Local anaesthetics 1

Question 1

What is the definition of anaesthesia?

Answer 1

State of controlled, temporary loss of sensation or awareness induced for medical purposes

Question 2

What is the definition of general anaesthesia?

Answer 2

Suppresses central nervous system
Consciousness is lost, total lack of sensation

Question 3

What is the definition of sedation?

Answer 3

Suppresses CNS to a lesser degree than GA, inhibiting anxiety and creation of long term memory

Question 4

What is the definition of local anaesthesia?

Answer 4

Block transmission of nerve impulse
Loss of sensation in specific areas of the body

Question 5

Which sensory nuclei does the trigeminal nerve arise from?

Answer 5

• principal sensory
• spinal
• mesencephalic

Question 6

Where does the opthalmic nerve come out from onto the face?

Answer 6

Superior orbital fissure

Question 7

Where does the maxillary nerve come out from onto the face?

Answer 7

Foramen rotundum

Question 8

Where does the mandibular nerve come out from onto the face?

Answer 8

Foramen ovale

Question 9

Which branch of the trigeminal nerve is also motor?

Answer 9

Mandibular nerve

Question 10

What does the trigeminal nerve supply?

Answer 10

Predominantly supplies the sensory distribution to the oro-facial tissues

Question 11

What 3 branches does the ophthalmic nerve split into?

Answer 11

• frontal- supraorbital, supratrochlear
• nasociliary- long ciliary, short ciliary, nasal, ethmoidal
• lacrimal

Question 12

What structures does the ophthalmic nerve supply on the face?

Answer 12

• upper eyelid and associated conjuctiva
• eyebrow
• forehead
• scalp to lambdoid structure

Question 13

What structures does the ophthalmic nerve supply on the skull?

Answer 13

• roof of orbit
• frontal, ethmoid, sphenoid sinus

Question 14

What structures does the ophthalmic nerve supply to the eye?

Answer 14

• intraocular structures, eg. cornea
• lacrimal gland and sac

Question 15

What does the maxillary branch supply?

Answer 15

• skin of lower eyelid
• prominence of cheek
• lateral part of nose
• part of temple
• upper lip
• inferior posterior portion of nasal cavity
• upper teeth
• palate mucosa
• buccal gingiva

Question 16

What does the maxillary branch split into?

Answer 16

• meningeal
• zygomaticus- zygomaticofacial and zygomaticotemporal
• greater and lesser palantine
• nasopalatine
• posterior superior alveolar nerve
• pharyngeal
• infraorbital- anterior superior alveolar nerve and middle superior alveolar nerve

Question 17

What are the branches of the mandibular nerve?

Answer 17

• lingual, buccal, auriculotemporal
• inferior alveolar- mental, nerve to mylohoid
• other motor branches

Question 18

What does the motoric mandibular nerve supply anteriorly?

Answer 18

• masseter
  medial and lateral pterygoid
• tensor tympani
• tensor veli palatini
• temporal

Question 19

What does the motoric mandibular nerve supply posteriorly?

Answer 19

• mylohyoid
• anterior belly of digastric

Question 20

What does the sensoric branch of the mandibular nerve supply?

Answer 20

• buccal mucosa
• mucoperiosteum of lower teeth
• anterior 2/3rd of tongue
• chin
• lower lip
• auricular
• temporal region of scalp

Question 21

For an ID block which nerve do we numb?

Answer 21

Inferior alveolar nerve

Question 22

Which areas are numb for an ID block?

Answer 22

• lower molars ipsilateral
• ipsilateral half of lip
• ipsilateral half of tongue

Question 23

Where is LA depot placed for an ID block?

Answer 23

Pterygomandibular space

Question 24

What is the medial/inferior border of pterygomandibular space?

Answer 24

medial pterygoid muscle

Question 25

What is the lateral border of pterygomandibular space?

Answer 25

Medial surface of the ramus

Question 26

What is the anterior border of the pterygomandibular space?

Answer 26

Pterygomandibular raphe and insert fibres of buccinator

Question 27

What is the superior border of the pterygomandibular space?

Answer 27

Lateral pterygoid muscle

Question 28

Which nerve is numb in long buccal nerve block?

Answer 28

- buccal nerve

Question 29

Which areas are numb in long buccal nerve block?

Answer 29

Soft tissue on buccal side in mandibular molar region

Question 30

Where is LA depot placed in long buccal nerve block?

Answer 30

- disto buccally of last molar in mucous membrane

Question 31

Which areas are numb in a mental block?

Answer 31

- chin - lower lip - labial gingiva of/and premolars/anterior teeth

Question 32

Where is LA depot placed in mental block?

Answer 32

- base of buccal sulcus between lower 4 and 5

Question 33

Which areas are numb and where is LA placed for a supplementary lingual nerve block?

Answer 33

- lingual tissue - lingual mucosa surrounding teeth to be extracted

Question 34

What is the supplementary incisive nerve infiltration?

Answer 34

- due to cross over nerve fibres in mandibular symphysis region - areas that are numb are buccal tissue of lower anterior teeth - LA is placed on lingual mucosa surrounding teeth to be extracted

Question 35

Which nerve do we numb for buccal infiltration for maxillary teeth?

Answer 35

- anterior superior alveolar nerve- incisors/canine - middle superior alveolar nerve- premolars - posterior superior alveolar nerve- molars

Question 36

Which teeth does the nasopalatine nerve supply?

Answer 36

Incisors and canine - each tooth has own branch

Question 37

Which teeth does the greater palatine nerve supply?

Answer 37

premolars to molars - each tooth has own branch

Question 38

What should you be careful about when injecting 2nd molar palatally?

Answer 38

- proximity of lesser palatine nerve - anaesthesia of soft palate if injecting distally of 2nd molar - swallowing difficulties and great distress

Question 39

What are the 3 methods for placing LA for palatal anaesthesia of maxillary teeth?

Answer 39

- palatal infiltration - nasopalatine block - greater palatine nerve block