Where mandibular nerve passes through in the skull - ANSWERForamen Ovale Where nasopalatine nerve passes through - ANSWERIncisive Foramen Maxillary division of Trigeminal Nerve is - ANSWERSensory Nerve NOT associated with the mandibular nerve branch - ANSWERInfraorbital nerve Teeth that PSA innervates - ANSWER1st, 2nd, and 3rd maxillary molars, but may not innervate MB root of the maxillary 1st molar What injection is needed to anesthetize linguals of max anteriors - ANSWERNasopalatine What injections are needed to anesthetize the entire palate on one side - ANSWERGreater Palatine and Nasopalatine How far do you insert the needle on an IANB? - ANSWER20-25 mm or 3/4 the length of the needle What happens during depolarization? - ANSWERSodium in and Potassium out When do you aspirate? - ANSWERRight before anesthetic is to be deposited Which local anesthetic is metabolized by pseudocholinesterase? - ANSWEREsters Topical anesthetics are least effective on? - ANSWERKeratinized tissues Which is true of topical anesthetics? - ANSWERNo systemic problems Which has the highest occurrence of allergic reactions - ANSWEREster option; Benzocaine. What is the significance of giving an amide anesthetic to a patient with cirrhosis? - ANSWERDue to amide anesthetics being metabolized by the liver. What is the landmark for the IANB injection? - ANSWERCoronoid notch Psychogenic pain - ANSWERNo organic base for the pain Max epi dose for cardiac & normal pt - ANSWERCardiac- .04mg Normal- .2mg What is trismus? - ANSWERLimited opening of mouth Management of hematoma - ANSWERCold compression and pressure to bleeding site Management of trismus - ANSWERHeat therapy, saline rinses, asprin and jaw exercises Hematoma can occur if needle penetrates into the pterygoid plexus of veins during which injection? - ANSWERPSA What needle should be used for infiltration? - ANSWER27g short Volume of solution of a single cartridge of LA - ANSWER1.8-1.7ml Antioxidant preventing biodegration of LA by preventing oxidation of vasopressor by oxygen - ANSWERSodium bisulfite Actions of vasopressors - ANSWERIncrease duration of LA, hemostasis, reduce chance of toxicity What would cause a dry cornea? - ANSWERAnesthetizing the facial nerve. The facial nerve can be anesthetized if bone is not contacted during the IANB and anesthetic solution is deposited into the parotid gland. Temporary bell's palsy would not allow the patients eyelid to blink or close, which would cause the dry eye. How to calculate amount of epi in a solution - ANSWER1% solution = 10 X 1.8 (or 1.7) = 18mg (or 17mg) 2% solution = 20 X 1.8 (or 1.7) = 36mg (or 34 mg) 3% solution = 30 X 1.8 (or 1.7) = 54 mg (or 51 mg) Cause of burning upon injection - ANSWERacidic pH of solution, injection too fast, cartridge being wiped with alcohol or sterilizing solution. Cause of needle breakage - ANSWERBending needle, patient movement Why would a patient receive an electric shock during delivery of anesthesia? - ANSWERNeedle touched the nerve sheath Ongoing numbness of the anterior 2/3 of tongue is caused by which nerve being anesthetized? - ANSWERLingual Nerve What is the benefit of slow deposition rate? - ANSWERLess pain, less complications Location for the long buccal injection - ANSWERDistal and buccal to the 2nd mandibular molar