Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NBDE Part II > Oral Surgery > Flashcards

Oral Surgery Flashcards

1
Q

most common alloplastic bone graft?

A

Hydroxyappetite (Granular form or Particulate form)

  • When placed subperiosteal, HA bonds mechanically and chemically
  • No viable osteogenic cells, thus can’t undergo osteogenesis phase I
  • completely biocompatible and nonresorbable

Autograft

  • Osseous coagulum = corticol bone + blood
  • Bone blend = removed bone that is titrated and mended into a plastic form
  • Cancellous BM = From max. tuberosity or edentulous ridges
  • Cancellous extra-oral sites = From the iliac crest

Allogenic grafts

  • Fresh frozen
  • Freeze-dried bone graft (FDB) = osteoconductive *most used
  • Demineralized FDB (DFDB) = osteoinductive + BMP *most ideal

Xenograft = bioss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Inject LA when doing a biopsy __ cm away from site

A

1 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Put biopsy in _ % formalin

A

10% (4% formaldehyde)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Biopsy indications for:

  1. cytology
  2. aspiration
  3. incision
  4. excision
A
  1. mucosal change (herpes, pemphigus, PAP smear)
  2. lesion with fluids
  3. > 1 cm AND malignant
    4.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Distal wedge

A

Must have attached keratinized ST in any edentulous space (retromolar, max. tuberosity, or M/D of any last tooth in the arch)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Conditions with multiple supernumerary teeth:

A
  1. Cleidocranial Dysplasia
  2. Gardner’s Syndrome
  3. Down Syndrome
  4. Sturge-Weber Syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Referred Pain is due to what?

A

CN 7,9,10 are distributed in the sub nucleus caudal of CN V.

Max Incisors –> forehead
Max canine, 1 PM –> Nasolabial
Max 2PM –> Temporal
Max Molars –> zygomatic, temporal, occipital

Mand anteriors + PM –> mental region
Mand Molars –> posterior neck, ear, ramus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MMR

A

Koplick Spot = Rubeola (Measles) = v. contagious = paramyxovirus = buccal mucos

Rubella = german disease = benign virus = soft palate petechiae

Mumps = acute contagious = parositis = parotid gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

small pox

A
  • variola
  • acute viral disease
  • first appears on face as macules/papules then spreads
  • Oral lesions include ulcers, glossitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

childhood vs adult hypothyroidism

A 
Child hypothyroidism = Cretinism = large tongue, class II, anterior open bite
Adult hypothyroidism = myxedema (most common is Hashimotos, 2nd most common is tx for hyperthyroidism)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pituitary tumor in adults and kids

A

Gigantism = Pituitary tumor in kids
Acromegaly = Pituitary tumor in adults (post epiphysis fusion)
• large tongue = Class III = longer roots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tonic-clonic (grand mal) seizures

A
  1. Prodromal phase = usually not noticed by patient or dentist
  2. Aura phase = immediately precedes convulsive phase
  3. Convulsive = unconscious and muscle tonicity = usually 1-3 minutes. Longer than 5 mintues its called status epilepticus = medical ER (Tx: IV Diazepam)
  4. Post-convulsive Phase = significant CNS depression → RISK resp. depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Most common dwarfism

A

Achondroplasia

  • short limb dwarf (short legs, arms with normal torso)
  • small maxilla
  • normal size, but crowded teeth due to limited space
  • class III
  • most common dwarfism
  • saddle-like nose appearance

Pituitary Dwarf

  • underdeveloped mandible
  • delayed eruption of teeth
  • smaller clinical crowns
  • opposite of gigantism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hemangioma
Neuroblastoma
Lymphangioma
Neurofibroma

A 
Hemangioma
•	Vascular birthmark
•	female
•	Lips, tongue, buccal mucosa (capillary type is most common)
•	No tx needed
Neuroblastoma = abdomen (near adrenal gland)
Lymphangioma = neck, axilla
Neurofibroma = schwann cells = if multiple think NF Type I or II (von Recklinghausen)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Type I DM

A
  • children
  • ketoacidosis
  • polyphagia (hunger)
  • polyurea (pee)
  • polydypsia (thirst)
  • weight loss

Lab: > 120mg/dL fasting glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Down Syndrome

A

Low risk for caries, but high risk for periodontal disease

  • small, conical roots
  • chronic mouth breathing
  • Class III
  • Hypoplastic face
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Most common pathogens that cause of cellulitis

A

Group A Strept.

S. aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ANUG Bub

A

prevotella intermedia (spirochete)

NOTE: Localized agressive perio in children = A.a = will not have any localized factors to explain the etiology (i.e. plaque)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

ESR represents what?

A

inflammation

  • Thus, steroids will not increase ESR rates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Granulomatous inflammation

A

Type of chronic infection
- TB, leprosy, fungal, syphillus, cat scratch disease

Casseous = TB
non-necrotizing = sarcoidosis
Non-casseous = Chron's
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

EBV

A

Mono-nucleosis spot test = B cells

  • Biopsy shows starry night
  • X-ray shows moth eaten, poor margins
  • Clinical exam shows nodular mass that are hemorrhagic
  • burkitt lymphoma / Non-Hodgkin’s lymphoma. Burkitt lymphoma is the first cancer with viral etiology. African Type involves the jaws, non-african type involves the abdomen.
  • nasopharyngeal carcinoma
  • hairy leukoplakia (opportunistic, non-malignant white patches on tongue, AIDS)
  • infectious mononucleosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Acanthosis

A

Abnormal increase thickening of prickle cell layer of epithelium (due to smoking)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Define:

  1. Neoplasm
  2. Tumor
  3. Hyperplasia
  4. Anaplasia
  5. Hypertropy
  6. Carcinoma
  7. Sarcoma
  8. Hamartoma
  9. Choristoma
  10. Teratoma
A
  1. Neoplasm = uncontrolled growth of tissue
  2. Tumor = localized swelling (may or may not be a true neoplasm)
  3. Hyperplasia = proliferation in the number of cells, that is non-neoplastic
  4. Anaplasia = undifferentiated cells with various sizes and shapes (pleomorphism)
  5. Hypertrophy = size of cells
Carcinoma = Epithelium
Sarcoma = Mesenchymal = CT (non-epithelium) 
Hamartoma = Developmental defect as an overgrowth of normal tissue in a normal location
Choristoma = Normal tissue in an abnormal location
Teratoma = Neoplasm of multiple tissues foreign to the organ, either benign of malignant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Cancer grade versus TNM

A 
Neoplasm Grade = Degree of differentiation 
1	Well differentiated 
2	Moderately – well
3	Poor
4	Undifferentiated = Anaplasia

TNM = prognosis and degree of spread. But has no record of depth of penetration.
T size
N Regional lymph node involvement
M metastases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Enamel Hypoplasia vs Hypocalcification

A

Enamel Hypoplasia = normal quality (hard), but limited quantity = incomplete matrix formation = developmental = amelogenesis imperfecta
• Turner Hypoplasia = one permanent tooth affected due to damage/PA radiolucency of the primary tooth it replaced.
• Common in 1M

Enamel Hypocalcification = defective maturation of ameloblasts normal quantity (soft) = hereditary = chalky, dentin color

Quality + Quantity of enamel effected:

  • Syphillus
  • Sturge-Weber
  • Fluorosis
  • VIT A,C,D deficiency
26
Q

TMJ

A
  • Condyles are not identical
  • Posterior aspect is round and convex
  • Anterior-Inferior part is concave
  • Disc is attached by collateral ligaments, which are medial and lateral to the condyles; dense fibrous CT
  • Anterior part of the disc are held by lateral pterygoid. Disc displacement occurs when the collateral ligaments are weak/torn and the lateral pterygoids pull them anterior-medial.
  • Protruded contact position is symmetrical and the underside of the TMJ meniscus moves distally relative to the superior surface of the mandibular condyle
  • Ginglymoathrodial joint = glides and rotates
  • Upper compartment = mandibular fossa-articular disc = sliding/translation
  • Lower compartment = condyle-articular disc = rotation/hinge
  • Click = disc displacement
  • Crepitius = degenerative disease (arthritis)
27
Q

Bone Quality

A

= density of corticol and trabecular bone
• Type I = mostly cortical bone (Ant. Mandible)
• Type II = thick cortical + dese cancellous
• Type III = thin cortical + dense cancellous
• Type IV = thin cortical + thin cancellous (posterior max)
• Implant failure is higher in maxilla > mand due to max posteriors having Class IV quality

28
Q

Internal derangement Stages:

A
  1. Reciprocal click = rarely associated with severe pain, may occur spontaneously
  2. Reciprocal click with intermittent locking = locked jaw
  3. Closed lock
29
Q

