- Shuffle
Toggle OnToggle Off
- Alphabetize
Toggle OnToggle Off
- Front First
Toggle OnToggle Off
- Both Sides
Toggle OnToggle Off
Front
How to study your flashcards.
Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key
Up/Down arrow keys: Flip the card between the front and back.down keyup key
H key: Show hint (3rd side).h key
PLAY BUTTON
PLAY BUTTON
45 Cards in this Set
- Front
- Back
|
What is the most commonly used and easiest injection to perform?
|
Supraperiosteal injection
|
|
When would the supraperiosteal injection be used?
|
To anesthetize any of the maxillary teeth or can be used in peds patients on mand incisors
|
|
What is the mechanism by which the supraperiosteal injection works by?
|
Local anesthesia diffuses through periostem, cortical plate and cancellous bone to reach the plexus of nerves
|
|
Where is the supraperiosteal injection given?
|
In the alveolar mucosa, just above the mucogingival line at the area of the apical 1/3 of the target tooth
|
|
While injecting, small amounts of anesthetic are given before proceeding, how long do you wait in between advancements?
|
minium of 5 seconds
|
|
How should the needle be angled in a supraperiosteal injection?
|
parallel to the long axis of the targeted tooth and then when at the apical 1/3 of tooth it is reoriented horizontally so that periosteum in contacted
|
|
What is the most common nerve block administered for mandibular teeth?
|
inferior alveolar nerve block
|
|
What are the two branches of the interior alveolar nerve?
|
Incisive and Mental nerve
|
|
What do the inferior alveolar, incisive, and mental nerves supply?
|
Inferior alveolar - pulps of mand molars and 2nd premolar
Incisive - pulps of mand teeth and bone from 1st premolar to midline Mental - buccal soft tissue anterior to 1st molar, lip and chin |
|
What does the lingual nerve innervate?
|
Lingual soft tissue from mandibular 3rd molar to midline, taste and sensation to anterior 2/3 of tongue, lingual vestibule, salivary glands
|
|
What does the buccal nerve innervate?
|
Buccal mucosa and cheek from mand 3rd molar to mesial of 1st molar
|
|
What structures are palpated when giving a inferior alveolar nerve block?
|
Deepest portion of the coronoid notch: determines hight of injection
Internal oblique line: determines anterior/posterior point of injection (9-11 mm from internal oblique line to lingula) |
|
Where is the puncture of the inferior alveolar nerve block in relation to coronoid notch, temporalis, pterygomandibular raphe, buccal fat pad?
|
Vertical level of coronoid notch
Medial to deep tendon of temporalis Lateral to pterygomandibular raphe Medial and posterior to buccal fat pad |
|
What needle is recommended for the inferior alveolar?
|
short 25 gauge
|
|
How is the inferior alveolar given?
|
From the contralateral premolar region, advanced til contact with medial surface of ramus, then advanced toward lingula, sliding over lingular notch into mandibular sulcus
|
|
Where is the buccal nerve block given?
|
1 cm above the occlusal plane, 1/2 way between the anterior border of the ramus and the internal oblique line
|
|
Describe the relationship between inferior alveolar and the sphenomandibular ligament, interpterygoid facia, temporalis
|
Inferior alveolar lies lateral to sphenomandibular ligament
Inferior alveolar is attaches to lateral aspect of interpterygoid facia (Lingual nerve to medial aspect) Internal oblique line is the insertion of the deep tendon of the temporalis |
|
What is the final destination of the needle in the inferior alveolar block?
|
Tip in the pterygomandibular space
- Lateral wall = ramus of mandible - Medial wall = medial pterygoid muscle - Roof = lateral pterygoid muscle Just medial to deep tendon of temporalis Just lateral to lingual nerve Just above lingual notch Just lateral to inferior alveolar nerve |
|
Describe the boundaries of the infratemporal fossa (PSA)
|
Superior = greater wing of sphenoid
Anterior = Posterior surface of maxilla Medial = lateral pterygoid lamina Lateral = zygomatic arch and ramus of mandible Posterior - articular tubercle of temporal bone and spine of sphenoid |
|
what is the primary clinical problem with ovarian carcinoma?
|
its asymptomatic and undetectable nature of the cancer in its earliest stages.
