hemostasis, reduce change of toxicity
How much epi is in 1% solution?
1% solution = 10 X 1.8 (or 1.7) = 18mg (or 17mg)
How much epi is in 2% solution?
2% solution = 20 X 1.8 (or 1.7) = 36mg (or 34 mg)
How much epi is in 3% solution?
3% solution = 30 X 1.8 (or 1.7) = 54 mg (or 51 mg)
Innervation of the soft palate?
Lesser Palatine Nerve
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?
Give pt. epi
Injection site if you wanted to infiltrate on the Lingual of #13
near apex of tooth
What type of injection is LA?
Where would you inject to numb the maxilary incisors?
if you were going to scale the maxillary 2nd molar and already performed PSA, what other injection would you give?
which BEST describes topical anesthetic
Diffuse through mucous membraines
what is the least preferable way to recap needle?
using a 2 hand method
what would 1ML per min of LA do to a patient?
produce no adverse effects?
When giving a IA injection at what point will the needle contact the bone?
2/3 the length of the long needle is when needle will contact the Ramus
#15 has a perio abcess, you've already given the PSA, what other injection will you need to numb the lingual?
options: Lesser palatine, Greater Palatine, Nasopalatine or MSA
You are scaling the lingual of #13, where would you give the injection for an infiltration?
options: Mucobuccal fold, Mucogingival junction, free gingival margin, or apex of #13.
apex of #13?
A central Incisor has a periodontal defect on the lingual root surface, what injection would you use?
Post op Hematoma management?
options: Do nothing, heat, cold and compression for 12 hours
You are seeing a patient for SRPP and they have Cirrhosis of the liver, what complications could arise from using an amide local anesthetic?
options: Patient has complications excreting the drug, Patient has complications metabolizing the drug, no complications
You admin 3 -1.8mL cartridges of 3% Mepivacaine, how much local anesthetic have you administered?
- answers were in 1.7mL
Some manufacturers have changed how many mL of solution are in a cartridge, how much would be administered if you had given 2 full cartridges?
allergic reaction management for a patient who immediately starts gasping for air and BP drops below 90/60mmHg
THIS SET IS OFTEN IN FOLDERS WITH...
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DH Local Anesthesia Board Review (Dr. D 2012)
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