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Download Understanding the Role of Neurons, Axons, and Anesthetics in Nerve Conduction and more Quizzes Health sciences in PDF only on Docsity!
types of neuron/nerve cells
sensory (afferent) & motor (efferent)
TERM 2
axoplasm
DEFINITION 2
cytoplasm of an axon
TERM 3
axolemma
DEFINITION 3
nerve membrane (myelinated or unmyelinated)
TERM 4
impulses (action potential) move faster thru
myelinated membranes because of
DEFINITION 4
saltatory conduction
TERM 5
myelin sheath is made from
DEFINITION 5
Schwann cells
depolarization involves
Na+ moving across the membrane
TERM 7
resting potential
DEFINITION 7
-70mV
TERM 8
firing (slow depolarization to threshold
potential)
DEFINITION 8
-50 to -60mV
TERM 9
potential (rapid depolarization)
DEFINITION 9
TERM 10
repolarization
DEFINITION 10
-60 to -90mV (K+ moves across membrane)
repolarization requires
energy
TERM 17
local anesthetics are classified as
DEFINITION 17
esters and amides
TERM 18
_ are most commonly used in
dentistry
DEFINITION 18
amides
TERM 19
most anesthetics are _, but some are _
DEFINITION 19
tertiary amines, secondary amines
TERM 20
Amides have a _ group
DEFINITION 20
NH
esters have a _ group
C=O
TERM 22
the lipophilic part of an amine
DEFINITION 22
R group
TERM 23
the intermediate chain of an amine
DEFINITION 23
A = (CO)OR1 B = (NH)CO-R
TERM 24
hydrophilic part of an amine
DEFINITION 24
A = R2-N-R3 B = R3-N-R
TERM 25
RNH+ RN +
H+
DEFINITION 25
Definition
major factor of diffusion
concentration gradient
TERM 32
esters are metabolized in
DEFINITION 32
blood plasma
TERM 33
amides are metabolized mainly in the
DEFINITION 33
liver
TERM 34
bundles of nerve fibers
DEFINITION 34
fasciculi
TERM 35
fasciculi located near the surface of a nerve
DEFINITION 35
mantle bundles
fasciculi near the center of the
nerve
core bundles
TERM 37
the _ binds nerves together as fasciculi
DEFINITION 37
perineurium
TERM 38
the _ (innermost layer of perineurium) is the
greatest barrier to diffusion
DEFINITION 38
perilemma
TERM 39
lidocaine
DEFINITION 39
lipid solubility = 4. concentration = 2%. protein binding =
65. duration = 90-200min.
TERM 40
Bupivacaine
DEFINITION 40
lipid solubility = 30. concentration = .5-.75%. protein binding
= 95. duration = 180-600min.
level of LA depends on
rate drug is absorbed into CVS, rate of distribution,
elimination of drug thru metabolic or excretory pathways
TERM 47
metabolism of esters
DEFINITION 47
hydrolized bypseudocholinesterase in plasma
TERM 48
metabolism of amides
DEFINITION 48
primary site of biotranformation in liver
TERM 49
in urine, parent compounds of amides are
DEFINITION 49
found in greater concentration than esters
TERM 50
_ can raise blood levels
DEFINITION 50
kidney or liver dysfunction
systemic problems (side effects) related to
blood or plasma levels
TERM 52
at low levels, no_
effects
DEFINITION 52
CNS
TERM 53
at high levels, people can
experience
DEFINITION 53
tonic - clonic convulsions
TERM 54
vasoconstrictors
DEFINITION 54
slow down the process of local blood vessels absorbing the
unused anesthetic
TERM 55
vasoconstrictors
DEFINITION 55
epinephrine or levonordefrin
epinephrine stats (concentrations, max dose,
cardiac dose)
1:100,000, 1:50,000, 1:200,000. max= 0.2mgs or 20mL of
1:100,000. cardiac =0.04 mgs or 2 carps
TERM 62
levonordefrin stats (5 things)
DEFINITION 62
AKA Neo-cobefrin. 1/6th strength of epi. usual dose 1:20,000.
