Unit 313 Flashcards
1
Q
What are the components of a local anaesthetic cartridge?
A
Water - liquid volume
Buffering agent - maintains a neutral PH
Preservative - allows storage
Vasoconstrictor - constricts the blood vessels
Anaesthetic - blocks nerve signals to the brain
2
Q
Usual ratio of adrenaline in local anaesthetic
A
1:80,000
3
Q
What component of local anaesthetic should not be used for pregnant patients?
A
Felypressin - brings on labour
4
Q
Nerve supply to the upper 1s, 2s and 3s
A
Anterior superior dental nerve
5
Q
Nerve supply to the upper 4s, 5s and mesiobuccal root of the 6s
A
Middle superior dental nerve
6
Q
Nerve supply to the upper distobuccal root of the 6s, 7s and 8s
A
Posterior superior dental nerve
7
Q
Nerve supply to the front of the soft palate (1s, 2s and 3s)
A
Nasopalatine nerve
8
Q
Nerve supply to the back of the palate (4s, 5s, 6s, 7s and 8s)
A
Greater palatine nerve
9
Q
Nerve supply to the back of the hard palate (behind the teeth)
A
Lesser palatine nerve
10
Q
Nerve supply to all lower teeth
A
Inferior dental nerve
11
Q
Nerve supply to the floor of the mouth and 2/3 of the tongue
A
Lingual nerve
12
Q
Nerve supply to the buccal of the lower 6s, 7s and 8s
A
Long buccal nerve
13
Q
Nerve supply to the labial gingivae of the lower anterior teeth, lips and chin
A
Mental nerve
14
Q
What is a foramen
A
A hole in the bone where the nerves and blood vessels can pass through
15
Q
Signs of a partially blocked airway
A
Wheezing
Coughing
Red face
16
Q
Signs of a fully blocked airway
A
Cyanosis
Collapsing
Grasping at the neck
17
Q
Symptoms of a fully blocked airway
A
Panic
Unable to cough
18
Q
What should you do if someone has a blocked airway
A
Encourage them to cough
If this does not work, administer 5 back blows and 5 abdominal thrusts
Call 999
19
Q
Signs of anaphylactic shock
A
Swelling of the face
Rash
Rapid, weak pulse
20
Q
Symptoms of anaphylactic shock
A
Breathing difficulty
Feeling faint
Nausea
21
Q
What should you do if someone is in anaphylactic shock
A
Administer adrenaline 1:1000 and call 999
22
Q
Signs of a grand mal seizure
A
Unconsciousness
Rigid limbs
Convulsions
23
Q
Symptoms of a grand mal seizure
A
Possible aura beforehand
Halt in breathing
24
Q
Signs of a petit mal
A
Dazed
In a world of their own
25
Symptoms of a petit mal
Daydreaming
| Feeling spaced out
26
What should you do if someone is having an epileptic seizure
Time the seizure
Administer buccal midazolam
Call 999 if its been over 5 minutes, if it is their first seizure or if they fall in and out of seizures
27
What medication can cause gingival hyperplasia
Epanutin
28
What medication reverses midazolam
Flumazenil
29
Signs of an angina attack
Pale, clammy skin
| Irregular pulse
30
Symptoms of an angina attack
Crushing pain in the chest and left arm
| Unable to catch breath
31
What should you do if someone is having an angina attack
Administer GTN spray sublingually - 2 sprays - 0.4mg
| Call 999
32
Signs of a myocardial infarction
Cyanosis
Grey pallor
Collapsing
33
Symptoms of a myocardial infarction
Severe pain
| Vomiting
34
What should you do if someone is having a myocardial infarction
Try GTN spray
Administer aspirin 300mg
Call 999
35
Signs of cardiac arrest
No pulse
Loss of consciousness
No breathing
36
What should you do if someone is having a cardiac arrest
Call 999
| Perform CPR
37
Signs of hypoglycaemia
Pale, clammy skin
Trembling
Slurred speech
38
Symptoms of hypoglycaemia
Sweating
| Blurred vision
39
What should you do if someone is hypoglycaemic
Offer a sugary drink or tablet if conscious and administer glucogel
Administer glucagon 1mg injection if unconscious
40
Signs of a vasovagal syncope
Pale, clammy skin
| Weak, thready pulse
41
Symptoms of a vasovagal syncope
Nausea
Tunnel vision
Tiredness
42
What to do if someone is having a vasovagal syncope
Lay them back with their feet higher than their head - restore blood flow to the brain
Give a sugary drink or tablet if conscious
Administer glucogel
43
Name of oral cancer
