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Local Anesthesia
Test 2
| Question | Answer |
|---|---|
| what is the ADA criteria for the syringe? | must withstand repeat sterilization accepting a wide variety of cartridges and needles inexpensive, self contained, lightweight and simple to use with one hand effective aspiration, blood easily observed in cartridge |
| what is the most common syringe used in dentistry today? | breech loading, metallic, cartridge type, aspirating syringe |
| what is a jet syringe? | no needle obtain topical anesthesia prior to insertion of a needle |
| what is a pressure syringe used for? | periodontal ligament injection |
| what are safety syringes? | reduce risk of accidental needle stick injury needle is sheathed and guarded however, awkward, single use and costly |
| What is the wand? | timed released of local anesthesia expensive, cumbersome and time consuming |
| what are the problems with aspirating syringes? | leakage during injection, broken cartridges, bent harpoon, harpoon removed from plunger during aspiration, surface deposits |
| what is the weakest portion of the needle that breaks | hub |
| what are the numbers in the needle gauge? | diameter of the lumen of the needle smaller number, the greater the diameter |
| what needle should be used for deflection and accuracy? | larger gauge needles, less deflection, greater accuracy 27 gauge is preferred |
| what is the short length of a needle? | 1 inch or 25 mm |
| what is the long length of a needle? | 1 5/8 or 40 mm |
| after how many penetrations should you change the needle? | 3-4 tissue penetrations |
| what is the cartridge? | glass cylinder containing the local anesthetic drug |
| what is the pH of a cartridge containing vasopressor? | lower pH 3.4-4 |
| what is the antioxidant put in the cartridge? | sodium bisulfite prevents biodegradation of the vasopressor by oxygen |
| why is the sodium chloride added to the cartridge? | added to make solution isotonic with the body tissues |
| why is the distilled water added to the cartridge? | used as a diluent to provide volume |
| why was methylparaben added to the cartridge? | bacteriostatic agent used in multi dose vials |
| should you soak the cartridge in alcohol? | no, membrane diffusion |
| what is local infiltration? | treatment or incision is made into the same area in which the local anesthetic has been deposited deposited above the apex of the tooth to be treated |
| what is a field block? | local is deposited near the larger terminal nerve branches, treatment is done into an area away from the site of injection of the anesthetic |
| what is a nerve block? | anesthetic deposited close to a main nerve trunk usually at a distance from the site of operative intervention |
| What nerves of blocked during the posterior superior alveolar or PSA? | PSA pus branches |
| what areas are anesthetized during PSA? | maxillary molars except MB root of 1st molar buccal alveolar bone and soft tissues, periodontium antral lining in corresponding region |
| what are the indications for the PSA? | surgical or operative procedurs on molars and supporting structures two or more maxillary molars |
| what are the contraindications for the PSA? | when risk of hemorrhage is too great |
| what is the technique for the PSA nerve block? | use 27 needle, insert at height of mucobuccal fold above max 2nd molar target is PSA which is medial posterior and superior to posterior border of the mandible |
| step by step technique for the PSA | pull tissue taut at injection site, insert the needle and advance slowly superiorly 45 degrees to occlusal plane and posteriorly at 45 degree angle to long axis of 2nd molar. average depth 16 mm, aspirate slowly and deposit 2/3 carp |
| what nerves are blocked for the middle superior alveolar (MSA) | MSA and terminal branches |
| what areas are anesthetized for the MSA? | pulps of maxillary 1st and 2nd premolars, medial buccal root of 1st molar buccal periodontal tissues and bone over those teeth |
| what are the indications for the use of MSA | dental procedures involving both maxillary premolars when infraorbital injections fails to provide anesthesia DISTAL to the maxillary canine |
| what are the contraindications for the MSA block? | infection and inflammation in the area of injection or needle insertion |
| what is the technique for the MSA block? | 27 gauge needle inserted at the height of the mucobuccal fold above the maxillary 2nd premolar target area is maxillary bone above the apex of the maxillary second premolar |
| what is the step by step technique for the MSA block? | elevate the lip and retract the tissues at the injection site taught, advance needle slowly until tip is above the apex of max 2nd premolar. aspirate slowly and deposits 1/2-2/3 of a carp |
| what nerves are blocked for the ASA or infraorbital nerve block? | ASA, MSA, infraorbital inferior palpebral, lateral nasal and superior labial |
| what areas are anesthetized for the ASA or infraorbital nerve block? | pulps of max centrals incisors through canine 70% of patients pulp of max premolars and MB root of max first molar labial periodontium and bone of teeth, lower eyelid, later nose, upper lip |
| what are the indications for the ASA or infraorbital nerve block? | procedures involving greater than 2 max teeth or overlying bone and soft tissue when supraperiosteal infiltrations have been ineffective because of dense bone |
| what are the contraindications for the ASA or infraorbital nerve block? | when only 1-2 teeth need treatment infection located at the site |
| what is the technique for the ASA or infraorbital nerve block? | 25 or 17 needle, long or short insert at the height of mucobuccal fold directly over the 1st premolar target area is infraorbital foramen, directly below infraorbital notch |
