DENTAL ANESTHESIA – Nerves and Doses

Q1. Define verrills sign.

Ans. Drooping of the upper eyelid to a position half way across the pupil is an indication that the maximum sedative dose has been administered.

Q2. Mention a few oropharyngeal airway.

Ans.

1. Brooks airway .
2. Gudels airway

Q3. Explain rule of thumb (young rule).

Ans. Child’s dose = Child’s age/Age + 12

Q4. Explain Clark’s rule.

Ans. Childs dose = Child’s weight in (pounds)/150

Q5. Define malignant hyperthermia.

Ans. It is a pharmacogenetic disorder that is characterized by exclusive calcium ion release from sarcoplasmic reticulum of the muscle that leads to the rapid development of metabolic respiratory acidosis.

Q6. Mention the branches of trigeminal nerve.

Ans.

1. Ophthalmic nerve.
2. Maxillary nerve.
3. Mandibular nerve.

Q7. Mention the branches of ophthalmic division of trigeminal nerve.

Ans.

1. Lacrimal nerve.
2. Frontal nerve. (supra trochlear, supra orbital nerve)
3. Nasocillary nerve.

Q8. Explain various branches of nasocillary nerve.

Ans.

A) Branches in the orbit.

• Short ciliary nerve.
• Long ciliary nerve.
• Posterior ethmoid nerve.
• Anterior ethmoid nerve.   

B) Branches arising in the nasal cavity.

• These branches supply the mucous membrane lining the cavity.

C) Terminal branches of the ophthalmic divisions on the face.

• They pass below the trochlear nerve to supply sensory fibers to skin of the medial parts of both eyelids in lacrimal sac,  lacrimal caruncle.

Q9. What are the branches of maxillary division of trigeminal nerve ?

Ans.

I. Branches in the middle cranial fossa

II. Branches in the Pterygopalatine fossa.

1. Zygomatic nerve.
2. Zygomatico facial nerve.
3. Zygomatico temporal nerve.

III. B- pterygopalatine (sphenopalatine) nerves.

1. Orbital
2. Nasal
3. Palatine branches

• Greater or anterior palatine nerve.
• Middle palatine nerve.
• Posterior palatine nerve.

C) Posterior superior alveolar branches.

D) Branches in the infra orbital groove canal.

1. Middle superior alveolar nerve.
2. Anterior superior alveolar nerve.

E) Terminal branches of maxillary division on the face.

1. Inferior palpebral branches.
2. External or lateral nasal branches.
3. Superior labial branches.

Q10. Classify branches of mandibular division of trigeminal nerve.

Ans.

I. Branches from main trunk

• A Nervous spinosum
• B Nerve to medial pterygoid

II. Branches from the anterior division

1. Branches to lateral pterygoid
2. Branches to masseter muscle.
3. Branches to temporal muscle.

• Anterior deep temporal nerve.
•  Posterior deep temporal nerve.

4. Buccal (long buccal) nerve.

III.  Posterior division

1. Auriculotemporal nerve.
2. Lingual nerve.
3. Inferior alveolar nerve.

Q11. Mention few Ultra-long acting local anesthetics.

Ans.

1. Tetradotoxin (TTX)
2. Saxitoxin (STX)
3. Dinofiagellates (STX)

Q12. Define Transcutaneous electric nerve stimulation.

Ans. Transcutaneous electrical nerve stimulation (TENS) employs electrodes buccally and lingually, which carry a minute electrical current to interfere with local nerve conduction useful in restorative procedures where profound analgesia is not required.

Q13. What are the advantages of electronic dental anesthesia?

Ans.

1. No need for needle.
2. No need for injection of drugs.
3. Patient is in control of the anesthesia.
4. No residual anesthesia effect at the end of the procedure.

Q14. Define Hyaluronidase.

Ans. It is an enzyme that breaks down intra cellular cement. It has been advocated as an additive to local anesthesia because it permits injected solutions to spread and penetrate tissue. It is widely used in plastic surgery, dermatology and ophthalmologic procedures.

Q15. Mention an alternative preservative of methylparaben.

Ans. Caprylhydrocuprenotoxin