| Term 
 
        | What are the 3 branches of V1? |  | Definition 
 
        | - nasociliary - frontal - lacrimal   (NFL) |  | 
        |  | 
        
        | Term 
 
        | What are the 2 branches of the frontal nerve? |  | Definition 
 
        | - supraorbital - supratrochlear |  | 
        |  | 
        
        | Term 
 
        | What are the 3 branches of the trigeminal nerve? |  | Definition 
 
        | V1 - ophthalmic V2 - maxillary V3 - mandibular |  | 
        |  | 
        
        | Term 
 
        | What are the branches of V2? |  | Definition 
 
        | - zygomatic - 2 pterygopalatine trunks - PSA - infraorbital   (ZIPP) |  | 
        |  | 
        
        | Term 
 
        | What are the 9 branches of the infraorbital nerve? |  | Definition 
 
        | - ASA - MSA - orbital - pharyngeal branch - pterygopalatine trunks - nasopalatine - greater palatine - lesser palatine - posterior palatine |  | 
        |  | 
        
        | Term 
 
        | What does the PSA innervate? |  | Definition 
 
        | - 3rd molar - 2nd molar - DB and palatal root of 1st molar - associated BUCCAL gingiva |  | 
        |  | 
        
        | Term 
 
        | The MSA is absent in what percent of people? Is this clinically relevant? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What does the MSA innervate? |  | Definition 
 
        | - MB root of 1st molar - 2nd premolar - 1st premolar - associated BUCCAL gingiva |  | 
        |  | 
        
        | Term 
 
        | When absent, what nerve supplies the region normally supplied by the MSA? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What does the ASA innervate? |  | Definition 
 
        | - canine - incisors to midline - when MSA absent, premolars and MB root of 1st molar |  | 
        |  | 
        
        | Term 
 
        | What does the greater palatine nerve innervate? |  | Definition 
 
        | - hard palate posterior to D line angle of canine   (anterior border = D line angle of canine medial border = midline of hard palate)   |  | 
        |  | 
        
        | Term 
 
        | What does the nasopalatine nerve innervate? |  | Definition 
 
        | - hard palate anterior to D line angle of canines |  | 
        |  | 
        
        | Term 
 
        | What are the branches of the sensory root of V3? |  | Definition 
 
        | -mylohyoid (MOTOR) - auriculotemporal - lingual - inferior alveolar (incisive and mental branches)     (MAIL) |  | 
        |  | 
        
        | Term 
 
        | What are the branches of the motor root of V3? |  | Definition 
 
        | - buccal (SENSORY) - lateral pterygoid muscle - temporal muscle - masseter muscle   (BLT...Mmmm) |  | 
        |  | 
        
        | Term 
 
        | What can be anesthetized by an IAN block? |  | Definition 
 
        | - the entire ipsilateral half of the mandible except for B gingiva posterior to 2nd premolar   *lingual area not supplied by IAN, but lingual nerve is so close to IAN that block of IAN also affects lingual |  | 
        |  | 
        
        | Term 
 
        | What is innervated by the incisive branch of the IAN? |  | Definition 
 
        | - 1st premolar - canine - incisors (to midline) |  | 
        |  | 
        
        | Term 
 
        | What is innervated by the mental branch of the IAN? |  | Definition 
 
        | - lower lip - gingiva anterior to mental foramen   (SOFT TISSUE) |  | 
        |  | 
        
        | Term 
 
        | What nerve must be accounted for when placing an implant in the region of the 1st mandibular premolar? How? |  | Definition 
 
        | - mental branch of IAN - it loops anteriorly before entering mental foramen, so implants must be placed at least 2mm anterior to mental foramen to avoid damage |  | 
        |  | 
        
        | Term 
 
        | What is innervated by the buccal nerve? |  | Definition 
 
        | - buccal mucosa and gingiva posterior to mental foramen (i.e., the midline of the 2nd premolar) - the cheek and the corner of the mouth |  | 
        |  | 
        
