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Final W2015 Flashcards

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0
Q

Structure type of all anesthetics

A

Tertiary amines

Two types: ester and amide

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1
Q

Which channel do anesthetics block in the nerve membrane?

A

Na

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2
Q

What physical characteristic is used to determine the dose of LA?

A

Lean body mass- receives most of the LA that makes it into the blood stream

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3
Q

Which three tissues metabolize LA?

A

Kidney, lung, liver

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4
Q

Half life of lidocaine

A

1.6 hrs

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5
Q

Half life of mepivicaine

A

1.9 hrs

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6
Q

Half life of bupivicaine

A

3.5 hrs

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7
Q

Which enzyme hydrolyzes ester LA

A

Plasma pseudocholinesterase

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8
Q

Amides are metabolized in which organ?

A

The liver

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9
Q

Which LA can cause sedation?

A

Lidocaine

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10
Q

A metabolite of which LA can cause methemoglobinemia?

A

Prilocaine

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11
Q

Which LA can be absorbed in the gastrointestinal system?

A

Cocaine

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12
Q

Which LA produces vasoconstriction?

A

Cocaine

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13
Q

What is the primary effect of LA on the CNS?

A

Sedation

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14
Q

How can LA cause convulsions/seizures?

A

By inhibiting the areas of the brain that inhibit seizures

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15
Q

Which LA can cause sedation at normal levels in some normal patients?

A

Lidocaine

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16
Q

Which three LA can produce ventricular fibrillation?

A

Bupivicaine, etidocaine, ropivicaine

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17
Q

The maximum dose of epinephrine for a healthy patient

A

0.2 mg

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18
Q

The maximum dose of epinephrine for a medically compromised patient?

A

0.04mg

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19
Q

Which artery is of main concern?

A

Inferior alveolar

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20
Q

Which veins are of major concern?

A

Pterygoid plexus arteries

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21
Q

Name the nerves of cutaneous innervation of V2 (3)

A

Zygomaticotemporal
Zygomaticofacial
Infraorbital

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22
Q

Name the cutaneous nerves of V3

A

Auriculotemporal
Buccal
Mental

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23
Q

What does the Infraorbital nerve innervate?

A

Soft tissue of the front of the face

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24
Which nerves innervate the maxillary teeth?
Posterior, middle, and anterior superior alveolar nerves of V2
25
Which nerves innervate the mandibular teeth?
Inferior alveolar and mental nerves
26
What is the rate of a slow injection?
1min/1carpule
27
How much of a nerve do you need to cover with anesthetic to stop saltatory conduction?
8-10mm
28
How does the pka of an LA affect its efficacy?
The lower the pka, the faster the LA
29
What preservative is added to LA to preserve the epi?
Sodium bisulfite
30
What effect does sodium bisulfite have on LA efficacy?
It acidifies it, causing it to work more slowly
31
Which teeth can be singly anesthetized by supraperiostial injections?
Maxillary incisors and back to the MB root of the first molar
32
Amount of anesthetic used in a supraperiostial injection
1/2-3/4 carpule
33
What vessels do you need to avoid when doing a PSA?
Pterygoid plexus
34
Depth of the needle in a PSA
16mm
35
Amount deposition in a PSA
3/4 carpule
36
Tissues anesthetized in a PSA
Pulp of molars except MB 1st Alveolar bone Soft tissues buccal side
37
MSA site of injection
Depth of vestibule above premolars
38
Tissues anesthetized MSA
Premolars, MB1st molar, gingiva and buccal mucosa
39
Amount to deposit MSA
3/4-1 carpule
40
Tissues anesthetized by ASA
Pulp- midline to premolars Gingival Buccal soft tissue
41
Where to inject the ASA
Depth of vestibule over the first premolar
42
How much LA ASA?
3/4-1 carpule
43
Amount of LA to inject- Infraorbital
3/4-1 carpule
44
How do you know when you reach the right spot for an Infraorbital block?
Keep your finger over the io canal. Touch bone with the needle.
45
IO amount to inject
3/4-1 carpule
46
Which two max injections are essentially the same?
Infraorbital and ASA
47
For a greater palatine injection, insert the needle just () to the foramen
Anterior
48
Which palatine injection can be made less painful through a 3 step process?
Nasopalatine
49
Amount to deposit Nasopalatine
1/4-1/2 carpule
50
Amount to deposit palatal infiltration
1/4 carpule
51
Issues anesthetized by AMSA
Anterior teeth, palate, and gingiva to midline | Not the lip
52
Amount to inject AMSA
1/2 carpule
53
Depth of penetration lingual nerve injection
5mm
54
Amount to deposit lingual injection
1/4-1/2 carpule
55
How do you find the depth of penetration for the mandibular injection after you have given the lingual injection?
Proceed until you contact bone. Back off 1mm. Aspirate and inject
56
IA and lingual nerve block area anesthetized
Anterior 2/3 tongue and FOM Mandibular teeth on that side Buccal mucosa anterior to mental foramen Bone
57
Depth of insertion IA block
Should feel bone 20-25mm in
58
Depth of insertion buccal block
Just into mucosa
59
Amount to inject buccal block
1/4-1/2 carpule
60
Mental/incisive amount to inject
1/2 carpule
61
How to find injection location for mental/incisive block
Put finger over mental foramen | Depth of vestibule
62
Which teeth can be anesthetized with a mandibular infiltration
Incisors only
63
How much drug is in 2%
36mg
64
How much drug is in 3%
54 mg
65
How much drug is in 4%
72mg
66
Bony target of the how gates
Condylar head
67
Amount to inject how gates
3/4-1 carpule
68
Nerves anesthetized with a how gates
Mandibular Lingual Buccal Auriculotemporal
69
What must the patient do for a successful gow gates?
Open fully and hold
70
Why can't you do an infiltration of maxillary molars?
The maxillary buttress has thick cortical bone
71
What nerve would you anesthetize to biopsy the soft palate?
The lesser palatine
72
The difference between the mandibular nerve blocks in adults and children
Children is at occlusal plane | Adults is above the occlusal plane
73
Duration of 3% mepivicaine infiltration
5-10 min
74
Duration of 3% mepivicaine nerve block
20-40 min
75
Duration of 4% Prilocaine infiltration
10-15 min
76
Duration of 4% Prilocaine nerve block
40-60 min
77
Duration of 0.5% bupivicaine infiltration
60 min
78
Duration of .5% bupivicaine nerve block
Up to 12 hours
79
Calculate the max dose of anesthetic
Multiply the max dose per kg by your pt in kg= max dose mg | Divide by mg/carpule= # of carpules you give
80
Most common size of anesthesia needle to break?
30 gauge, some 27
81
Most common nerve to experience parasthesia
Lingual or mandibular
82
Sign that patient may experience parasthesia- don't inject
A shock is felt as the needle goes in
83
Most common muscle to experience this us
Medial pterygoid
84
Most common injections resulting in trismus
IA nerve block, PSA, akinosi
85
Treatment of trismus
Heat, NSAIDS
86
Which injection should not be done on patients who take anticoagulant meds?
IA block
87
Indicators not to give the IA block
``` INR <50 sec hemophilia Liver disease XS anti platelet meds Chemo pt ```
88
Anti platelet drugs to watch for (4)
Coumadin Aspirin Dabigatran Clopidogrel
89
Hematoma treatment
Pressure, cold packs
90
What two ingredients can cause an allergic rxn?
Na bisulfite and esters
91
Treatment of post injection ulceration
Chlorhexidine and pain meds- heals in a couple weeks
92
Which distance was the same in all people?
From the rap he to the IA foramen 21mm

Anesthetics (1 decks)

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