Squamous cell carcinoma
44
Signs of clinical shock
Pale, clammy skin
| Rapid pulse
45
Symptoms of clinical shock
Nausea
| Confusion
46
What to do if someone is in clinical shock
Call 999
| Do not let them eat or drink
47
Premalignant patches
Leukoplakia (white)
| Erythroplakia (Red)
48
Herpes labialis
Cold sores
49
Herpes varicella
Chicken pox
50
Zoster virus
Shingles
51
Non premalignant white patches
Lichen planus
52
What is mumps caused by
Parotitis - swelling of the parotid salivary gland
53
What is a mucocele
Minor salivary gland cyst
54
What are analgesics
Pain killers
55
What are antibiotics
Treat bacterial infections
56
What are anticonvulsants
Control epileptic fits
57
What are sedatives
Reduce anxiety/depression
58
Systolic number for a health adult
120 - pressure of the blood leaving the heart
59
Diastolic number for a healthy adult
80 - pressure of the blood in the arteries when the heart is not beating
60
Masseter - origin and insertion points
Originates at the zygomatic arch
| Inserts at the ramus
61
Temporalis - origin and insertion points
Originates at the temporal bone
| Inserts at the coronoid process
62
Medial pterygoid - origin and insertion points
Originates at the back of the maxilla - medial pterygoid plate
Inserts at the angle
63
Later pterygoid - origin and insertion points
Originates at the back of the maxilla
| Inserts at the condyle neck
64
Muscles of facial expression
Orbicularis oris - encircles the mouth
Orbicularis oculi - encircles the mouth
Buccinator - pushes food onto the posterior teeth
65
What are the components of saliva
98% water
Proteins
Enzymes
Inorganic ions
66
What duct does the submandibular gland secrete saliva through
The whartons duct
67
What duct does the parotid gland secrete saliva through
The stensons duct
68
What duct does the sublingual gland secrete saliva through
18-22 ducts - Rivinus ducts
69
What are the two signs that should prompt a rescuer to begin BLS?
Unconsciousness and abnormal breathing
70
What does asystole mean?
The heart has stopped beating
71
What does fibrillating mean?
The heart is beating in effectively
72
What is an increased rate of respiration?
Faster than 20 breaths per minute
73
What is an increased heart rate?
Faster than 100 beats per minute
74
What is a falling blood pressure?
Systolic reading below 90
75
What is the ABCDE approach?
Airway, breathing, circulation, disability, exposure
76
What is the aim of BLS?
To maintain the flow of oxygenated blood around the casualty’s body until they recover, specialists arrive, the rescuer is too exhausted or the death of the casualty
77
After how long will the brain cells suffer irreversible damage without oxygen?
3-4 minutes
78
What does DRSABC stand for?
Danger, response, shout for help, airways, breathing, circulation
79
What does ACVPU stand for?
Alert, confused, verbal, pain, unresponsive
80
When should you not perform head tilt, chin lift?
If the casualty is suspected of having a spinal/neck injury
81
How long do you assess a casualty’s breathing for?
10 seconds
82
What is the normal rate of breathing?
12-20 breaths per minute
83
What does gasping or stridor (high pitched inspirations) indicate?
Upper airway is blocked
84
What does snoring indicate?
Semi conscious or unconscious casualty who is laying flat due to the tongue falling back
85
What does gurgling and rattling indicate?
Presence of fluid in the airway
86
What does wheezing indicate?
Narrowed bronchi and bronchioles (often during an asthma attack)
87
What is the log roll technique?
Rolling a casualty with suspected spinal/neck injury onto their back keeping their head in line with their neck
88
How many chest compressions per minute should be carried out?
100
89
How deep should the chest be compressed during BLS?
4-5cm
90
How much oxygen is in expired air?
16%
91
What is the most common problem during rescue breathing?
The chest does not lift when the breath is being given
92
What is being done if the abdomen is rising during a rescue breath?