        | Term 
 
        | What is innervated by the lingual nerve? |  | Definition 
 
        | - lingual gingiva and mucosa - tongue |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - painful sensation to normal touch |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - complete lack of sensation |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - spontaneous abnormal sensation |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - decreased sensation to normal touch |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - increased sensation to normal touch |  | 
        |  | 
        
        | Term 
 
        | T/F: The mechanism of action of LAs is reversible. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | T/F: Binding of LA molecule to Na channel decreases rate of depolarization. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which organ is more susceptible to damage from LAs: the brain or the heart? |  | Definition 
 
        | - the brain (must have much larger concentration to affect heart) |  | 
        |  | 
        
        | Term 
 
        | What is the special term for the cell membrane surrounding an axon? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | The composition of myelin is mostly what? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What is the special term for the cytoplasm within an axon? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | T/F: Unmyelinated fibers do not have Schwann cells. |  | Definition 
 
        | - false (they do have Schwann cells, but lack the corresponding lipoprotein sheath) |  | 
        |  | 
        
        | Term 
 
        | T/F: The AP threshold is reached by increasing the negative membrane potential by 15mV. |  | Definition 
 
        | - false (it is reached by DECREASING the negative membrane potential by 15mV (from -70mV to -55mV) |  | 
        |  | 
        
        | Term 
 
        | Which takes longer, depolarization or repolarization? |  | Definition 
 
        | - repolarization (.7 ms)   (depolarization takes .3 ms) |  | 
        |  | 
        
        | Term 
 
        | To which ion(s) is a nerve freely permeable at rest? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | T/F: A nerve membrane is impermeable to Na at rest. |  | Definition 
 
        | - FALSE (it's slightly permeable to Na) |  | 
        |  | 
        
        | Term 
 
        | What materials contribute to the negative charge of the intracellular membrane of a nerve at rest? |  | Definition 
 
        | - proteins and amino acids |  | 
        |  | 
        
        | Term 
 
        | Which ion has the largest extracellular concentration? Intracellular? (Cl, K, or Na) |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which is greater, the ratio of intra- to extracellular K, or the ratio of extra- to intracellular Na? |  | Definition 
 
        | - intra- to extracellular K |  | 
        |  | 
        
        | Term 
 
        | Are newer LAs esters or amides? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Do biotoxins act by blocking Na channels internally or externally? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | T/F: The mechanism of action of benzocaine is receptor-dependent. |  | Definition 
 
        | - false (it acts by expanding the nerve membrane) |  | 
        |  | 
        
        | Term 
 
        | According to the specific receptor theory, LAs act by binding to channel receptors on which surface(s) (internal, external)? |  | Definition 
 
        | - either internal or external |  | 
        |  | 
        
        | Term 
 
        | Why might infection make an LA ineffective? |  | Definition 
 
        | - the acidic environment will lead to a higher ratio of protonated to deprotonated LA, meaning that more of it will be charged and unable to penetrate the cell membrane |  | 
        |  | 
        
        | Term 
 
        | Typically, are LAs with a higher pKa more likely to be protonated (charged) or deprotonated (uncharged) at physiological pH? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What is considered the gold standard for LAs? |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | - increasing tolerance to drug that is given repeatedly |  | 
        |  | 
        
        | Term 
 
        | Increased protein binding = __ duration and potency. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Increased pKa = __ onset and __ duration. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Increased lipid solubility = __ potency. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Increased (nonnervous) tissue diffusibility = __ onset. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Increased vasodilator activity = __ potency and duration. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What is the uppermost limit of a safe dose of a typical LA (in mg/Kg) |  | Definition 
 
        | - 5 mg anesthetic / 1 Kg body weight |  | 
        |  | 
        
        | Term 
 
        | How many mg of anesthetic are in 1 cc? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the structural characteristics of a catecholamine? |  | Definition 
 
        | - OH groups in 3rd and 4th position of aromatic ring - NH2 attached to aliphatic side chain |  | 
        |  | 
        
