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CDCA local anesthesia exam review.
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CDCA local anesthesia exam review.
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CDCA local anesthesia exam reviewwhich has thicker cortical plate, maxillary or mandibular? - ANS-mandibular (this
decreased the amount of the local anesthesia molecules that can penetrate to nerves
during infiltration injections)
due to the thickness of cortical bone, which is a good option for local anesthetic in the
mandibular arch during infiltrations? - ANS-Articaine (Septocaine) is sometimes
effective for mand. infiltrations (4% vs. 2% for lidocaine) due to the increased number of
molecules
hematomas are most common with which type of injection, and why? - ANS-PSA due to
nicking a vessel in the pterygoid plexus of veins
what is the TX for a hematoma? - ANS-pressure, cold compresses on/off, NSAIDS, and
time.
a positive aspiration when administering a PSA is due to what? - ANS-aspirating
hemorrhage caused by injection
what are the three most common locations for hematomas to occur? - ANS-1. PSA
2. IA
3. mental
blanching of the tissue following/during an injection is caused by what? -
ANS-vasospasm/vasoconstriction caused by epinephrine or brushing against autonomic
nerves stimulation vasospasm
the pterygomandibular space/triangle is bordered by what anatomical structures? -
ANS-ramus, lateral pterygoid muscle, and medial pterygoid muscle
the pterygomandibular space/triangle is identified intra-orally by what? - ANS-pterygoid
hamulus (palpation), coronoid notch (palpation), and pterygomandibular raphe (visual)
the mandibular foramen lies approx. __________________________ of the distance
from the anterior border of the ramus to the posterior border - ANS-1/2 to 2/3
, Antero-posteriorly, the greater palatine foramen is located between the
___________________________. - ANS-middle oft he maxillary second molar and the
middle of the third molar in about 80-90% of patients.
all arteries leading to the oral cavity receive blood from what? - ANS-external carotid
(most are direct or indirect branches from the maxillary artery with the exception of the
lingula -- this is a direct branch from the external carotid)
veins from the oral cavity will drain into what? - ANS-internal jugular (both internal and
external drain into the brachiocephalic veins which drain to the superior vena cava
do myelinated or un-myelinated nerves create faster impulse? - ANS-myelinated
(impulses jump from node to node -- node of ranvier)
what is saltatory conduction? - ANS-the process of nerve impulses jumping from nodes
of ranvier along a myelinated nerve
what is the resting potential charges of a nerve? - ANS-inside is negative and outside is
positive
what molecules are predominately outside/inside at resting potential? - ANS-Na+
outside and K+ inside
what is depolarization? - ANS-Na+ channels open , Na+ flows in reversing polarity; K+
flows out to restore neutrality; the Na+ and K+ pumps restore polarity (resting potential)
what is the mechanism of action for local anesthetics? - ANS-blocks the Na+ channels
preventing depolarization
what is the basic structure of anesthetics? - ANS-aromatic ring (lipid soluble),
intermediate chain (amide or ester configuration), and terminal amine (able to ionize
and become water soluble)
lipophilic vs. hydrophyllic - ANS-lipophilic is lipid soluble and hydrophyllic is water
soluble
what makes the terminal amine so important to the structure of local anesthetic? -
ANS-this allows the local anesthetic to the both lipid soluble and water soluble at the
apporpriate times (ex: hydrophyllic for dilution and pH control; lipophyllic in order to
penetrate neuron cell membrane; hydrophyllic to block Na+ channels)
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