Introduction to local anaesthetic

Question 1

Name some formulas of local anaesthetic

Answer 1

1. Articaine 4% with epinephrine
2. Bupivacaine 0.5% with epinephrine
3. Lidocaine 2% with epinephrine
4. Mepivacaine 2% with levonordefrin
5. Mepivacaine 3% plain
6. Prilocaine 4% with epinephrine or plain

Question 2

What is the max dose of 2% lidocaine plain in mg/kg and no of cartridges

Answer 2

4.4 mg/kg

7 cartridges

Question 3

What is the max dose of 2% lidocaine with adrenaline in mg/kg and no of cartridges

Answer 3

6.6 mg/kg

10 cartridges

Question 4

What is the max dose of 4% Articaine with adrenaline in mg/kg and no of cartridges

Answer 4

7.0 mg/kg

5 cartridges

Question 5

What is the max dose of 3% prilocaine with octapressin in mg/kg and no of cartridges

Answer 5

9.0mg/kg

18 cartridges

Question 6

What is the max dose of 3% mepivicaine plain in mg/kg and no of cartridges

Answer 6

4.4 mg/kg

9 cartridges

Question 7

What is the max dose of 2% mepivicaine plain in mg/kg and no of cartridges

Answer 7

4.4 mg/kg

14 cartridges

Question 8

Which cranial nerve are we aiming to anaesthetise when administrating LA

Answer 8

Trigeminal nerve (V)

Question 9

Name the 3 division of the trigeminal nerve

Answer 9

V1: Ophthalmic divison
V2: Maxillary division
V3: Mandibular division

Question 10

Which of the divisions of the trigeminal nerves is the largest

Answer 10

The mandibular division

Question 11

Describe the mandibular division of the trigeminal nerve

Answer 11

It conveys afferent sensory and efferent motor fibres

Question 12

What do the motor fibres of V3 do

Answer 12

They innervate the:

1. muscles of mastication
2. Mylohyoid muscle
3. Anterior belly of the digastric muscle
4. Tenor veli palatini
5. Tensor tympani muscle

Question 13

What does V3 divide into

Answer 13

the anterior and posterior trunks

Question 14

Describe the anterior trunk of V3

Answer 14

It is predominantly muscular

Question 15

Describe the posterior trunk of V3

Answer 15

Mainly sensory

Question 16

What does the anterior trunk of V3 give rise to

Answer 16

The motor branches supplying the masticatory muscles

Question 17

Which key nerve originates fro the anterior trunk of v3

Answer 17

The long buccal nerve

Question 18

Describe the path of the inferior alveolar nerve

Answer 18

1. Branches from the mandibular nerve below the foramen ovale passing down between the lateral and pterygoid muscles
2. Enters the mandibular foramen along with its artery

Question 19

What is the mandibular foramen shielded by

Answer 19

By lingula

Question 20

Describe lingula

Answer 20

Formed as a pointed and thin bony spicule

Question 21

What is the lingula

Answer 21

It is the lower attachment point of the sphenomandibular ligament which extends from the sphenoid bone to the ramus.

Question 22

What is the mandibular nerve supply

Answer 22

The pulps of all the teeth of its own side and part of the periodontal ligament

Question 23

Name a key brach of the inferior alveolar nerve

Answer 23

Th mental nerve

Question 24

Where does the metal nerve go after branching from the inferior alveolar nerve

Answer 24

Exits through the metal foramen

Question 25

Where is the metal foramen located

Answer 25

Usually located at the apices of the premolars

Question 26

What does the mental nerve supply

Answer 26

It supplies sensation to the skin of the chin, lower lip, mucosa of the lp and gingival attachment

Question 27

Name the largest branch of the posterior trunk of V3

Answer 27

Lingual nerve

Question 28

Where does the lingual nerve emerge from

Answer 28

Emerges from the between the 2 pterygoid muscles about 1cm in from of and medial to the inferior alveolar nerve

Question 29

Talk through the path the lingual nerve takes

Answer 29

1. Emerges from the pterygoid muscles
2. After leaving the inferior alveolar nerve it is joined by chorda tympani
3. Runs downwards across the medial ptergoid
4. enters the mouth by passing under the lower border of the inferior constrictor of the pharynx

Question 30

What does the lingual Neve supply

Answer 30

It is the sensory nerve to the:

1. anterior 2/3rd of the tongue
2. Floor of the mouth
3. Lingual aspect of the mandible

Question 31

What is the chorda tympani

Answer 31

It carries both the sensory from the geniculate ganglion and pregangionic parasympathetic nerve fibres

Question 32

If we are going to carry out exodontia or minor oral surgery on mandibular teeth which nerves MUST we anaesthetise

Answer 32

1. Inferior alveolar nerve or mental nerve
2. Long buccal nerve
3. Lingual nerve