QUIZ 2: Week 3 Lecture 1: PSA, NP, GP & Palatal Infiltration

What nerve is anesthetized in the PSA nerve block?

posterior superior nerve - branch of the V2 division of trigeminal nerve

What areas are numbed by the PSA nerve block injection?

Pulpal and buccal tissues of mx molars, excluding the MB root of the mx 1st molar

When do we use an PSA nerve block injection?

For treatment of more than one mx molar

What is the penetration site of the PSA nerve block injection?

within height of maxillary mucobuccal fold superior to apices of maxillary 2nd molar

What is the target site of the PSA nerve block injection?

PSA foramina

What is the technique for administering an ASA nerve block injection?

Short needle (not 30 gauge)

45 degrees (up, back, and in)

Insert ½ - ¾ of the short needle (no more than ¾)

DOUBLE aspirate

How much of a cartridge are you using for a ASA nerve block injection?

Deposit .9 (1/2) -1.7ml (1 cartridge) and aspirate during

What are the outcomes of a PSA injection?

High success rate

Atraumatic

Hematoma --> too far posterior where plexus of veins contacted

Positive aspirations about 3.1%

Mandibular anesthesia --> Position was too lateral or low

What is the contraindication for receiving a PSA injection outcome?

pts with a bleeding disorder

What are the types of palatal block injections?

Nasopalatine --> most uncomfortable

Greater palatine nerve

When would we use a NP palatal block injection?

lingual tissues of 6-11

What areas are numbed by a NP palatal block?

Anterior portion of the hard palate anesthetized from canine to canine (6-11)

Lingual tissues only

What is the penetration site for a NP palatal block?

palatal tissue lateral to incisive papilla

What is the target site for a NP palatal block?

incisive foramen

What is the technique for administering an NP nerve block injection?

Short needle

Apply topical & pressure anesthesia before, during, and after

45-degree angle to papilla & bevel toward bone/palate

Depths vary, but generally, just need to insert to cover bevel

How much of a cartridge are you using for a NP palatal block injection?

aspirate and deposit .45 ml (¼ cartridge)

What are the outcomes of a NP palatal block injection?

<1% positive aspirations

Tissue may bleed after removal of the needle

What is the contraindication for receiving a NP palatal block injection?

if the anterior hard palate has trauma / thermal burn

When would we use a GP palatal block injection?

treatment on several areas, lingual soft tissues only

What areas are numbed by a GP palatal block?

the lingual soft tissue on the posterior portion of the palate

What is the penetration site for a GP palatal block?

1-2 mm anterior to the greater palatine foramen (feels squishier)

What is the target site for a GP palatal block?

greater palatine foramen

What is the technique for administering an GP nerve block injection?

Short needle

Approach is from the opposite side of the arch. 90-degree angle

Apply topical and pressure anesthesia

Depths vary, but generally, just need to insert to cover bevel

Bevel toward bone / palate

How much of a cartridge are you using for a GP palatal block injection?

Deposit .45 - .6 ml

When do we use a palatal infiltration injection?

one tooth - lingual soft tissues

used alongside a SP which numbs the tooth and buccal side

What is the penetration sight of the palatal infiltration injection?

5-10 mm. from the gingival margin using pressure anesthesia

What is the technique for administering a palatal infiltration injection?

Short needle

Use for one or two small areas to achieve lingual soft tissue anesthesia

Depths vary, but generally, just need to insert to cover bevel

Bevel toward bone/palate

How much of a cartridge are you using for a palatal infiltration injection?

Deposit .2-.3 ml