Every 1 C increase in body temp, there is a __ increase in HR

A

9-10 beats.minute

  • Rectally is best
  • Auxillary is worst

STAGE I HTN = 140-159 HR: 90-99

30
Q

Normal values of:

  1. INR
  2. PT
  3. PTT
  4. Bleeding Time
  5. Platelet count
A
  1. PT = 11-13.5 seconds
  2. PTT = 25-36 seconds
  3. Bleeding Time =
31
Q

CPR

A
  • 4 minute golden time to begin CPR
  • Pulse check: 5-10 sec

Adults:

  • If no pulse: 2 breaths + 30 compressions (100/min)
  • Rescue breaths: 1 breath/5 sec or 10-12 breaths/minute
  • 2 inches deep

Pedo:

  • Brachial a.
  • Rescue breaths: 1 breath/3 sec or 20 breaths/minute
  • 1/3 chest depth

Liver may be damaged if too much pressure is used
Revived person will have pupils constrict

Brain damage occurs past 3-5 minutes without O2. Body has 2 minutes of O2 before unconsciousness.

32
Q

TMJ internal derangement stages

A
  1. Reciprocal click = rarely associated with severe pain, may occur spontaneously
  2. Reciprocal click with intermittent locking = locked jaw
  3. Closed lock (
33
Q

Occlusal splint types

A
  1. Autoreposition (when no skeletal issues re present, just muscle or joint)
  2. Anterior reposition (protrudes the mandible, thus receipting the normal condyle relationship)
34
Q

Which is more prone to complications post mandibular fracture?

A

Angle of the mandible.

Most common fracture sites of the mandible:
condyle > angle > symphysis > body > rams > coronoid process

Tx:
Wiring jaws shut = inter-maxillary fixation = maxillo-mandibular fixation

Most common facial fracture:
ZMC > nasal > LeFort I > II, III > Zygomatic arch

35
Q

Stages of fracture healing

A
  1. Inflammation: lasts 2-3 weeks
  2. Soft callous: 2-3 weeks post fracture. New bridge forms, but not seen on x-ray
  3. Hard callous: 4-8 weeks post fracture. Hard bony bridge filling fracture site.
  4. Bone remodel: 8-12 weeks post fracture and last for several years
36
Q

Wound Healing stages:

A
  1. Inflammatory = initial lag = 2-5 days
    - Hemostasis (platelets, vasoconstriction, thromboplastin)
    - Inflammation (vasodilation, phagoctyes)
  2. Proliferative = fibroblast = 5 days to 3 weeks
    - Granulation (fibroblasts lay collagen bed, new capillaries)
    - Contraction of wound edges
    - Epithelialization
  3. Remodel = maturation = 3 weeks to 2 years
    - New collagen → increased tensile strength
37
Q

ZMC fracture includes what 4 anatomical sutures?

A
  1. ZF
  2. ZT
  3. ZM
  4. ZS

NOTE: displaced fractures largely depend on the line o fracture, not the direction of muscle fibers

38
Q

Fracture Types

A
  1. Simple = divides the bone in two in a closed fracture (no communication with outside)
  2. Greenstick: extends only through corticol bone without a complete fracture (incomplete fractures) and are thus closed fractures = most common in kids
  3. Compound fractures = open fracture = infection is common)
  4. Multiple fractures = comminuted (may be simple or compound)

Most common in adult = nasal > zygoma > and. > maxilla
Child = frontal and orbital

39
Q

What anatomical structure prevents complete removal of the maxillary 1M besides the max sinus?

A

root of the zygoma

  • Teeth are EXT using Class II level systems

Most difficult to remove in mandible: disto-angular (opposite of maxilla)

40
Q

Tx Dry Socket

A

localized osteitis

  • Eugenol is the sedative in dressings
  • no curretting!
  • no Abx needed
41
Q

Auto-transplant of teeth

A

most important success factor: adequate bone

Most common transplant: Mand 1 M

42
Q

pre-general anesthesia tests

A 
chest x-ray
ECG, if over 40 y/o
CBC
WBC
urine analysis
43
Q

incision to remove:

  1. wide labial frenum
  2. mandibular tori
A
  1. Z-Y incision
  2. envelope flap with no vertical slits

NOTE: genial tubercules is the attachment site for the supra-hyoid. If cut, the tongue would be flaccid

44
Q

EXT deciduous molars in which direction?