        | Term 
 
        | Which adrenergic receptor is responsible for vasoconstriction? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which adrenergic receptor is associated with increased heart rate, strength of contraction, lipolysis and glycogenolysis? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which adrenergic receptor is associated with broncho- and vasodilation? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Norepinephrine has the least effect on which adrenergic receptors? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | In a 1:1000 ratio, what do the 2 numbers stand for? |  | Definition 
 
        | 1 = grams of drug 1000 = mL of solution |  | 
        |  | 
        
        | Term 
 
        | In a concentration of 1:25,000, how many mg/mL are there? |  | Definition 
 
        | 1g / 25,000mL = 1000mg / 25,000mL = .04 g/mL |  | 
        |  | 
        
        | Term 
 
        | For epinephrine, which adrenergic receptor activity predominates? (a or ß) |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which has higher vasopressor potency, epinephrine or NE? |  | Definition 
 
        | - epinephrine (NE is 25% as potent) |  | 
        |  | 
        
        | Term 
 
        | Activity in which adrenergic receptor for NE predominates? (a or ß) |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What is the correct dosage of epinephrine for a healthy person? For the CV impaired? |  | Definition 
 
        | healthy = .2 mg CV impaired = .04 mg |  | 
        |  | 
        
        | Term 
 
        | What is the correct dosage of NE for a healthy person? For the CV impaired? |  | Definition 
 
        | healthy = .34mg CV impaired = .14mg |  | 
        |  | 
        
        | Term 
 
        | Articaine is __x as potent and __x as toxic as lidocaine. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the contraindications for articaine? |  | Definition 
 
        | - methemoglobinemia (idiopathic or congenital) - sulfur allergy |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - eutectic mixture of local anesthesia oil in water solution w/ high concentrations of prilocaine and lidocaine |  | 
        |  | 
        
        | Term 
 
        | T/F: An EMLA is ineffective on intact skin. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | T/F: The presence of a vasoconstrictor lowers the pH of an LA solution. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What compound is added to an LA solution to maintain its pH near physiological norms? |  | Definition 
 
        | - sodium bicarbonate (NaHCO2) |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - tonic contraction of muscles of mastication (various causes) |  | 
        |  | 
        
        | Term 
 
        | What are the 5 advantages of a reusable syringe? |  | Definition 
 
        | - long-lasting - autoclavable - rust resistant - visible cartridge - easy aspiration |  | 
        |  | 
        
        | Term 
 
        | What are the 3 disadvantages of a reusable syringe? |  | Definition 
 
        | - large - heavy - disease transmission w/ improper care |  | 
        |  | 
        
        | Term 
 
        | What is a pressure type syringe used for? |  | Definition 
 
        | - PDL (periodontal ligament) injections |  | 
        |  | 
        
        | Term 
 
        | What is the main disadvantage of a pressure type syringe? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the 2 main advantages of a pressure type syringe? |  | Definition 
 
        | - enclosed barrel - ease of administration |  | 
        |  | 
        
        | Term 
 
        | What are the 2 advantages of a jet injector? |  | Definition 
 
        | - no needles - can be used instead of topical |  | 
        |  | 
        
        | Term 
 
        | What are the 2 disadvantages of a jet injector? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What is caused by an off-center perforation (of the cartridge by the needle)? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the lengths of a long and short dental needle? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the 3 typical gauges of dental needles? |  | Definition 
 
        | - 25 (largest, red), 27 (yellow) and 30 (smallest, blue) |  | 
        |  | 
        
        | Term 
 
        | What are the 5 advantages of a larger gauged needle? |  | Definition 
 
        | - less deflection - easier aspiration - no difference in comfort - less breakage - greater accuracy |  | 
        |  | 
        
        | Term 
 
        | What is the volume of a typical dental anesthetic cartridge? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | A 1% solution is how many mg drug / mL solution |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What 2 ingredients do vasopressor-containing LAs have that plain LAs don't? |  | Definition 
 
        | - vasopressor (usually epinephrine) - sodium metabisulfite (antioxidant) |  | 
        |  | 
        