The breath is too forceful or prolonged
93
How long should a lone rescuer perform BLS for before going to call for specialist help for a child?
1 minute
94
What side should an unconscious pregnant woman be laid on?
Left side
95
What blood vessels are squashed when a pregnant woman is laying on her back?
Inferior vena cava
96
Why should you place someone into the recovery position?
So that the tongue does not fall to the back of the mouth and any liquids can drain out of the mouth
97
Why are the maxilla bones hollow?
They would be too heavy to lift the head if they were solid
98
What is the name of the region where the two halves of the maxilla meet?
The intermaxilliary suture
99
What is the back end of each alveolar process called?
The maxillary tuberosity
100
When can the maxillary tuberosity be fractured?
During difficult upper wisdom tooth extractions
101
What is the name of the area where the 2 halves of the mandible join?
The mental symphysis
102
What is the vertical section of the mandible called?
The ramus of the mandible
103
What is the horizontal section of the mandible called?
The body of the mandible
104
What is the junction called where the body and ramus meet?
The angle
105
What type of joint is the TMJ?
A hinge joint
106
Where does the TMJ and the mandible meet?
At the head of the condyle
107
What does the alveolar process do?
Supports the lower teeth
108
Where does the condyle rest when the mouth is shut?
In the glenoid fossa
109
What does the front edge of the glenoid fossa form into?
The articular eminence
110
What disc prevents the two bones grating against eachother?
The meniscus disc
111
What is subluxation?
When the meniscus slips in front or behind it’s position causing clicking
112
How does the mouth open?
The condyle slides from the glenoid fossa to the crest of the articular eminence
113
What is trismus?
Involuntary painful contraction of the TMJ
114
Other than the TMJ, what can cause trismus?
Pericoronitis, after surgical extraction of lower wisdom teeth and during mumps
115
What do the suprahyoid muscles do?
Allow mouth opening and swallowing
116
What is trigeminal neuralgia?
A condition affecting the sensory nerves of the maxillary or mandibular divisions of the trigeminal nerve
117
What is Bells Palsy
Temporary paralysis of the facial nerve
118
What is a combination nerve?
A nerve carrying both sensory and motor fibres
119
What are the major arteries carrying oxygenated blood to the head and neck called?
Common carotid arteries
120
What does the external carotid artery supply?
The outside of the cranium including the face and oral cavity
121
What does the internal carotid artery supply?
The inner cranial structures including the brain and the eyes
122
Why is it easier for localised infections to spread to the head and neck?
Because the flow of deoxygenated blood is not always in one direction due to the veins not having a one way valve system
123
What arteries supply blood to the teeth?
The carotid arteries
124
What arteries supply blood to the tongue?
The lingual artery
125
What artery supplies blood to the upper teeth?
The maxillary artery
126
What artery supplies blood to the lower teeth?
The inferior alveolar artery
127
Where is the lining membrane found?
The inner surfaces of the checks and lips, floor of the mouth, underside of the tongue and soft palate
128
Where is the masticatory membrane found?
Covering the gingivae, topside and edges of the tongue and the hard palate
129
Where is the specialised membrane found?
Interspersed throughout the masticatory membrane on the top side and edges of the tongue
130
What does the lining membrane do?
Provides a physical barrier between anything entering the mouth and the deep structures of the oral cavity
131
What does the masticatory membrane do?
Provides a hard wearing surface that prevents traumatic damage from food, chemicals etc
132
What does the specialised membrane do?
Provides taste sensation
133
What does the soft palate do?
Seals off the oral cavity from the nasal cavity during swallowing
134
Correct term for swallowing
Deglutition
135
Why are drugs often administered sublingually?
It has a thin lining epithelium of mucous membrane
136
What is the correct term for inflammation of the tongue?
Glossitis
137
What causes glossitis?
Iron and vitamin B deficiency
138
What does glossitis look like?
Smooth, red glazed appearance of the tongue
139
What is dysphagia?
Difficulty swallowing
140
Name of mineral crystals and percentage of them in enamel
96% calcium hydroxyapatite
141
What happens to the enamel when it comes into contact with fluoride?
