Week 3

Question 1

MOA of topical anesthetics

Answer 1

decrease Na+ ion permeability -> decrease depolarization

Question 2

T/F: The best method for topical anesthetics is using a cotton tip applicator.

Answer 2

False! the choice of method is based on the individual pt

Question 3

Which TA is associated with methemoglobinemia

Answer 3

benzocaine spray

Question 4

Why do we need the site to be dried with gauze or sponge before we apply the TA?

Answer 4

dryer site = will absorb the anesthetic better

Question 5

Name some characteristics of benzocaine

Answer 5

it’s an ester
low toxicity
duration: 5-15 mins
no MRD
methemoglobinemia is associated with the spray version

Question 6

Name some characteristics of lidocaine

Answer 6

it’s an AMIDE
low toxicity
lasts for 15-45 mins
MRD: 300 mg but we can give 200mg safely
category B pregnancy

Question 7

Benzocaine + Butamben + Tetracaine = ?

Answer 7

cetacaine

Question 8

Name some characteristics of cetacaine

Answer 8

it’s a combo product
it’s an ester
lasts for 30-60 mins
MRD: 200mg
category C pregnancy

Question 9

T/F: The concentration of topicals are lower than injectable LA’s.

Answer 9

False!! They’re higher

Question 10

T/F: There are NO vasoconstrictors in topicals

Answer 10

True!

Question 11

Know the toxicity and adverse rxns of topicals

Answer 11

-irritation @ site
-sloughing
-taste alteration
-CNS effects
-CV effects

Question 12

What do a (+) and (-) for the aspiration mean?

Answer 12

(+) means blood entered the carpule
(-) no blood but small bubble may enter carpule

Question 13

The larger the gauge the _______ the diameter

Answer 13

smaller

Question 14

What is the weakest part of the needle?

Answer 14

Hub + Needle Adaptor

Question 15

what are the 2 needle lengths commonly used in dentistry?

Answer 15

Long: 32mm
Short: 20mm

Question 16

The needle length selection is based on?

Answer 16

the amount of tissue that must be penetrated

Question 17

T/F: A long needle is always required for a mandibular block

Answer 17

True

Question 18

How much LA does the stopper remove?

Answer 18

0.2mL
the carpule has 2mL total and the solution is 1.8mL

Question 19

What can cause a pt to experience syncope?

Answer 19

drastic drop in BP
emotional response to injection

Question 20

How can we help a pt experiencing syncope?

Answer 20

-supine position
-cool damp cloth on forehead
-ammonia capsule or 100% O2

Question 21

What is the most common cause of a LA overdose?

Answer 21

injecting into a vessel

Question 22

T/F: High doses of LA result in CNS and CV depression

Answer 22

True

Question 23

Name some common causes of an allergic rxn

Answer 23

-methyparaben
-sodium bisulfite
-ester topicals

Question 24

What could cause a burning feeling during injection?

Answer 24

contaminated or expired anesthetic
heated anesthetic solution

Question 25

Name some causes of hematoma

Answer 25

puncture of blood vessel poor technique multiple needle penetrations

Question 26

How do we prevent facial paralysis?

Answer 26

contact bone BEFORE depositing the anesthetic

Question 27

Facial paralysis can be caused by LA being deposited into the _________ gland.

Answer 27

parotid

Question 28

List some local complications

Answer 28

1) needle breakage 2) pain during injection 3) burning during injection 4) hematoma 5) facial paralysis (transient) 6) paresthesia 7) trismus 8) infection 9) edema 10) soft tissue injury 11) tissue sloughing

Question 29

Which branch of CNV has sensor and motor

Answer 29

CN V3

Question 30

Name the 5 major branches of CNV2

Answer 30

1) nasopalatine 2) greater palatine 3) PSA 4) infraorbital -> ASA and MSA 5) zygomatic

Question 31

Which nerves emerge from the anterior and posterior trunks of CNV3?

Answer 31

anterior: long buccal N and muscular branches posterior: IA nerve, lingual N, auriculotemporal N

Question 32

5 major branches of CNV3

Answer 32

1) long buccal 2) muscular branches 3) auriculotemporal 4) lingual 5) IA

Question 33

T/F: The facial nerve courses through the parotid gland

Answer 33

true! gotta be careful of it when doing mandibular block

Question 34

Branches of maxillary A in the infratemporal fossa

Answer 34

1) middle meningeal 2) inferior alveolar -> mental + incisive 3) mm of mastication 4) buccal

Question 35

Branches of maxillary A in pterygopalatine fossa

Answer 35

1) PSA 2) infraorbital -> ASA 3) greater palatine 4) sphenopalatine

Question 36

What protects the maxillary A from being compressed during mandibular movement?

Answer 36

pterygoid plexus

Question 37

What is associated with hematoma and spread of infection? hint: venous

Answer 37

pterygoid plexus