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WREB LOCAL ANESTHESIA STUDY GUIDE
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WREB LOCAL ANESTHESIA STUDY GUIDE
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WREB LOCAL ANESTHESIA STUDY GUIDEWhat exits the foramen rotundum? - answers-maxillary branch of trigeminal nerve
What exits the foramen ovale? - Answers-Mandibular Branch of Trigeminal Nerve
What exits the mandibular foramen? - Answers-Inferior Alveolar Nerve
Purpose of Myelin Sheath? - Answers-Protective Covering for the nerves
What causes psychogenic pain? - Answers-Mental or emotional problems that affect the
experience of pain, there is no organic (medical) base for the pain.
Injection and landmarks for mandibular premolars/incisors, including pulpal - Answers-
Incisive
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for mandibular premolars/incisors, tissue - Answers-Mental
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for palate near molars - Answers-GP
Anterior depression of GP foramen, lingual to second molar
Injection and landmarks for maxillary molars. - Answers-PSA
Height of mucobuccal fold above second molar
Injection and landmarks for maxillary premolars - Answers-MSA
Height of mucobuccal fold above second premolar
Injection and landmarks for maxillary incisors (facial) - Answers-ASA
Height of mucobuccal fold above canine
Injection and landmarks for mandibular molars - Answers-IA
Medial to internal oblique ridge, lateral to pterygomandibular raphe, at or above height
of coronoid notch
Injection and landmarks for buccal tissue of mandibular molars - Answers-LB
Mucous membrane distal and lateral to most posterior molar
Injection and landmarks for palate near anteriors - Answers-NP
Just lateral to incisive papilla
Landmarks for AMSA - Answers-Halfway between premolars and palatine suture.
Dose of IA - Answers-1.5-1.8ml
,Dose of LB - Answers-.2-.3ml (stopper)
Dose of Mental/Incisive - Answers-.6ml
Dose of infiltrations - Answers-.6ml
Dose of NP - Answers-.4ml
Dose of GP - Answers-.4-.6ml
Dose of AMSA - Answers-.9-1.8ml
but, with a 4% anesthetic it's .7-.9ml
Dose of PSA - Answers-.9-1.8ml
Dose of MSA - Answers-.9-1.2ml
Dose of ASA - Answers-.9-1.2ml
Nerve that innervates the soft palate? - Answers-Lesser palatine
Molar root not anesthetized by PSA - Answers-Mesiobuccal root of first molar
Types of topical - Answers-Ester-Benzocaine, tetracaine
Amide-Lidocaine
Ketone-Dyclonine
What happens during depolarization? - Answers-Slow Na ion influx until firing threshold
is reached.
What happens during rapid depolarization? - Answers-Once firing threshold has been
reached (-50 to -55 mv) there is a rapid influx of Na ions.
What happens during repolariztion? - Answers-Na begins to move with concentration
gradient out of cell, there is an absolute refactory period, Na continues to move out of
cell with help of sodium pump, there is a relative refactory period until resting state is
reached.
What does LA do to deporlariztion? - Answers-Inhibits Na influx by displacing Ca ion.
Esters (and Articaine) are metabolized by...
Excreted by.... - Answers-Pseudocholinesterase in blood plasma
Kidneys
Amides are metabolized by...
, Excreted by.... - Answers-Liver (prilocaine in the lungs as well)
Kidneys (mostly unchanged)
Avoid esters (and articaine) if... - Answers-Pt's have atypical pseudocholinesterase
Sulfur allergy
Myasthinia Gravis
If there's methemoglobinemia... - Answers-Avoid prilocaine and benzocaine.
If they're taking beta blockers... - Answers-Limit or avoid vaso's
If they're taking phenothiazides.... - Answers-Do not use 1:50,000 epi
If they're taking tricyclic antidepressants - Answers-No levo.
Volume in one carpule of LA - Answers-1.8ml
What is the function of Sodium Chloride in LA solutions? - Answers-Isotonicity
What is the function of Sodium Bisulfite in LA solutions? - Answers-Antioxidant prevents
biodegredation of LA (delays deterioration of epi)
Why use vaso? - Answers-Increases depth and duration of LA.
Maximum carpules Articaine - Answers-6 (A6, or Asics-the shoes)
Maximum carpules Prilocaine - Answers-5 (depri5, P5)
Maximum carpules Mepivicaine - Answers-2%=8
3%=5.5
Maximum carpules Lidocaine - Answers-8 (L8, late)
Most common LA without vaso? - Answers-Mepivicaine 3%
If a pt. is allergic to red wine, what LA to give them? - Answers-Anything plain (no vaso)
(you wouldn't want to put wine in vases! :).
On which oral tissue is topical anesthetic least effective? - Answers-Keratinized
Why does infiltration work better on the maxilla as opposed to the mandible? - Answers-
Mandible has denser bone.
How would you best achieve homeostasis? - Answers-Use 1:50k epi
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