Sympsoiums yr2 > 10- Local anaesthesia > Flashcards

10- Local anaesthesia Flashcards

(48 cards)

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1
Q

What does the conduction of a nerve depend on?

A

changes in the electrophysical status of the nerve

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2
Q

How does an impulse travel through a nerve

A

Impulse stimulates neurone, Na+ channels open, Na moves into cell depolarising the membrane, triggers action potential

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3
Q

What does local anaesthetic do?

A

Blocks the sodium channels, stopping the depolarization of the nerve

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4
Q

What are 2 categories of local anaesthetic?

A
  1. Amino-esters

2. Amino-amides

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5
Q

Give an example of amino-ester?

A
  • procaine
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6
Q

Give an example of amino-amides?

A
  • lidocaine
  • mepriocaine
  • prilocaine
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7
Q

What category is lidocaine?

A

Amino-amide

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8
Q

What is potency?

A

the minimum concentration of local anaesthetic needed to produce the same effect

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9
Q

What is the most potent LA?

A

Lidocaine

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10
Q

What is the least potent LA?

A

Procaine (amino-esters)

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11
Q

Where are amino-esters metabolised?

A

in the blood

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12
Q

Where are amino-amides metabolised?

A

In the liver

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13
Q

Which LA would you give to a patient with liver problem?

A

amino ester i.e. procaine

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14
Q

Name the three branches of the trigeminal?

A

V1 - Ophthalmic branch
V2 - Maxillary branch
V3 - Mandibular branch

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15
Q

What does the ophthalmic branch innervate?

A

sensory innervation to :

  • lacrimal gland
  • conjunctiva
  • skin between nose and eyes
  • skin of upper eyelid
  • forehead
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16
Q

What does the maxillary branch innervate?

A

sensory innervation to:

  • teeth of maxilla and soft tissue
  • buccal gingiva of upper jaw
  • mucous membrane of cheek
  • interdental papilla
  • periodontal ligament
  • hard palate
  • side of the nose
  • upper lip
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17
Q

What does the mandibular branch innervate?

A
  • motor branches for muscles of mastication
  • skin of anterior temple
  • lower teeth
  • gingiva of lower teeth
  • skin of lower lip
  • chin
  • taste buds
  • submandibular and subgingival glands
  • lingual gingiva
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18
Q

What position should you put the patient in when injecting maxilla?

A

Flat/ supine (should be perpendicular to the floor)

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19
Q

What position should you put the patient in when injecting mandible?

A

Semi-supine

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20
Q

What must you do to the soft tissue before you apply topical anaesthetic?

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A

must dry the soft tissue

21
Q

What 4 things should be written on the LA Cartridge

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A

1, LA drug

  1. Vasoconstrictor
  2. Expiry date
  3. Batch number
22
Q

What is unique about the ultra-safety plus XL?

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A

can be resheathed

23
Q

What are the different types of anaesthesia of the upper jaw?

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A
  • infiltration
  • posterior, middle, anterior alveolar nerve block
  • greater palatine nerve block
  • nasopalatine nerve block
  • anterior, middle, superior nerve block
  • 2nd division nerve block
24
Q

What are the different types of anaesthesia of the lower jaw?

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A
  • infiltration (soft tissues)
  • mental nerve block (mental foramen)
  • inferior alveolar nerve block
  • long buccal nerve
  • lower anteriors
  • lower first premolar and anteriors
  • lower molars and second premolar
25
Where should you aim when injecting upper jaw?
Aim for root of tooth, inject on mucogingival line
26
How much should you inject when infiltrating the upper jaw?
1/2 cartridge
27
What teeth does does the greater palatine nerve block cover?
all upper molars and premolars (i.e. area distal to canine) 4-8
28
What teeth does the nasopalatine nerve block cover?
Canine to canine 3-3
29
What LA would you use when doing restorative work in the maxillary teeth?
Buccal infiltration
30
What LA would use when extracting maxillary teeth?
(SINGLE TOOTH) = buccal and palatal infiltration | (MULTIPLE TEETH) = nasopalatine and greater palatine nerve block
31
What is unique about the maxilla that makes it easier to inject?
maxilla is a spongey bone, easier for LA to reach
32
Why is it harder to inject the lower jaw?
Mandible made up of cortical bone which is extremely dense
33
What does infiltration in mandible cover?
only soft tissues
34
What does the mental nerve block in the mandible cover?
premolars and anterior teeth
35
Where should you aim inferior alveolar nerve block?
around lingula (do this by finding coronoid notch, internal oblique ridge, pterygomandibular raphe
36
How much of the cartridge do use when doing iD block?
at least one whole cartridge
37
What does the long buccal nerve block cover in mandible?
Only soft tissues around molars/wisdom teeth
38
Where do you inject long buccal in mandible?
slightly anterior to coronoid notch depression
39
What injection should you do when working on lower anterior teeth?
- Buccal infiltration (pulp) | - Lingual infiltration (lingual soft tissues)
40
What injection should you do when working on lower first premolar and anterior?
- Mental nerve block (pulp) | - Lingual infiltration (lingual soft tissue)
41
What injection should you do when working on lower molars and second premolar?
- ID nerve block - Lingual nerve block (can be done when doing ID) - Long buccal nerve block
42
What are some of the general complications of LA?
1. Psychogenic 2. Toxic 3. Allergy reaction 4. Drug reaction
43
Name some psychogenic reactions?
-palpitations -restlessness -fainting -cold sweat -excittion (ATYPICAL= clonic convulsions, rolling of eyes, rigidity) (HYPOXIA= blood pressure drops, patient holding breath)
44
Name some Toxic reactions?
- convulsions - loss of consciousness - respiratory disease
45
How do toxic complications occur?
overdosing i.e injecting more than patient can take | - consider patient having a liver problem (unable to break down anaesthetic)
46
Why would an allergic reaction occur?
often due to the presence of sodium metabisulphate
47
What might LA have a drug interaction with?
non cardio-selective beta blockers
48
Name some local complications
- contaminated needles - infected area - trismus - laceration of nerve or blood vessels - facial paresis - LA injected too fast or too much
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