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Flashcards in Unit 313 Deck (237)
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1

What are the components of a local anaesthetic cartridge?

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

Usual ratio of adrenaline in local anaesthetic

1:80,000

3

What component of local anaesthetic should not be used for pregnant patients?

Felypressin - brings on labour

4

Nerve supply to the upper 1s, 2s and 3s

Anterior superior dental nerve

5

Nerve supply to the upper 4s, 5s and mesiobuccal root of the 6s

Middle superior dental nerve

6

Nerve supply to the upper distobuccal root of the 6s, 7s and 8s

Posterior superior dental nerve

7

Nerve supply to the front of the soft palate (1s, 2s and 3s)

Nasopalatine nerve

8

Nerve supply to the back of the palate (4s, 5s, 6s, 7s and 8s)

Greater palatine nerve

9

Nerve supply to the back of the hard palate (behind the teeth)

Lesser palatine nerve

10

Nerve supply to all lower teeth

Inferior dental nerve

11

Nerve supply to the floor of the mouth and 2/3 of the tongue

Lingual nerve

12

Nerve supply to the buccal of the lower 6s, 7s and 8s

Long buccal nerve

13

Nerve supply to the labial gingivae of the lower anterior teeth, lips and chin

Mental nerve

14

What is a foramen

A hole in the bone where the nerves and blood vessels can pass through

15

Signs of a partially blocked airway

Wheezing
Coughing
Red face

16

Signs of a fully blocked airway

Cyanosis
Collapsing
Grasping at the neck

17

Symptoms of a fully blocked airway

Panic
Unable to cough

18

What should you do if someone has a blocked airway

Encourage them to cough
If this does not work, administer 5 back blows and 5 abdominal thrusts
Call 999

19

Signs of anaphylactic shock

Swelling of the face
Rash
Rapid, weak pulse

20

Symptoms of anaphylactic shock

Breathing difficulty
Feeling faint
Nausea

21

What should you do if someone is in anaphylactic shock

Administer adrenaline 1:1000 and call 999

22

Signs of a grand mal seizure

Unconsciousness
Rigid limbs
Convulsions

23

Symptoms of a grand mal seizure

Possible aura beforehand
Halt in breathing

24

Signs of a petit mal

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