        | Term 
 
        | What 3 ingredients to all LA solutions contain? |  | Definition 
 
        | - anesthetic drug - HCL - sterile water |  | 
        |  | 
        
        | Term 
 
        | What causes an extruded rubber plunger? |  | Definition 
 
        | - freezing - storing too long in disinfectant |  | 
        |  | 
        
        | Term 
 
        | What gas forms bubbles in LA cartridges? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the 5 causes of burning on injection? |  | Definition 
 
        | - high temperature of LA - contamination with disinfectant - vasoconstrictor - low pH - rapid injection |  | 
        |  | 
        
        | Term 
 
        | T/F: Used needles should be stored with used cartridges. |  | Definition 
 
        | - fasle (stored in separate containers) |  | 
        |  | 
        
        | Term 
 
        | T/F: At low doses, LAs have anticonvulsant properties because they block epileptic foci. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | The first CNS effect of LAs is on which impulse (inhibitory or facilitory)? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the 5 causes of failure to achieve anesthesia? |  | Definition 
 
        | - pt variation (anatomic or metabolic) - too much delay b/w injection and procedure - intravascular injection - intramuscular injection - injection in infected area |  | 
        |  | 
        
        | Term 
 
        | What are the 4 most common anatomical variations that cause anesthetic failure? |  | Definition 
 
        | - mylohyoid - multiple canals - lingual nerve - cervical plexus |  | 
        |  | 
        
        | Term 
 
        | For an infiltration, how long does it take for anesthetic depth? For a block? |  | Definition 
 
        | infiltration = 2 min block = 5 min |  | 
        |  | 
        
        | Term 
 
        | What is the most common cause of a brief seizure? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What is the most common complication in the dental office? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are 4 strategies to overcome anesthesia failure in an infected area? |  | Definition 
 
        | - give more anesthetic - do a block - do a PDL injection - use bicarbonate in LA solution (to maintain more neutral pH, which preserves vasoconstrictor) |  | 
        |  | 
        
        | Term 
 
        | What are the advantages of a PDL injection in an infected area? |  | Definition 
 
        | - it's direct acting - it's under pressure |  | 
        |  | 
        
        | Term 
 
        | What injections can be used in ALL pts w/ bleeding disorders? |  | Definition 
 
        | - infiltration - PDL - intraosseous |  | 
        |  | 
        
        | Term 
 
        | A pt's anticoagulant can be witheld if they are not at high risk. An example of high risk is __, and an example of low risk is __. |  | Definition 
 
        | high = valve replacement or clotting disorder low = deep vein thrombosis |  | 
        |  | 
        
        | Term 
 
        | What vitamin deficiency leads to increased clotting time? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | If platelet count is greater than __, you can proceed w/ Tx. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | T/F: You can do a procedure on a pt with a moderate clotting factor deficiency. |  | Definition 
 
        | - true (mild-mod, but not high) |  | 
        |  | 
        
        | Term 
 
        | What are the solutions to a -caine "allergy"? |  | Definition 
 
        | - use amide - use antihistamine - get allergy testing |  | 
        |  | 
        
        | Term 
 
        | What are the LA-associated chemicals that most commonly cause allergic reactions? |  | Definition 
 
        | - PABA (from ester metabolism) - methylparaben (perservative used in multi-dose vials) - sodium metabisulfate (anti-oxidant used in LAs with vasoconstrictors) |  | 
        |  | 
        
        | Term 
 
        | Which 2 LAs can be used in epinephrine-sensitive pts (b/c they cause least amount of vasodilation w/o a vasoconstrictor)? |  | Definition 
 
        | - prilocaine - bupivicaine |  | 
        |  | 
        
        | Term 
 
        | What are the 4 indications for an intraosseous injection? |  | Definition 
 
        | - failed block - short procedure - bleeding disorder - more profound anesthesia required |  | 
        |  | 
        
        | Term 
 
        | What are the 5 advantages of an intraosseous injection? |  | Definition 
 
        | - profound anesthesia - no need for block - safe in those w/ bleeding disorders - immediate onset - minimal complications |  | 
        |  | 
        
        | Term 
 
        | Why is there more profound anesthesia from an intraosseous injection? |  | Definition 
 