1mg/appt or 20 ml. usually combined with mepivacaine
(carbocaine)
TERM 63
LAs without added vasoconstrictor
DEFINITION 63
mepivacaine and prilocaine (Citanest)
TERM 64
contraindications of
vasoconstrictors
DEFINITION 64
certain BP meds or tricyclic antidepressants
TERM 65
vasoconstrictors require acidic preservatives
which cause
DEFINITION 65
less RN = reduced onset
the preservatives are usually responsible for
any allergic reactions
TERM 67
amides
DEFINITION 67
lidocaine, mepivacaine, bupivacaine, etidocaine, articaine
TERM 68
lidocaine stats (8 things)
DEFINITION 68
most commonly used amide. usually 2%. brand names
Xylocaine, Octocaine, Alphacaine. metabolized in liver,
excreted in kidneys (10% parent compund). onset = 2-3 min.
with epi 1:100,000 (or 1:50,000). max dose = 300mgs ~
carps. pulpal anes = ~1hr
TERM 69
mepivacaine stats (6 things)
DEFINITION 69
amide, brand names: Carbocaine and Isocaine. 2-3% w/ or
w/out vaso. metabolized in liver, excreted in kidneys. usually
with 1:20,000 Neo-Cobefrin. onset = 1.5-2min, pulpal 45 min.
no allergies
TERM 70
Bupivacaine stats (7 things)
DEFINITION 70
amide, brand name Marcaine. 0.5% w/ 1:200.000 epi.
metabolized in liver, excreted in kidneys. onset = 6-10min.
LONG duration. pulpal - 90-180min, soft tissue - 9hrs. not for
kids
topicals (benzocaine)
ester 20%, came stuff in sunscreen preps
TERM 77
topicals (lidocaine)
DEFINITION 77
amide, base form =5%, HCl form =2%, penetrates tissue
more easily (more potential for toxicity)
TERM 78
topicals (Oraquix)
DEFINITION 78
amide, 2.5% lido and 2.5% prilo. 1.7g/gel. need Rx. max dose
=5 carp. onset = 30s. duration = 20min
TERM 79
broken needle
DEFINITION 79
retrieve if visible, inform pt, document, refer. usually breaks
at hub.
TERM 80
burning on injection
DEFINITION 80
caused by pH, to fast, contaminated w/ alcohol or sterilizing
solution, too warm. usually transient (short)
paresthesia
loss of sensation from needle trauma, alcohol or sterilizing
agents, hemorrage/edema. usually fixed in ~8wks. usually
inferior alveolar or lingual nerve
TERM 82
trismus
DEFINITION 82
(soreness) limited opening dur to muscle spasm. treated with
heat, muscle relaxers, analgesics, physiotherapy (keep
mouth moving), delay elective treatments. should improve in
48 hrs. persistance may be infection, hematoma, TMD.
TERM 83
hematoma
DEFINITION 83
blood leaked into tissue. discoloration 7-14 days. more
common with PSA and IA injections. may have pain, swelling,
and trismus. treatment: apply pressure, ice then moist heat.
TERM 84
edema
DEFINITION 84
swelling of tissues caused by trauma, infection, hemorrage,
irritating solutions, allergy. needs treatment.
TERM 85
facial nerve paralysis
DEFINITION 85
IA injection went into parotid gland. facial nerve (7th cranial)
motor and sensory for muscles of facial expression. transient.
short needle length
20mm
TERM 92
long needle length
DEFINITION 92
32mm
TERM 93
cartridge storage temp
DEFINITION 93
room temp
TERM 94
cartridge bubbles
DEFINITION 94
1-2mm okay
TERM 95
hygienist law
DEFINITION 95
formal training, direct supervision, cannot induce.
relative contraindications to nitrous
pregnancy, COPD (loss of hypoxic drive), psychotic pt (esp.
paranoid), nasal congestion, prior med w/ sedative drugs,
within 4hrs after large meal, drug abusers
TERM 97
stages of anesthesia
DEFINITION 97
analgesia, excitement stage, surgical anesthesia, respiratory
paralysis
TERM 98
anesthetic affects
DEFINITION 98
the ascending midbrain reticular activating system,
decreasing the activating influence on the cerebral cortex
TERM 99
nitrous may cause
DEFINITION 99
amnesia
TERM 100
stage 1
DEFINITION 100
analgesia, mild to deep sedation, no delay in responses in
plane 1, pulse and BP may reduce as a result of lowered
anxiety, may not like euphoria, BP and rulse rise as stage 2 is
approached, may become rigid in plane 3