Anesthesiology Exam2
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| Inferior Alveolar Block- Standard Technique. NEEDLE | 25 LONG
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| Inferior Alveolar Block- Standard Technique. DEPTH | 20-25mm
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| Inferior Alveolar Block- Standard Technique. DISTRIBUTION | Ipsilateral teeth, periosteum, alveolar bone
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| 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.
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| 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.
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| Inferior Alveolar Block- Standard Technique. CONTACT? | YES- Bony Contact
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| 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.
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| Gow-Gates. NEEDLE | 25 Long
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| Gow-Gates. DEPTH | 20-25 mm
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| Gow-Gates. DISTRIBUTION | 1. inferior alveolar, 2. lingual, 3. mental, 4. incisive, 5. myohyoid, 5. auriculotemporal, 6. buccal.
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| Gow-Gates. TARGET | Neck of condyle. below insertion of lateral pterygoid
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| Gow-Gates. PATH | Medial tendon of temporalis. At height of 2M, slightly distal to 2M. Insert from canine of opposite side.
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| Gow-Gates. OTHER | Follow tragus divergence. Closest thing to a full mandibular block. Long onset, 5 min. Smaller chance of aspiration.
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| Gow-Gates. CONTACT? | Yes
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| Akinosi. NEEDLE | 25 Long
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| Akinosi. DEPTH | 23-27 mm
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| Akinosi. DISTRIBUTION | Inferior alveolar, lingual, mental, incisive, myohyoid (same as G-G but without auriculotemporal and buccal)
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| 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.
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| Akinosi. CONTACT? | NO!!!! No bony contact.
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| Long Buccal. NEEDLE | 25 Long
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| Long Buccal. DEPTH | 2-3 mm
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| Long Buccal. DISTRIBUTION | Buccal Gingiva at 2PM to 2M
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| Long Buccal. PATH | Medial to external oblique at level of occlusal plane as buccal n. crosses mandibular ramus
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| Mental Nerve Block. NEEDLE | 27 short
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| Mental Nerve Block. DEPTH | 10 mm
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| 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
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| Mental Nerve Block. CONTACT? | NO! No bony contact
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| Supraperiosteal Injection. NEEDLE | 27 short
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| Supraperiosteal Injection. DEPTH | 3-4mm
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| Supraperiosteal Injection. PATH | inject into vestibule above tooth, toward apex.
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| Supraperiosteal Injection. CONTACT? | NO! Do NOT contact bone
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| Anterior Superior Alveolar Block. NEEDLE | 27 short
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| Anterior Superior Alveolar Block. DEPTH | 3-4mm
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| Anterior Superior Alveolar Block. DISTRIBUTION | Centrals, Laterals, and Canines pulps and buccal gingiva
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| Anterior Superior Alveolar Block. TARGET | at apex of canine
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| Middle Superior Alveolar Block. NEEDLE | 27 short
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| Middle Superior Alveolar Block. DEPTH | 3-4 mm
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| Middle Superior Alveolar Block. DISTRIBUTION | Max PMs and MB of 1M
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| Middle Superior Alveolar Block. TARGET | apex of 2PM
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| Posterio Superior Alveolar Block. NEEDLE | 25 short
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| Posterio Superior Alveolar Block. DEPTH | 16mm
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| Posterio Superior Alveolar Block. DISTRIBUTION | molars except for MB root of 1M
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| Posterio Superior Alveolar Block. TARGET | Post. superior alveolar nerve foramen at midheight on posterior wall of maxilla
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| Posterio Superior Alveolar Block. PATH | depth of maxilallary vestibule fold, posterior to zygomatic process. normally adjacent or slightly posterior to DB root of 2M.
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| Posterio Superior Alveolar Block. CONTACT? | No! No bony contact
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| Maxillary Root Lengths | CI 12.5/LI 13.5/C 17/1PM 14/2PM 13/1M 13/2M 12
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| Infraorbital Nerve Block. NEEDLE | 25Long
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| Infraorbital Nerve Block. DEPTH | 15mm
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| Infraorbital Nerve Block. TARGET | Infraorbital nerve foramen (1 cm below infraorbital notch on the infraorbital margin)
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| Infraorbital Nerve Block. PATH | Inject lateral to apex of 2PM
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| 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!
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| Greater Palatine. NEEDLE | 27 short
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| Greater Palatine. DEPTH | 3-6 mm
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| Greater Palatine. DISTRIBUTION | palatal gingiva and palate of PMs and Ms
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| Greater Palatine. TARGET | just anterior to the greater palatine foramen
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| Nasopalatine. NEEDLE | 27 short
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| Nasopalatine. DEPTH | 3-5 mm
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| Nasopalatine. TARGET | inject lateral to incisive papilla
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| Nasopalatine. OTHER | First do infiltrations between CIs and then intrapalliary of CIs.
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| V2 High Tuberosity. NEEDLE | 25 Long
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| V2 High Tuberosity. DEPTH | 30-35mm
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| 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)
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| V2 High Tuberosity. TARGET | pterygopalatine folla, 10-15mm lateral/inferior to maxillary n.
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| V2 High Tuberosity. PATH | insert at maxillary vestibule, posterior to zygomatic process, slightly posterior to DM root of Maxillary 2PM.
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| V2 Ptyrgopalatine Approach. NEEDLE | 27 long
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| V2 Pterygopalatine Approach. DEPTH | 25-35 mm
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| V2 Pterygopalatine Approach. DISTRIBUTION | hemimaxilla
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| V2 Pterygopalatine Approach. TARGET | pterygopalatine fossa, 100 mm below maxillary n.
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| V2 Pterygopalatine Approach. PATH | insert into greater palatine foramen
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| V2 Pterygopalatine Approach. COMPLICATIONS | get go into eye, nose or infratemporal fossa
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