        | - higher concentration of nerve endings |  | 
        |  | 
        
        | Term 
 
        | What are the 3 disadvantages of an intraosseous injection? |  | Definition 
 
        | - technique sensitive - difficult to access in posterior mandible - short duration |  | 
        |  | 
        
        | Term 
 
        | Why is the duration of an intraosseous injection short? |  | Definition 
 
        | - bone is highly vascularized and has large surface area |  | 
        |  | 
        
        | Term 
 
        | T/F: An intraosseous injection is administered in conjunction with a local infiltration. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the 3 causes of common bleeding abnormalities? |  | Definition 
 
        | - hemophilia (missing clotting factor) - thrombocytopenia (low platelets) - anticoagulant medication |  | 
        |  | 
        
        | Term 
 
        | For pts with liver disorders, which type of LA should be avoided (amide or ester)? |  | Definition 
 
        | - amide (it's metabolized in liver by CYP450) |  | 
        |  | 
        
        | Term 
 
        | For pts with renal disorders, what strategy should be used? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What precautions should be taken with ASA II pts? ASA III? |  | Definition 
 
        | II - exercise caution III - limit epi to .04 |  | 
        |  | 
        
        | Term 
 
        | What are 3 the causes of needle breakage? |  | Definition 
 
        | - small (gauged) needle - bent needle - manufacturer defect |  | 
        |  | 
        
        | Term 
 
        | How do you prevent needle breakage? |  | Definition 
 
        | - don't bend needle - use higher gauge - don't insert into tissue all the way to the hub |  | 
        |  | 
        
        | Term 
 
        | What are the 2 causes of pain on injection? |  | Definition 
 
        | - dull needle - rapid deposition |  | 
        |  | 
        
        | Term 
 
        | How do you avoid pain on injection? |  | Definition 
 
        | - proper technique - sharp needle - use topical - correct temp |  | 
        |  | 
        
        | Term 
 
        | How do you avoid burning on injection? |  | Definition 
 
        | - proper technique - do not warm solution - do not store in solution |  | 
        |  | 
        
        | Term 
 
        | What are the 3 causes of persistent anesthesia? |  | Definition 
 
        | - direct nerve trauma - contaminated solution - neurotoxicity |  | 
        |  | 
        
        | Term 
 
        | What can you do to prevent persistent anesthesia? |  | Definition 
 
        | - proper technique - do not store/soak in solution |  | 
        |  | 
        
        | Term 
 
        | What are the 5 causes of trismus? |  | Definition 
 
        | - muscle trauma - hemotoma - infection - excess volume - contaminated solution |  | 
        |  | 
        
        | Term 
 
        | How do you avoid trismus? |  | Definition 
 
        | - proper technique - do not store in solution |  | 
        |  | 
        
        | Term 
 
        | How do you clinically manage trismus? |  | Definition 
 
        | - heat - exercise - analgesics / NSAIDS - muscle relaxants - antibiotics |  | 
        |  | 
        
        | Term 
 
        | What is the cause of a hematoma? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What is the treatment for a hematoma? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the 5 causes of edema? |  | Definition 
 
        | - traumatic injection - hemorrhage - allergy - irritation - infection   (HAITI) |  | 
        |  | 
        
        | Term 
 
        | How do you prevent edema? |  | Definition 
 
        | - atraumatic injection - proper handling of armamentarium - complete medical Hx |  | 
        |  | 
        
        | Term 
 
        | What are the 2 causes of localized sloughing? |  | Definition 
 
        | - epithelial desquamation - sterile abscess |  | 
        |  | 
        
        | Term 
 
        | How do you prevent sloughing? |  | Definition 
 
        | - proper injection technique |  | 
        |  | 
        
        | Term 
 
        | What do you do if you inadvertently paralyze the facial nerve? |  | Definition 
 
        | - reassure pt - manually close eye (tape shut at night) - avoid contacts |  | 
        |  | 
        
        | Term 
 
        | What are the 2 causes of intraoral lesions? |  | Definition 
 
        | - aphthous ulcers - herpes |  | 
        |  | 
        
        | Term 
 
        | What drugs can be used to treat intraoral lesions? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | LA overdose is usually caused by what? |  | Definition 
 
