anatomical considerations review

what is division I and where does it exit

ophthalmic and exits thru superior orbital fissure

what is division II and where does it exit

Maxillary and exits thru the foramen rotundum

what is division III and where does it exit

Mandibular and exits thru foramen Ovale

why is the pterygopalatine space important

many nerves travel from the base of the skull to their next destination

where is the pterygopalatine space loacted

anterior to the pterygoid plates of the sphenoid and posterior to the maxilla

what nerve branches does the maxilla bone have that we will be anesthetizing

CN V

is it easier to penetrate maxillary or mandibular bone

maxillary (it is tissue paper thin)

what landmarks on the maxilla are associated w LA (3)

incisive foramen, alveolar canals, and infraorbital foramen

what parts of the palatine bone is important for LA

greater palatine f. and lesser palatine f.

what landmarks on the mandible are associated w LA

mental foramen, mandibular foramen and coronoid notch

mental f is where what nerve exits the mandible

mental nerve

what nerve enters the mandible via mandibular foramen

inferior alveolar n

the coronoid notch is the location for the thumb when identifying the

inferior alveolar n insertion point

what is the function of CN V division I (sensory)

provides sensory to skin of upper 1/3 of face and maxillary sinus

what is the function of CN V division II (sensory)

sensory to middle 1/3 of face and palate and pulp of maxillary teeth

what is the function of CN V division III (sensory + motor)

sensory: to the lower 1/3 of face, floor of the mouth, and anterior 2/3 of tongue

Motor: muscles of mastication + retracts mandible

where does the greater palatine n pass thru

passes thru the palatine bone via greater palatine foramen

greater palatine n is the sensation to what

posterior 2/3 of palate and gingiva to the maxillary posterior teeth

where does the lesser palatine n pass thru

passes thru palatine bone via lesser palatine foramen

lesser palatine nerves gives sensation to

soft palate and tonsils

Nasopalatine passes through

maxilla thru incisive foramen

nasopalatine gives sensory to the

anterior 1/3 of palate, and gingiva of maxillary anterior teeth

PSA branches off in the

pterygopalatine space

PSA gives sensory to

pulp, PDL, alveolar bone of max molars (except MB root of max 1st) and buccal gingiva and mucosa

PSA is anesthesized by

PSA nerve block

Infraorbital n exits maxilla via

infraorbital foramen

if LA is deposited into the infraorbital nerve, what other nerves will be blocked

MSA and ASA

MSA provides sensory to

pulp, PDL, alveolar bone, facial gingiva of max premolars + MB root of max 1st

MSA travels from the __________ nerve through the ______________________________ and enters teeth through ___________________

infraorbital nerve, alveolar canals, apical foramina

how can MSA be anesthetized

either thru MSA block or IO block

ASA provides sensory to

pulp, PDL, alveolar bone and facial gingiva to the anteriors and part of the sinus

ASA travels from the __________ nerve through the ______________________________ and enters teeth through ___________________

infraorbital nerve, alveolar canals, apical foramina

ASA can be anesthetized by either

ASA filtration or IO block

zygomatic nerve branches off in the _____________and enters via_______________________

pterygopalatine space and enters via inferior orbital fissure

zygomatic nerve provides sensory to skin on

side of the forehead and cheeks

what are the 2 branches of the zygomatic nerve

Zygomaticofacial nerve

Zygomaticotemporal nerve

the auriculotemporal n gives afferent and proprioceptive fibers to

TMJ, skin of outer ear, and lateral aspect of the skull

auriculotemporal n is anesthetized with 2 options

Gow gates block and sometimes with inferior alveolar block

buccal nerve is sensory to

mucosa, skin of the cheek, and buccal gingiva of mand molars

buccal nerve is anesthetized by

buccal n block

lingual n provides sensory to

floor of mouth, lingual gingiva of mand teeth and anterior 2/3 of tongue

lingual n is anesthetized by

Inferior alveolar block

inferior alveolar n provides sensory to

pulp of mand teeth to midline, supporting bone/ PDL (w the help of terminal branches the facial gingiva and labial mucosa of anteriors and premolars)

inferior alveolar n enters mandible via ______________ and enters teeth via ____________________

mandibular foramen, apical foramina

2 branches of the inferior alveolar n are

incisive n and mental n

inferior alveolar n is anesthetized thru what block

inferior alveolar n block

incisive n is sensory for

mandibular anteriors and premolars

incisive n is anesthetized by

inferior alveolar n block

mental n is sensory for

chin, lower lip, labial mucosa, and gingiva of anteriors and premolars

mental n is anesthetized by (2 ways)

inferior alveolar n block or separately by mental n block

facial nerve (CNVII) exits skull via ____________ into _______________________

internal acoustic meatus, into petrous part of temporal bone

afferent fibers of CN VII go thru __________________ and provide TASTE to _______________

petrotympanic fissure and provide TASTE to anterior 2/3s of tongue

efferent fibers of CN VII go thru __________________ and provide MOTOR to _______________

stylomastoid foramen and provide MOTOR to muscles of facial expression, stylohyoid and platysma

secretory fibers of CN VII are for what glands

sublingual and submandibular

CN VII passes thru what gland but doesnt provide fibers to it

parotid gland

what nerve can we NOT anesthetize because it can result in facial paralysis

facial nerve!!!

numerous deep veins drain blood from the upper part of the face, tissues of the lips, and muscles around the mouth, posterior part of nasal cavity, palate, maxillary alveolar process, and maxillary teeth into the _____________________

pterygoid plexus

nicking artery or vein may lead to a

hematoma

a hematoma most associated w what LA

PSA (extraoral) and IA (intraoral)

what can happen if we do not aspirate or if we move and do not reaspirate

increase HR and/or more severe overdose symptoms