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Anesthesiology Exam2

QuestionAnswer
Inferior Alveolar Block- Standard Technique. NEEDLE 25 LONG
Inferior Alveolar Block- Standard Technique. DEPTH 20-25mm
Inferior Alveolar Block- Standard Technique. DISTRIBUTION Ipsilateral teeth, periosteum, alveolar bone
Inferior Alveolar Block- Standard Technique. TARGET Into the pterygomandibular space. behind lingula and right above mandibular foramen into the mandibular sulcus on the coronoid process.
Inferior Alveolar Block- Standard Technique. PATHWAY Palpate coronoid notch at deepest concavity with thumb. Insert needle along the bisecting line of the thumb. This will pierce the buccinator muscle.
Inferior Alveolar Block- Standard Technique. CONTACT? YES- Bony Contact
Inferior Alveolar Block- Standard Technique. OTHER Often fail because inject too low. If patient has class III malocclusion, inject 1 cm above bisecting line. Has high rate of positive aspiration.
Gow-Gates. NEEDLE 25 Long
Gow-Gates. DEPTH 20-25 mm
Gow-Gates. DISTRIBUTION 1. inferior alveolar, 2. lingual, 3. mental, 4. incisive, 5. myohyoid, 5. auriculotemporal, 6. buccal.
Gow-Gates. TARGET Neck of condyle. below insertion of lateral pterygoid
Gow-Gates. PATH Medial tendon of temporalis. At height of 2M, slightly distal to 2M. Insert from canine of opposite side.
Gow-Gates. OTHER Follow tragus divergence. Closest thing to a full mandibular block. Long onset, 5 min. Smaller chance of aspiration.
Gow-Gates. CONTACT? Yes
Akinosi. NEEDLE 25 Long
Akinosi. DEPTH 23-27 mm
Akinosi. DISTRIBUTION Inferior alveolar, lingual, mental, incisive, myohyoid (same as G-G but without auriculotemporal and buccal)
Akinosi. TARGET into retromolar mucosa. midway between the maxilla and ramus of CLOSED mouth. at level of mucogingival junction until tip is 1/2 between anterior and posterior planes.
Akinosi. CONTACT? NO!!!! No bony contact.
Long Buccal. NEEDLE 25 Long
Long Buccal. DEPTH 2-3 mm
Long Buccal. DISTRIBUTION Buccal Gingiva at 2PM to 2M
Long Buccal. PATH Medial to external oblique at level of occlusal plane as buccal n. crosses mandibular ramus
Mental Nerve Block. NEEDLE 27 short
Mental Nerve Block. DEPTH 10 mm
Mental Nerve Block. DISTRIBUTION Buccal mucosa between midline and 2PM. Palpate mental foramen with index finger. Inject into mucobuccal fold at or just anterior to foramen, located between apices of 1PM and 2PM
Mental Nerve Block. CONTACT? NO! No bony contact
Supraperiosteal Injection. NEEDLE 27 short
Supraperiosteal Injection. DEPTH 3-4mm
Supraperiosteal Injection. PATH inject into vestibule above tooth, toward apex.
Supraperiosteal Injection. CONTACT? NO! Do NOT contact bone
Anterior Superior Alveolar Block. NEEDLE 27 short
Anterior Superior Alveolar Block. DEPTH 3-4mm
Anterior Superior Alveolar Block. DISTRIBUTION Centrals, Laterals, and Canines pulps and buccal gingiva
Anterior Superior Alveolar Block. TARGET at apex of canine
Middle Superior Alveolar Block. NEEDLE 27 short
Middle Superior Alveolar Block. DEPTH 3-4 mm
Middle Superior Alveolar Block. DISTRIBUTION Max PMs and MB of 1M
Middle Superior Alveolar Block. TARGET apex of 2PM
Posterio Superior Alveolar Block. NEEDLE 25 short
Posterio Superior Alveolar Block. DEPTH 16mm
Posterio Superior Alveolar Block. DISTRIBUTION molars except for MB root of 1M
Posterio Superior Alveolar Block. TARGET Post. superior alveolar nerve foramen at midheight on posterior wall of maxilla
Posterio Superior Alveolar Block. PATH depth of maxilallary vestibule fold, posterior to zygomatic process. normally adjacent or slightly posterior to DB root of 2M.
Posterio Superior Alveolar Block. CONTACT? No! No bony contact
Maxillary Root Lengths CI 12.5/LI 13.5/C 17/1PM 14/2PM 13/1M 13/2M 12
Infraorbital Nerve Block. NEEDLE 25Long
Infraorbital Nerve Block. DEPTH 15mm
Infraorbital Nerve Block. TARGET Infraorbital nerve foramen (1 cm below infraorbital notch on the infraorbital margin)
Infraorbital Nerve Block. PATH Inject lateral to apex of 2PM
Infraorbital Nerve Block. DISTRIBUTION ASA (CI, LI, C), MSA (1PM, 2PM, MB root of 1M), inferior palpebral (lower eyelid), lateral nasal (side of nose), superior labial (upper lip), buccal gingiva. NOT Molars!
Greater Palatine. NEEDLE 27 short
Greater Palatine. DEPTH 3-6 mm
Greater Palatine. DISTRIBUTION palatal gingiva and palate of PMs and Ms
Greater Palatine. TARGET just anterior to the greater palatine foramen
Nasopalatine. NEEDLE 27 short
Nasopalatine. DEPTH 3-5 mm
Nasopalatine. TARGET inject lateral to incisive papilla
Nasopalatine. OTHER First do infiltrations between CIs and then intrapalliary of CIs.
V2 High Tuberosity. NEEDLE 25 Long
V2 High Tuberosity. DEPTH 30-35mm
V2 High Tuberosity. DISTRIBUTION hemimaxilla- pulpal of all teeth on that side, buccal and palatal soft tissue, skin of eyelid, side of nose, cheek and upper lid. (may be incomplete due to cross innervation at midline)
V2 High Tuberosity. TARGET pterygopalatine folla, 10-15mm lateral/inferior to maxillary n.
V2 High Tuberosity. PATH insert at maxillary vestibule, posterior to zygomatic process, slightly posterior to DM root of Maxillary 2PM.
V2 Ptyrgopalatine Approach. NEEDLE 27 long
V2 Pterygopalatine Approach. DEPTH 25-35 mm
V2 Pterygopalatine Approach. DISTRIBUTION hemimaxilla
V2 Pterygopalatine Approach. TARGET pterygopalatine fossa, 100 mm below maxillary n.
V2 Pterygopalatine Approach. PATH insert into greater palatine foramen
V2 Pterygopalatine Approach. COMPLICATIONS get go into eye, nose or infratemporal fossa
Created by: peanut3399
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