Term
| when are 4 times you should not use a cartridge |
|
Definition
1. bubbles larger than 2mm (from freezing)
2. broken cartridge
3. extruded stopper
4. leakage of cartridge during injection |
|
|
Term
| describe pathway and branching of V3 |
|
Definition
exits skull through foramen ovale
menigeal branch supplies meninges
nerve splits between anterior and posterior brs
anterior: musc of mast + long buccal
posterior: lingual, I.A., mylohyoid
IA brs to mental and insicive |
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|
Term
| what is the injection technique for the IA? |
|
Definition
1. enter at mid-coronoid notch where pterygoidmandibular raphe upturns
2. should be at contralateral PM
3. hit bone
4. reposition so that you are more straight on and hit bone again |
|
|
Term
| what could happen if you give IA w/o hitting bone? |
|
Definition
| injection into parotid gland resulting in Bells Palsy |
|
|
Term
| what do the Aa, Ab, Ac, and C nerve fiber parts sense? |
|
Definition
Aa: proprioception of muscle postion
Ab: proprioception
Ac:pain, temp, touch-->myleinated
D: pain, temp, tough -->unmyleinated |
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|
Term
|
Definition
| Specific receptor theory: by blocking sodium channels |
|
|
Term
| what are the 2 nerve coverings of a nerve? |
|
Definition
perineurium: surrounds groups of nerve fibers
epineurium: surrounds indiv nerve fibers |
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|
Term
| how does the LA spread after injection? |
|
Definition
into and then away from site
1. fat/muscle absorbs LA
2. capillaries carry LA away
3. interstitial fluid dilutes LA |
|
|
Term
| what are 4 characteristics of strict topical anesthetics |
|
Definition
1 must be applied in high concentrations
2 can diffuse through mucous membranes but not skin
3 must be dissolved in something (water, alcohol, etc.)
4 benzocaine alters membrane structure
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|
|
Term
what is the absolute dose of 2% lidocaine 1:100,000 epi for an adult?
What is the MRD for weight?
how many mg and ml are in a carpule? |
|
Definition
500mg max
6.6 mg/kg
36mg/1.7 ml |
|
|
Term
| True or False: When mixing LAs, the maximum amount of combined cartridges is the lower # calculated via weight |
|
Definition
|
|
Term
| what are 4 situation contraindications for not giving LA? |
|
Definition
1. dont inject into infected area
2. dont give IA in kids who will bites selves
3. dont give PSA to pts w/ high bleeding risk
4. dont infilitrate into dense bone |
|
|
Term
| what are 3 drug contraindications? |
|
Definition
1don't give amide LA to pts on cimetidine
2dont give esters to pts on sulfonamide Abs
3don't give vasoconstrictors to pts on tricyclic anti depressents, non specific beta blockers, or pts w/ bisulfate allergies |
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|
Term
| what is met-hemoglobin-emia? |
|
Definition
| heme gropu of hb is oxidized to Fe+3 and carries water instead of O2 resulting in hypoxia and cyanosis a 3-4 hrs after lg doses of prilocaine |
|
|
Term
| what is the order of symptoms for local anesthetic toxicity? |
|
Definition
anti convulsant/antiarrythmic
muscular twitching
unconsciousness
convulsions
coma
respitory arrest
CVS depression |
|
|
Term
| how do you anesthasize the mylohyoid nerve? |
|
Definition
| inject just posterior to mand m1 at apical portion, use pdl injection, use gowgates method. |
|
|
Term
| what does the ASA innervate |
|
Definition
| from M of CI to MB root of M1 (unless there is an msa) |
|
|
Term
|
Definition
|
|
Term
| what are advantages of using a larger guage needle? |
|
Definition
less deflection
greater accuracy
better aspiration
less breakage |
|
|
Term
| what are a + and a = of cocaine |
|
Definition
+: long action duration from longer vasoconstrictor time
-: sensitizes myocardium to epi, so cocaine addict could have heart attack in chair if took within 24hrs |
|
|
Term
| what are cardiovascular effects of vasoconstrictor overdose ? |
|
Definition
| angina, HTN, dysarythmias |
|
|
Term
| how much of IV injection would raise a heart rate by 25-70 bpm and BP 20-70mmHG |
|
Definition
|
|
Term
| what does 1: 100,000 parts epi mean? |
|
Definition
that you can give a max of 2 cartridges to an ASA III, IV pt
1 gr vasoconstrictor : 100,000ml
OR
1ug vasoconstrictor : 1 ml |
|
|
Term
| what are Type I and Type IV allergic rxns? |
|
Definition
I=antigen--IgE/anaphylaxis
IV= cell mediated/ delayed |
|
|
Term
| what is the only long duration LA? |
|
Definition
|
|
Term
| what is the only plain LA that lasts a moderate amoutn of time (1hr) |
|
Definition
| prilocaine as nerve block |
|
|
Term
| where aer the biggest risks for aspiration? |
|
Definition
|
|
Term
| what kind of LA injection receives a whole cartridge? |
|
Definition
|
|
Term
| What types of injections should get less than a whole cartridge? |
|
Definition
| MSA/ASA should get about half a cartridge and the rest should get only abouta quarter |
|
|
Term
| who gave the first anesthetic? |
|
Definition
|
|
Term
| why might a needle break? |
|
Definition
bent
repositioned while too deep
... |
|
|
Term
| what are problems with giving LAs? |
|
Definition
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