        | - an excessive total dose |  | 
        |  | 
        
        | Term 
 
        | How do you prevent vascular injection? |  | Definition 
 
        | - aspirate - inject slowly |  | 
        |  | 
        
        | Term 
 
        | In methemoglobinemia, iron is not changed from its __ state to its __ state (which it has to be in to bind oxygen). |  | Definition 
 
        | - oxidized (F3+) to reduced (F2+) |  | 
        |  | 
        
        | Term 
 
        | Which LAs can cause methemoglobinemia? |  | Definition 
 
        | - benzocaine, xylocaine (lidocaine) |  | 
        |  | 
        
        | Term 
 
        | Methemoglobinemia can be caused by a deficiency of what enzyme? |  | Definition 
 
        | - cytochrome b5 reductase |  | 
        |  | 
        
        | Term 
 
        | How is methemoglobinemia treated? |  | Definition 
 
        | - methylene blue - supplemental oxygen |  | 
        |  | 
        
        | Term 
 
        | When methemoglobin levels rise above __%, pts become cyanotic. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | When methemoglobin levels rise above __%, pts have dyspnea and weakness. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Methemoglobin levels above __% are incompatible with life. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are the signs of an anaphylactic allergic reaction? |  | Definition 
 
        | - erythematous rash - dyspnea - tachycardia - hypotension |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - coronoid notch - occlusal plane - pterygomandibular raphe - opposite corner of mouth - target = superior to mand. foramen, 3/4 distance from coronoid notch to pterygomandibular raphe NUMBS - entire half of mandible EXCEPT B tissue D to 2nd premolar   |  | 
        |  | 
        
        | Term 
 
        | What are the complications from an IAN? |  | Definition 
 
        | - VII block - hematoma - trismus - failed anesthesia (mylohyoid n?) |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Target = mucobuccal fold / ant. ramus near 3rd molar - given directly following IAN NUMBS - B tissue D to 2nd premolar |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - lingual vestibule near 3rd molar - target = posterior mylohyoid ridge |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - target = mandibular condyle - bite block for 1-2 min - success > 95% NUMBS - entire half of mandible (including cheek and temporal area) |  | 
        |  | 
        
        | Term 
 
        | What are the complications of a V3-Gow Gates? |  | Definition 
 
        | - hematoma -trismus - III, IV, VI paralysis (avoid by not injecting unless contacting bone) |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - mucogingival junction of max. 3rd molar - maxillary tuberosity - coronoid notch - target = soft tissue medial to ramus, behind max. tuberosity NUMBS - entire half of mandible EXCEPT B tissue D to 2nd premolar (same as IAN) - success rate = 80% |  | 
        |  | 
        
        | Term 
 
        | What are the complications of a V3-Closed? |  | Definition 
 
        | - hematoma - trismus - VII palsy |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - mucobuccal fold of mand. premolar - target = mental foramen - apply digital pressure for 1-2 min NUMBS - ipsilateral anteriors, associated tissue, skin of lip and chin |  | 
        |  | 
        
        | Term 
 
        | What is the complication from a mental block? |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | - gingival crevice of any tooth - inject under pressure - consider 30 gauge needle |  | 
        |  | 
        
        | Term 
 
        | For which mandibular injections do you use an entire carpule? |  | Definition 
 
        | - IAN - all V3s (gow-gates, closed) |  | 
        |  | 
        
        | Term 
 
        | Which mandibular block has the greatest chance of a positive aspirate? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which has a higher success rate, V3 open or closed? |  | Definition 
 
        | - open > 95% - closed = 80% |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - max. vestibule of tooth - target = apex of tooth NUMBS - pulp of 1 or 2 teeth |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - mucobuccal fold over 2nd molar - maxillary tuberosity - zygomatic process - target = above 3rd molar - 45˚ to O plane, midline, and axis of 2nd molar NUMBS - molars EXCEPT MB root of 1st   |  | 
        |  | 
        