A

palatal (adult is buccal)

45
Q

EXT are contraindicated in

A
  • uncontrolled diabetics
  • hematological disorders
  • acute pericornitis
  • end stage renal failure (No ASA, acetaminophen, NSAID, morphine, meperidine)
  • acute infections (EXCEPT acute apical abscess)
46
Q

IA nerve branches to what before entering the IA canal

A

mylohyoid nerve (thus, 1M may not have profound anesthesia in an IA block)

NOTE:
- sublingual gland is superior to the mylohyoid muscle

47
Q

Major TMJ arteries and nerves

A

External carotid artery = superficial temporal artery + maxillary artery

Drains at retro-discal tissue

Anterior: Masseteric n. (V3) + posterior deep temporal n. (V3)

Posterior: auriculotemporal n. (V3)

48
Q

Gland and duct matching

A

Parotid gland = Stensen duct = acinic
Submandibular gland = Wharton duct =
- submand. duct lay on the sublingual gland
Sublingual gland =Bartholin duct = mixed, but [mucous]

Ebner gland = circumvallate tongue papilla = serous (washes the food away)

49
Q

LA preservative

A

allergy to methylparaben (PABA = para aminobenzoic acid was an allergic by product of novocaine, and also decreases effectiveness of the antibiotic sulfonamides)

LA allergies are from antibody-antigen rxn

If allergic to both amides and esters, give diphenhydramine (benadryl) .

Most common ester allergy: tetracaine (also most used)

LA cross the blood-brain barrier.

Procaine and lidocaine do not give the usual CNS excitation first….only depression.

NOTE: LA have a direct action on the myocardium (myocardial depression: lower conduction, contraction) and vasculature (peripheral vasodilation of smooth muscles), but is more resistant to response that the CNS.

Lidocaine is used via IV for V-fib correction in the E.D.

Lidocaine has FDA pregnancy category of B, and is thus safe to use. All others have C.

50
Q

IA nerve block will affect what fossa for truisms?

A

infratemporal fossa (medial pterygoid muscle)

Tx: muscle relaxants (benzodiazepine)

51
Q

paresthesia of the lower lip is most caused by?

A

EXT of a horizontally impacted mand. 3M

52
Q

Differential blockade of LA

A

ORDER:

  1. pain (b/c normal nerves fire pain faster) = A delta, C fiber
  2. cold
  3. warm
  4. touch
  5. deep pressure
  6. motor (A alpha fibers)

nerves regain function in reverse order

53
Q

Patient is under general anesthesia and a lcryngeospasm happens. What to do?

A

O2 + succinylcholine (skeletal m. relaxant)

  • laryngeal reflex is lost under GA
  • the spasm is usually from an adverse effect of ketamine
54
Q

Shock

A

Tachy + heart muscle ischemia + mental status change + adrenergic response (anxiety, vomit, diarrhea) + vascular resistance (cool skin)

Stages:

  1. compensatory = tachy + peripheral resistance
  2. progressive = metabolic acidosis (compensation is not enough)
  3. irreversible / refractory = organ failure
55
Q

max dose of epi in adult

A

normal adult = 0.2 mg = 200 mg of epi = 11 carpules of 1:100,000

cardiac risk: 0.04 mg = 40 mg = 2 carpules of 1:100,000

56
Q

Heparin mechanism

A

high MW heteropolysacharide
- Neutralizes thromboplastin AND increases anti-thrombin III, thereby preventing conversion of fibrinogen to fibrin, and blocking thromboplastin generation

Warfarin stops liver from making 2,7,9,10

ASA = plavix = does no affect coagulation path, only platelets. NOTE: plavix (or Acetaminophen) does not cause stomach ulcers like ASA.

57
Q

BRONJ

A

zometa, actonel, boniva, fosamax

  • dronate
58
Q

EtOH addiction is tx with?

A

Disulfuram / metronidazole
- Inhibits the liver enzyme aldehyde dehydrogenase, resulting in high levels of acetaldehyde when EtOH is consumed. This results in a sick feeling.

59
Q

most abused drug by healthcare workers

A

Meperidine (Demerol)

  • synthetic opioid
  • not used in renal failure (along with morphine, NSAIDS, ASA, Aceto.)
  • Not used with MOA inhibitors (Anti-parkinson)
  • Increases concentrations of epi, NE, dopamine, serotonin leading to coma/seizures
60
Q

Opportunistinc sinus infection

A

mucormycosis

NBDE Part II (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions