Oral Landmarks for Local Anaesthesia Flashcards Preview

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Flashcards in Oral Landmarks for Local Anaesthesia Deck (35)
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What different types of anaesthesia are used in extractions and restorations/periodontal treatment

- Extractions - All nerves supplying the area need to be anaesthetised. Main supply plus all accessory nerves
- Restoration/periodontal treatment - usually sufficient to block main nerve supply.


What cranial nerve needs to be anaesthetised for dental treatment

Trigeminal - Ophthalmic, Maxillary and Mandibular branches


What are the three different parts of the trigeminal nucleus and what branch does each give rise to

Mesencephalic - Mandibular
Principal - ophthalmic
Spinal - Maxillary


Where do the branches of the trigeminal nerve go through (might be the termination points but i doubt it)

Ophthalmic - Superior Orbital Fissure
Maxillary - Foramen Rotundum
Mandibular - Foramen Ovale


What is the largest cranial nerve



What are the features of infiltration anaesthesia and where is it used

- Act locally to provide good LA
- Effective on local soft tissues
- Act on teeth where bone is reasonably thin
- Used for maxillary teeth
- Mandibular anterior teeth


Where is the nasopalatine nerve branch of the maxillary branch found

At the front of the hard palate, includes the rugae and dat.


Where is the greater palatine nerve branch of the maxillary branch found

On the left and right of the hard palate (and a bit of the soft palate).


What nerve branches innervate the maxillary teeth

Ant. Sup. alveolar n. = 1, 2 and 3
Mid. Sup. alveolar n. = 4 and5
Post. Sup. alveolar n. = 6, 7 and 8


Where are the pterygoid plexus of veins in danger when using anaesthesia

Posteriorly to upper second molars, danger to the pterygoid plexus of veins buccally.


How would you apply topical anaesthesia

- Dispense a pea sized amount of topical anaesthetic - Use a cotton pledget or cotton roll to pick up topical
- Clean and dry the mucosa before applying the topical
- Retract the lip and apply the gel to the injection site.


What do you do before put the needle in

• Retract
• Pull mucosa
• Patient mouth
partially open


Whats the difference between an infiltration and regional block

Infiltration = one branch of nerve
Regional = main source of nerve branches, so all branches are blocked


What are some of the branches of the mandibular branch

Inferior alveolar


On the ramus of the mandible what nerve runs inferiorly to the inferior alveolar nerve

the lingual nerve


What is the pterygomandibular raphe

The pterygomandibular raphe (pterygomandibular ligament) is a ligamentous band of the buccopharyngeal fascia, attached superiorly to the pterygoid hamulus of the medial pterygoid plate, and inferiorly to the posterior end of the mylohyoid line of the mandible.


In an inferior alveolar nerve block (IANB) what nerves are affected

Nerves affected: Inferior alveolar nerve, mental nerve


What is the injection site of an IANB

Mandibular foramen (difficult to locate)


What tissues are anaesthetised in an IANB

all mandibular teeth (pulps and periodontal ligaments); skin of chin, labial mucosa, lower lip


What is a hazard of an IANB

Hazards: parotid gland (anesthetizes facial nerve)


What is lateral, medial and inferior, superior and anterior to the pterygomandibular space

Lateral = ramus
Medial + Inferior = medial pterygoid muscle
Superior - lateral pterygoid
Anterior - buccinator


What can happen if you inject the LA into the parotid gland instead of an IANB

- Facial nerve (traverses the parotid gland)
- Hemifacial paresis (facial nerve palsy)
- Unable to close their eyelids on affected side
- Paralysis will resolve as the effect of the anaesthetic wears off.
- The eye must be protected until motor function is restored.


What can be done to reduce the chances of the LA entering the parotid gland

Ensuring the needle has contacted bone prior to administration of an inferior alveolar nerve block should reduce the chances of entering the parotid gland.


What is the injection site for a buccal nerve block

The retromolar fossa


What tissues are anaesthetised in a buccal nerve block

Skin and mucous membrane of cheek, buccal alveolar mucosa and gingivae of molars (on side of injection).


What nerves are blocked in a mental block

Nerves Affected:
Mental n. and anterior part of inf. alveolar n.


What is the injection site for a mental nerve block

Mental foramen


What tissues are anaesthetised in a mental nerve block

mandibular incisors and canine (pulps, perio. lig. and bone), labial gingiva, skin of chin.


What is the injection site of the lingual nerve block

Anterior and deep into inferior alveolar site


What tissues are anaesthetised in a lingual nerve block

Mucosa of ant. 2/3 of tongue, floor of mouth, lingual alveolar mucosa and lingual gingiva all teeth (on side of injection).