        | Term 
 
        | What are the complications from a PSA? |  | Definition 
 
        | - hematoma - mand. anesthesia |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - mucobuccal fold over 2nd premolar - target = apex of 2nd premolar NUMBS - MB root of 1st molar, premolars   *BUT, absent in 30-54% of pts, in which case this area is supplied by ASA nerve |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - mucobuccal fold over 1st premolar - infraorbital depression - target = infraorbital rim - apply digital pressure NUMBS - anteriors and associated B tissue, skin between lip and eye |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - junction of max. process and palate - around 1st molar - target = greater palatine foramen - cotton swab pressure for 30s NUMBS - ispilateral palate distal to canine, lateral to midline |  | 
        |  | 
        
        | Term 
 
        | What is the complication for a greater palatine? |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | - central incisor - incisive papilla - target = nasopalatine canal - cotton swab pressure NUMBS - anterior palate to M of 1st premolars |  | 
        |  | 
        
        | Term 
 
        | What is the complication for a nasopalatine? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | V2 - High Tuberosity Approach |  | Definition 
 
        | - (like PSA, but inserted farther) - mucobuccal fold over 2nd molar - maxillary tuberosity - zygomatic process - target = pterygopalatine fossa - 45˚ to O plane, midline, and axis of 2nd molar NUMBS - entire ipsilateral half of maxilla, skin between lip and eye |  | 
        |  | 
        
        | Term 
 
        | What are the complications from a V2 block - high tuberosity approach? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | V2 - Greater Palatine Approach |  | Definition 
 
        | - (same as greater palatine, but inserted farther) - junction of max. process and palate - around 1st molar - greater palatine foramen - target = pterygopalatine fossa NUMBS - entire ipsilateral half of maxilla, skin between lip and eye   |  | 
        |  | 
        
        | Term 
 
        | What are the complications of a V2 greater palatine approach? |  | Definition 
 
        | - hematoma - penetration into orbit or nose |  | 
        |  | 
        
        | Term 
 
        | What LAs have the longest duration (90+ min)? |  | Definition 
 
        | - bupivicaine - etidocaine |  | 
        |  | 
        
        | Term 
 
        | What LAs have the shortest duration (30 min)? |  | Definition 
 
        | - chloroprocaine - prilocaine - lidocaine - mepivicaine |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | - procaine - propoxycaine - tetracaine - cocaine |  | 
        |  | 
        
        | Term 
 
        | What is the only LA that is a ketone? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which injectable LA cannot be used for pulpal anesthesia? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which 2 LAs are the only ones that have a max dosage NOT between 6 and 7 mg/Kg? |  | Definition 
 
        | - bupivicaine = 1.3 - etidocaine = 8 |  | 
        |  | 
        
        | Term 
 
        | Which LA has the greatest vasodilation? Least? |  | Definition 
 
        | greatest = procaine least = mepivacaine |  | 
        |  | 
        
        | Term 
 
        | Which LA is not suitable for injection? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which are the topical LAs? |  | Definition 
 
        | - benzocaine - butacaine - cocaine - tetracaine - duclonine - lidocaine |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | procaine 9.1 bupivacaine 8.1 lidocaine 7.9 prilocaine 7.9 articaine 7.8 etidocaine 7.7 mepivacaine 7.6       |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | procaine 1/1 prilocaine 2/1 lidocaine 2/2 mepivicaine 2/2 articaine 2/2 etidocaine 4/2-4 bupivacaine 4/4 propoxycaine 7/7 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | 
bupivicaine - 1.3prilocaine - 6.0procaine - 6.6mepivicaine - 6.6lidocaine - 6.6lidocaine w/ epi - 7.0articaine - 7.0etidocaine - 8.0 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | 
greatest - procainemore than lidocaine - bupivicaine, etidicaineless than lidocaine - prilocaineleast - mepivicaine |  | 
        |  | 
        
        | Term 
 
        | Which receptor is responsible for vasoconstriction? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What is the Tx of choice for an acute anaphylactic reaction? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which anesthetic block should always be done with a long needle? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which anesthetic has the strongest protein binding? |  | Definition 
 | 
        |  |