Anesthesia Midterm 2

When are medical history questionnaires updated

every 6 months

How long do you wait to do a dental procedure after a patient had a myocardial infarction

6 months

what is the most important step before administering local anesthetic

updating medical history

What is the single most important element of preparation of dental office to prevent emergencies 

basic life support training for all staff members

during a physical exam, what are the 6 vitals to be taken

BP, pulse, respiratory rate, temp, height , weight

What is the most common psychogenic reaction to local anesthetic

syncope (fainting)

drug interactions associated with LA

Increased risk of serious elevation in BP along with bradycardia

What is the maximum dose of LA for a healthy patient

0.2mg per appointment

What is the maximum dose of LA for a cardiovascular disease involved pt

0.04 mg per apt

what is the maximum dose of 1:100,00 epinepherine for a healthy patient

11 carpules

what is the maximum dose of 1:100,00 epinepherine for a cardiovascular disease patient

2 carpules

what do vasoconstrictors do

homeostasis, decrease levels of toxicity, increase duration of anesthetic

what is the most effective vasoconstrictor for homeostasis

epinepherine

what is added to cartridges to preserve vasoconstrictors

sodium bisulfate

If a patient is allergic to sulfide, what should you not give them

vasoconstrictors

bone is less dense in which patients

children

is needle penetration more or less deep in children

less deep

why does the IA have a greater success in children

mandibular foramen is more inferior

What happens if a patient has an infection

Infected tissues have a more acidic pH, leading to a slower onset, and local anesthetic level in blood to be elevated

what is local infiltration

an injection in which LA is deposited at or above apex of tooth to be treated

What is field block

an injection in which LA is deposited near larger terminal nerve branches

another name for local infiltration

supraperiosteal

Nerve block

an injection in which LA is deposited close to a main nerve trunk

What needle is used for PSA

27 gauge short needle

what needle is used for MSA

27 gauge short needle

what needle is used for ASA

25 or 27 gauge short needle

What needle is used for greater palatine nerve block

27 gauge short needle

What needle is used for nasopalatine nerve block

27 gauge short needle

what needle is used for inferior alveolar nerve block

long 25 gauge needle

what nerve block has the greatest percentage for positive aspirations

IA

Why is the IA commonly missed

insertion of needle too low, accessory innervations ,anatomical variations

what needle is used for lingual nerve block

long 25 gauge needles

what needle is used for buccal nerve block

25 or 27 gauge long needle

what needle is used for mental nerve block

25 or 27 short needle

what injection requires pressure

incisive nerve block

Initial signs of LA overdose

talkativeness, elevated BP/pulse, slurred speech

moderate-high overdose signs of LA

CNS depression, hypotension, tonic-clonic seizure activity

how can you decrease risk for overdose

use an aspirating syringe, a large gauge needle, aspirate in 2 planes, inject slowly

contraindicators for vasoconstrictors

PT who is taking tricyclic antidepressants, monoamine oxidase inhibitors or non-selective beta blockers

what to do when there is a needle breakage

calmly inform the patient, refer to oral surgeon and document

what is trismus

prolonged spasms of the jaw muscles resulting in difficulty opening the mouth

how to manage trismus

heat therapy, physiotherapy, warm saline rinses

what causes facial nerve paralysis

depositing anesthetic into capsule of parotid gland

how to manage a hematoma

apply pressure and ice. DO NOT APPLY HEAT

how to manage syncope

patient should be placed in a trendelenburg position

what is the most serious reaction to LA a patient can have

an allergic reaction

What are the 3 tool that can prevent up to 90% of medical emergencies in the dental office

medical history questionnaire, dialogue history, physical examination

what is stable angina pectoris

chest pain that is relieved with nitroglycerin and the pain does not return

what is succinylcholine

depolarizing muscle relaxant

what are 2 vasoconstrictors

epinepherine and levonordefrin

how long should it take to administer a whole 1.8ml cartridge

2 minutes

when should a needle be changed

after 3-4 uses

What causes sloughing of tissues

Epithelial desquamation, resolves on its own

Which injection requires pressure at injection site intraorally or extraorally for 2 minutes

Incisive nerve block