| what is the step by step technique for the ASA or infraorbital nerve block? | index finger palpate the infraorbital notch, roll finger to facial curvature of infraorbital rim and apply pressure. Thumb and middle finger elevate lip and pull tissue taut. Needle advanced to depression blew infraorbital rim where foramen is located |
| what nerve does the greater palatine nerve block innervate? | greater palatine nerve |
| what is numb with the greater palatine nerve block? | posterior hard palate and soft tissue up to the 1st premolar |
| what are the indications for the greater palatine nerve block? | palatal anesthesia for surgery augment anesthesia for molar teeth palatine soft tissues distal to canine |
| what is the contraindications for the greater palatine nerve block? | infection at site of injection |
| what is the technique for the greater palatine nerve block? | 27 gauge needle, long or short insert at palatal mucosa just anterior to the greater palatine foramen |
| what are the step by step process for the greater palatine nerve block? | greater palatine foramen, distal to max 2nd molar where horizontal portion of palate meets the alveolar component. Apply pressure just anterior to the foramen to blanching, slowly insert needle into blanched area and touch bone, retract 1-2 mm, 1/4 carp |
| what nerve is innervated by the nasopalatine nerve block? | nasopaltine nerve |
| what will the patient feel with the greater palatine nerve block? | numbness in the posterior portion of the palate |
| what is numb by the nasopaltine nerve block | anterior hard palate and soft tissues from mx right 1st premolar to mx left 1st premolar |
| what is the indications for the nasopalatine nerve block? | anterior palatal anesthesia for surgery augment anesthesia of anterior teeth |
| what is the contraindications for the nasopalatine nerve block? | infection or inflammation at site of injection |
| what is the technique for the nasopalatine nerve block? | insert at palatal mucosa, just lateral to incisive papilla target area is the incisive foramen below incisive papilla |
| what is the step by step for the nasopalatine nerve block? | locate incisive papilla, apply pressure with cotton applicator until blanching, insert needle at 45 degree lateral to blanched papilla. advance rim until foramen is contacted, withdraw and aspirate. deposits 1/4 carp |
| what nerves are innervated by the maxillary nerve block? | maxillary division of CN V |
| what is numb for the maxillary nerve block? | maxillary teeth on affected side alveolar bone and soft tissue hard and soft palate upper lip, cheek, side of nose, lower eyelid |
| what area is numb for a maxillary nerve block? | maxillary teeth on affected side alveolar bone and soft tissue hard palate and soft palate upper lip, cheek, side of nose and lower eyelid |
| what are the indications for the maxillary nerve block? | extensive maxillary surgery, local infection precludes conventional blocks, diagnostic block |
| what are the contra indications for the maxillary nerve block? | inexperienced administrator, pediatric patients, uncooperative patients, patients infection of inflammation |
| what are the techniques for the maxillary never block? | 25 or 27 LONG needle, the entire maxillary nerve is anesthetized, target area is the greater palatine foramen |
| what are the step by step process of maxillary nerve block? | apple pressure to blanch soft tissue in greater palatine foramen, slowly insert needle and inject 1/8 carp to anesth. palatal region. redirect needle to 45 degrees to palate yo traverse canal and enter while admin anesth. as you do at depth of 30 mm asp |
| what nerves are blocked for maxillary infiltration? | nerves of the dental plexus at site of injection |
| what areas are anesthetized for maxillary infiltration? | pulp of tooth at site of injection buccal periodontium and bone at injection site |
| what are the indications for maxillary infiltration | dental procedures involving the tooth and supporting structures at site of injection |
| what are the contra indications for maxillary infiltration? | infection and inflammation in the area of injection or needle insertion |
| what is the technique for maxillary infiltration | 25 or 17 gauge needle long or shot insert at height go mucobuccal fold ABOVE the tooth to be anesthetized target area is above the apex of the tooth to be anesthetized |
| what is the step by step approach for maxillary infiltration | elevate and retract the tissues and hold taut, insert needle at height of muccobuccal fold adjacent and parallel to tooth to be anesthetized. advance needle slowly until the apex of tooth is anesthetized. aspirate and deposit 1/2-2/3 carp slowly |
| what nerves are blocked for the inferior alveolar nerve block? | inferior alveolar nerve, incisive branches mental nerve and sometimes long buccal and lingual nerves |
| what are the areas numbed by inferior alveolar nerve block? | body of mandible and inferior rams, mandibular teeth, mucosa and underlying tissues, anterior to 1st molar |
| what are the landmarks for the inferior alveolar nerve block | muccobuccal fold, anterior border of rams medial, pterygomadnibular raphe lateral to this |
| when would you use the inferior alveolar nerve block | operative procedures on all mandibular teeth, surgery on manx teeth underlying structures anterior to 1st molar |
| what is the technique for the inferior alveolar nerve block | insert mucous membrane medial to ramus lateral to pterygomandibuar raphe approximately 1 cm above occlusal plane, target is interior alveolar nerve prior to its entrance into the mandibular foramen and the lingual nerver anterior to the inferior alveolar |
| what is the step by step technique for the inferior alveolar nerve block | use thumb to ID internal and external oblique ridges, use fingers to extra orally estimate width of rams, thumb is placed in the coronoid notch and moved laterally stopping on external oblique ridge |
Created by:
Chobchi
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