Hydroxyapatite crystals turn into fluorapatite crystals - more resistant to acid attacks
142
Name of mineral crystal and percentage of them in dentine
80% calcium hydroxyapatite crystals
143
What are the nerve endings called in dentine?
Fibrils
144
Name of mineral crystals and percentage of them in cementum
65% calcium hydroxyapatite crystals
145
Number of cusps on premolars
2
146
Number of cusps on permanent first molars
5 (palatal cusp of carabelli)
147
Number of cusps on permanent second molars
4
148
Number of cusps on deciduous first molars
4
149
Number of cusps on deciduous second molars
5
150
Name of the outer surface of the alveolar bone
Lamina dura - hard and compact
151
Name of the inner surface of the alveolar bone
Cancellous bone - soft and spongy
152
What is the gingiva called which is attached to the bone?
The mucoperiosteal layer
153
What is the interdental papilla?
Gingival tissue between each tooth
154
What are the periodontal ligament fibres made of?
Collagen
155
Inflammation of the periodontal ligaments
Periodontitis
156
Where is the parotid salivary gland located?
Between the ramus and the ear
157
Where is the submandibular salivary gland located?
In the posterior area of the floor of the mouth, beneath the mylohyoid muscle
158
Where is the sublingual salivary gland located?
In the anterior area of the floor of the mouth, above the mylohyoid muscle
159
What microorganism causes mumps?
Paramyxovirus
160
What salivary gland is most commonly associated with benign and malignant tumours?
The parotid gland
161
What salivary duct is most likely to become blocked by salivary stones?
The Wharton’s duct from the submandibular gland
162
What condition is associated with xerostomia?
Sjogrens syndrome
163
What is ptyalism?
Excess salivation
164
What drug can be taken during oral surgery to reduce saliva flow?
Atropine
165
Usual bacteria associated with caries
Streptococcus mutans
Streptococcus sanguis
Lactobacilli
166
What food group is turned into acid by bacteria?
Carbohydrates
167
What are cariogenic foods?
Capable of causing caries
168
What are intrinsic sugars?
Sugars found naturally within the cell structure of foods
169
What are extrinsic sugars?
Sugars added to foods in manufacturing or cooking, some can occur naturally such as honey and lactose in milk
170
Most damaging NME (free) sugars
Sucrose and glucose (dextrose)
171
What type of sugar is lactose?
Milk extrinsic
172
What type of sugar is fructose?
Intrinsic
173
How long does an acid attack last?
20 minutes
174
How long does bacteria take to turn carbohydrates into acid?
A minute or 2
175
What are the most common stagnation areas?
Interproximal and occlusal areas
176
What does a remineralised spot on the tooth look like?
A brown spot lesion
177
How does pulp necrosis occur?
The pulp cannot swell therefore pressure builds up and compresses the blood vessels which will stop the blood supply to the tooth
178
How does an alveolar abscess occur?
The dead pulp tissue drains through the apical foramen into the surrounding alveolar bone and cause the tissue to inflame
179
How does an acute abscess form into a chronic abscess?
Pus drains through the sinus, relieving pressure and symptoms
180
What enzyme in saliva digests carbohydrates?
Ptyalin (amylase)
181
What is term for tooth loss due to extrinsic acid on the enamel?
Erosion
182
What medical conditions can cause tooth erosion?
Bulimia, reflux and stomach ulcers
183
What tooth surfaces are particularly affected by erosion?
Labial and palatal of upper incisors and occlusal of the lower molars
184
What is the term for tooth loss due to excessive forces (like brushing)?
Abrasion
185
What type of patient is more likely to have abrasion cavities?
Smokers - using abrasive smokers toothpaste or brushing harder to remove stains
186
What is the most common surface to see an abrasion cavity on?
The cervical area of the tooth on the buccal or labial surface
187
What is the term for tooth loss due to tooth on tooth contact?
Attrition
188
Other than tooth loss, what can bruxing cause?
Face pain and TMJ problems
189
What surface does bruxing affect the most?
Occlusal
190
What is the term for tooth loss due to shearing forces in a single standing tooth?
Abfraction
191
What is the difference between abrasion and abfraction?
Abrasion happens over time, abfraction happens suddenly
| Abfraction also affects the lingual and palatal surfaces, as well as the buccal and labial
192
What tooth is most likely to be affected by abfraction?
