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Cranio Exam 2 > Local Anesthetic Technique > Flashcards

Local Anesthetic Technique Flashcards

1
Q

MSA nerve in V2 is present —% of time

A

28%

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2
Q

ASA of V2 provides pulpal innervation to

A

central and lateral incisors
canine
PDL, buccal bone, mucous membrane of teeth

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3
Q

3 major types of local anesthesia

A
  1. local infiltration
  2. field block
  3. nerve block
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4
Q

where is the foramen rotundum?

A

pterygopalatine fossa

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5
Q

landmark for posterior superior alveolar nerve block

A
  • mucogingival sulcus
  • maxillary tuberosity
  • zygomatic process of maxilla

*insert needle at height of vestibule (16 mm depth)

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6
Q

PSA nerve block anesthetizes what?

A

maxillary molar tooth pulps
mesiobuccal root of 1st molar in 72%
buccal periodontium and bone

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7
Q

advantages of PSA nerve block

A
  • atraumatic
  • success rate >95%
  • minimal volume of anesthetic
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8
Q

PSA nerve block disadvantages

A
  • disfiguring hematoma risk
  • mesiobuccal root of 1st molar missed in 28%
  • aspiration rate about 3%
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9
Q

MSA anesthetizes what area

A

alveolar mucous membrane of premolars
mesiobuccal root of first molar 28% of time
buccal periodontium and bone

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10
Q

MSA nerve block landmark

A
  • depth of mucogingival sulcus above the maxillary second premolar
  • inject above premolar apices
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11
Q

anterior superior alveolar nerve areas anesthetized

A

through infraorbital nerve foramen

  • maxillary central through canine
  • premolars
  • mesiobuccal root of first molar in 28% of patients
  • buccal periodontium and bone
  • lower eyelid, side of nose, upper lip
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12
Q

indications of ASA nerve block

A
  • procedures on two or more teeth
  • inflammation or infection
  • dense cortical bone making supraperiosteal injections ineffective
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13
Q

maxillary labial bone is —

A

porous

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14
Q

supraperiosteal injection indications

A
  • procedures on one tooth

- soft tissue surgery in small area

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15
Q

advantages of local infiltration

A

simple

high success rate

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16
Q

disadvantages of local infiltration

A

not as useful in setting of abscess

slightly more volume needed to treat multiple teeth

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17
Q

in order to do a greater palatine nerve block, you have to —

A

contact bone

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18
Q

landmarks of greater palatine nerve block

A
  • greater palatine foramen

- junction of maxillary alveolar process and palatine bone adjacent to the maxillary first molar

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19
Q

areas anesthetized by greater palatine nerve block

A
  • posterior portion of hard palate
  • overlying soft tissues
  • no anesthesia of teeth
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20
Q

greater palatine nerve block indications

A
  • when palatal soft tissue anesthesia is needed –extractions, subgingival rest
  • putting on rubber dam for restoration
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21
Q

landmarks for nasopalatine nerve block

A
  • central incisors

- incisive papilla (lateral to papilla)

22
Q

areas anesthetized by nasopalatine nerve block

A
  • anterior portion of hard palate
  • both hard and soft tissues
  • no anesthesia of teeth
23
Q

indications of nasopalatine injection

A
  • when palatal soft tissue anesthesia is needed
  • pain control during periodontal or oral surgery
  • application of rubber dam
24
Q

buccal nerve is sensory to

A

molar buccal gingiva

25
buccal nerve block landmarks
- mandibular molars | - mandibular buccal vestibule/mucogingival sulcus
26
tissues anesthetized by buccal nerve block
- gingiva buccal to molars - retromolar pad mucosa - buccal mucosa in molar area - NO hard tissues anesthetized
27
largest branch of posterior division of mandibular nerve
inferior alveolar nerve
28
landmarks for inferior alveolar nerve block
- coronoid notch - pterygomandibular raphe - occlusal plane of the mandibular posterior teeth
29
for inferior alveolar nerve block, place the syringe at the level of?
coronoid notch across arch
30
inferior alveolar nerve block---penetration lateral to -->
pterygomandibular raphe
31
nerves anesthetized by inferior alveolar nerve block
- inferior alveolar - incisive - mental - lingual
32
disadvantages of inferior alveolar nerve block
- wide area anesthetized - unsuccessful in 15-20% of pts - inconsistent oral landmarks - 10-15% positive aspiration
33
alternatives to inferior alveolar nerve block
- mental nerve block - incisive nerve block - gow-gates block - vazirani-akinosi block - intraosseous or intraseptal injection
34
landmarks of mental nerve block
- mandibular premolars | - mandibular vestibule
35
areas anesthetized by mental nerve block
- mucosa anterior to foramen - skin of lower lip - chin - anterior mandibular teeth (incisive branch of IAN)
36
incisive nerve supplies--
incisors, canine, premolars
37
incisive nerve block areas anesthetized
- mucosa on buccal - lower lip - skin of chin - premolars, canines, incisors
38
indications of incisive nerve block
- procedures on anterior teeth - when inferior alveolar block is not indicated - to avoid bilateral mandibular blocks
39
advantages of incisive nerve block
- provides pulpal and hard tissue anesthesia without lingual anesthesia - high success rate
40
disadvantages of incisive nerve block
- no lingual anesthesia | - may be sensory overlap and midline (rare)
41
lingual nerve innervates ---
anterior 2/3 of tongue
42
lingual nerve blocked with:
- inferior alveolar nerve block (halstead) - gow-gates mandibular block - vazirani-akinosi block - infiltration in lingual sulcus
43
gow gates nerve block
true mandibular nerve block | needle contacts neck of condyle
44
landmarks for gow gates nerve block
-extraoral: lower border of tragus (intertragic notch) corner of mouth -intraoral: height of injection established by placement of needle tip just below the mesiopalatal cusp of maxillary second molar
45
nerves anesthetized by gow gates nerve block
-inferior alevolar -lingual -mylohyoid auriculotemporal buccal
46
disadvantages of gow gates nerve block
- longer onset, >5 mins | - no intraoral landmarks
47
vazirani-akinosi nerve block landmarks
- mucogingival junction of maxillary third (or second) molar - maxillary tuberosity - coronoid notch on mandibular ramus
48
height of vazirani-akinosi nerve block
in between gow gates and standard at maxillary muco-gingival line directly parallel to ramus
49
depth of vazirani-akinosi nerve block
25 mm
50
nerves anesthetized by vazirani-akinosi nerve block
- inferior alveolar - lingual - mylohyoid
51
advantages of vazirani-akinosi nerve block
- atraumatic - no need to open mouth - aspiration rate < 10 %
52
disadvantages of vazirani-akinosi nerve block
- difficult visualization - no bony contact - arbitrary insertion depth

Cranio Exam 2 (11 decks)

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