-pts often seek medical attention after ascities has iniciated; abdominal distention |
|
What are the boundaries for the pterygopalatine fossa? (palatine block)
|
Medial = vertical lamina of the palatine bone
Lateral = pterygomaxillary fissure Superior = body of sphemoid, orbital process of palatine Anterior = Maxilla (infratemporal surface) (same as infratemporal fossa) Posterior = pterygoid process of sphenoid Inferior = Pterygomaxillary junction. greater palatine canal |
|
What does the pterygopalatine fossa communicate with (palatine block)
|
Cranial cavity
Infratemporal fossa Nasal cavity Orbit Nasopharynx Oral cavity |
|
What is in the pterygopalatine fossa? (palatine block)
|
Maxillary nerve with posterior superior alveolar branches
Maxillary artery (3rd part) with branches and corresponding veins Sphenopalatine ganglion and branches |
|
Why is the greater palatine nerve block used?
|
To anesthetize the unilateral palatal gingiva and bone
From maxillary 3rd molar to cuspid and to the midpalatal suture NOT for tooth pulp, even though occasionally it does |
|
What is the injection site for the greater palatine block?
|
Just distal to the maxillary 1st molar and at the point where the palate curves upward toward the teeth
|
|
What needle is recommended for the greater palatine block?
|
30 gauge
|
|
Why is the tissue not pulled taught on the greater palatine or nasopalatine block?
|
Because it can't be.
Instead, pressure is applied til tissue visibly blanches |
|
Why is the nasopalatine given?
|
To anesthetize the palatal gingival (bilaterally) from cuspid to cuspid
To supplement pulpal anesthesia to maxillary anterior teeth |
|
What is the injection site for the nasopalatine block given?
|
Just lateral to and in the posterior 1/2 of the incisive papilla
Then inserted til tip is just over the foramen |
|
What needle is recommended for the nasopalatine block?
|
short 30 gauge
|
|
What does the infratemporal fossa communicate with? (PSA)
|
Temporal fossa
Orbit Pterygopalatine fossa Cranial cavity Pterygomandibular space |
|
What is contained in the infratemporal fossa? (PSA)
|
Maxillary nerve and posterior superior alveolar nerves
Lateral pterygoid muscle Sphenomandibular ligarment Interpterygoid fascia Maxillary artery (1st and 2nd parts) with branches Pterygoid venous plexus Chorda tympani Otic ganglion Mandibular nerve (BUccal, Lingual, IA, etc) |
|
What are the foramina associated with the infratemporal fossa? (PSA)
|
Foramen ovale
- Mandibular nerve - Accessory meningeal artery Foramen spinosum - Middle meningeal artery -Meningeal branch of mandibular nerve Posterior superior alveolar foramina (TARGET for PSA nerve block) - Posterior superior alveolar nerves and artery |
|
Why is a posterior superior alveolar nerve block given?
|
To anesthetize the buccal soft tissue and pulp of maxillary 3rd molar, 2nd molar, and 1st molar (EXCEPT for mesiobuccal root of 1st)
Effective when supraperiosteal fails To avoid areas of infection or inflammation |
|
What is the point of injection for a posterior alveolar block?
|
Distal to (behind) the zygomatic process
Above the middle of the maxillary 2nd molar |
|
What type of needle is recommended for a PSA?
|
short 25 gauge
|
|
What is the orientation of the syringe in a PSA?
|
Inward, upward, and backward plane.
Keeping contact with the periosteum 45 degree angle to the occlusal plane (on average) |
|
What do you do if a hematoma occurs?
|
Apply pressure and Ice
|
|
Penetrating too deep in a PSA can result in what?
|
Hematoma
Injurty to the maxillary artery |
|
Penetrating too far laterally during a PSA can result in what?
|
Injury to the pterygoid plexus of veins or lateral pterygoid muscle (pain and trismus)
|
|
What injections may be needed for complete anesthesia to a maxillary 1st molar, why?
|
Posterior Superior Alveolar
And additionally, Supraperiosteal or Infraorbital Because PSA does not anesthetize the mesiobuccal root |
|
What space is anesthetic injected into during a IA?
|
Pterygomandibular space
|
|
What fossa is the target during a PSA?
|
Infratemporal fossa
|
|
What fossa is the target during a Palatine nerve block?
|
Pterygopalatine fossa
|
|
What foramen is the target during a nasopalatine nerve block?
|
Nasopalatine foramen
|