Single standing premolars
193
What is the difference between periodontitis and gingivitis?
Gingivitis is the inflammation of the gingiva alone, periodontitis is the inflammation of all supporting structures
194
What are iatrogenic factors?
Factors caused by imperfect dentistry
195
What is the specialist gingiva called at the junction where the neck of the tooth and gingiva meet?
Junctions epithelium
196
How does gingivitis turn into periodontitis?
The toxins soak through micro-ulcers and penetrate the deeper tissues, destroying the periodontal ligaments and alveolar bone
197
What virus causes acute herpetic gingivitis?
Herpes simplex
198
What group of patients is most commonly affected by acute herpetic gingivitis?
Infants
199
What does acute herpetic gingivitis show as in the oral cavity?
Small painful ulcers (acute herpetic gingivo stomatitis)
200
What antibiotic is commonly prescribed for ANUG?
Metronidazole
201
What is an acute lateral periodontal abscess?
Pus is unable to drain through a pocket and therefore accumulates at the base of the pocket to form an abscess
202
What areas are assessed during an oral health assessment?
Extra and intraoral soft tissues, dentition, occlusion and periodontal tissues
203
What are the responses of an electric pulp tester?
Normal response - healthy pulp
Increased response - early pulpitis
Reduced response - pulp is dying
No response - pulp is dead
204
Where is oral cancer most commonly seen?
Borders and underside of the tongue and the floor of the mouth
205
What instruments would you set out for a tooth charting assessment?
Mouth mirror, angled probe, tweezers and a briault probe
206
What teeth are most likely to be crowded?
Upper canines
| Along with lower second premolars and lower third molars
207
What should be done when a score of 3 is recorded?
Radiographs should be taken to record bone levels, plaque retention factors removed and patient given effective oral hygiene advice
208
What should be done when a score of 4 is recorded?
Radiographs taken to see bone level, full pocket depths measured to see the problem areas and intensive periodontal treatment initiated
209
What is grade 1 mobility?
Side to side movement of less than 2mm
210
What is grade 2 mobility?
Side to side movement of more than 2mm
211
What is grade 3 mobility?
Vertical movement
212
What are the 3 things that can happen when taking an x ray?
X rays pass cleanly between atoms and are unaltered
X rays hit atoms and scatter, releasing energy as they do
X rays hit the atoms and are absorbed, releasing energy as they do
213
What must consent be?
Informed
Voluntary
Capacity
214
What act links to consent?
Mental capacity act
215
What is a right angled probe used for?
To defect occlusal caries
216
What is a briault probe used for?
To detect interproximal caries
217
What is a sickle probe used for?
To detect residual caries
218
What is a WHO probe used for?
BPE
219
What is a Williams probe used for?
6 point pocket charting
220
What are study models used for mainly?
Orthodontics
221
What is an elastomer material?
Putty
222
What is a silicone material?
Light body
223
What do the periodontal ligaments connect?
The cementum to the socket - the lamina dura lining
224
How does diabetes affect the salivary flow?
Reduce salivary flow - more prone to caries or perio
225
How does HIV affect the oral cavity?
High risk of all diseases and hairy leukoplakia
226
How will a patient suffering with a hernia affect the oral cavity?
Gastric reflux - acidic erosion
227
How does pregnancy affect the mouth?
Pregnancy gingivitis - interdental papilla grow to cause epilis
228
What can affect elderly patients more prominently than younger patients?
Gingival recession - root surface caries
229
What can cause xerostomia?
Chemotherapy, salivary gland blockages and calculi
230
What is lichen planus?
Inflammatory condition affecting the soft tissues, red swollen tissue, open sores or white Lacey patch
231
Leukoplakia
White patches caused by trauma or possible site for oral cancer
232
What should be noted when a patient is administered drugs and how long should this be kept for?
Expiry date and batch number - stored for a minimum of 2 years
233
Symptoms of hyperglycaemia
Increased thirst
| Ketone smell to breath
234
What should you do if someone is suffering with hyperglycaemia?
Administer insulin
235
What might a patient be treated for a stroke with?
Anticoagulants (blood thinners)
236
What valve separates the right atrium and right ventricle?
The triscupid valve
237
What valves separates the left atrium and left ventricle?
Mitral valve
