7- Inferior Alveolar Nerve Block Quiz

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Which area is anesthetized by the Inferior Alveolar Nerve Block?

Mandibular teeth to midline

Which nerve is anesthetized by the Inferior Alveolar Nerve Block?

Inferior alveolar nerve

Which area is not anesthetized by the Inferior Alveolar Nerve Block?

Contralateral molars

For which procedure is the Inferior Alveolar Nerve Block is recommended?

Procedures on multiple mandibular teeth in one quadrant

Which landmark is relevant for the Inferior Alveolar Nerve Block technique?

Coronoid Notch

Which structure is used as a guide for the insertion of the needle during the Inferior Alveolar Nerve Block?

Pterygomandibular Raphe

Which plane is considered during the administration of the Inferior Alveolar Nerve Block?

The Occlusal Plane of the Mandibular Teeth

What complication may arise if the needle is too deep during an inferior alveolar block?

Injection of local anesthetic solution near CN 7 in the parotid gland

What should be done if bone contact is not felt during the administration of an inferior alveolar block?

Retract and reposition the syringe medially

What can overinsertion of the needle during an inferior alveolar block lead to?

Inadvertent anesthesia of the facial nerve

What is the most common cause of inadequate LA with the IAN Block?

Injection too low

Which factor is commonly associated with inadequate LA after an IAN Block?

Accessory innervation

What could lead to inadequate LA with the IAN Block?

Injection too far anterior

How do you correct a low injection?

Reinjecting 5 to 10mm above the previous site

How do you correct an anterior injection?

Retract and reposition the syringe laterally and the needle will go medially, then advance posteriorly

How do you correct accessory innervation during a Bifid IAN?

  • Inject lower/higher for a Bifid IAN

How do you not correct accessory innervation during IAN?

Correct by reinjecting 5 to 10mm above the previous site

What is a disadvantage of the Inferior Alveolar Nerve Block (IAN) technique?

Positive aspiration: 10 – 15%

What is the rate of inadequate anesthesia associated with the Inferior Alveolar Nerve Block (IAN)?

31% - 81%

What is a potential complication of the Inferior Alveolar Nerve Block (IAN) in terms of anesthesia distribution?

Partial anesthesia in the presence of bifid IAN and bifid mandibular canals

What is an indication for an Incisive Nerve Block?

Pulpal anesthesia on mandibular teeth anterior to the mental foramen

What is a contraindication for the Incisive Nerve Block?

Infection in the area of injection

What is a disadvantage of the Incisive Nerve Block?

Does not provide lingual anesthesia

What is a potential complication of the Incisive Nerve Block?

Partial anesthesia at the midline

What is a disadvantage of the Buccal Nerve Block technique?

Potential for pain if the needle contacts the periosteum

What is a contraindication for the Buccal Nerve Block?

Infection or acute inflammation in the area of injection

Which nerve is not anesthetized by the Gow-Gates Mandibular Nerve Block?

infraorbital

What percentage of patients experience buccal nerve anesthesia with the Gow-Gates Mandibular Nerve Block?

75%

What is the primary indication for a Gow-Gates Mandibular Nerve Block?

Anesthesia for multiple mandibular teeth

When would a Gow-Gates Mandibular Nerve Block be preferred over a conventional Inferior Alveolar Nerve Block?

When a conventional IAN block is unsuccessful

In which situation is a Gow-Gates Mandibular Nerve Block contraindicated?

Patients who might bite their lip or tongue

Where is the area of insertion for the Gow-Gates Mandibular Nerve Block?

Mucous membrane on mesial of the ramus

What is the relevant line for the insertion of the Gow-Gates Mandibular Nerve Block?

From the intertragic notch to the corner of the mouth

Which area is anesthetized by the Gow-Gates Mandibular Nerve Block?

Mandibular teeth, body, and ramus

Where is the target area for a Gow-Gates Mandibular Nerve Block?

Condylar neck just below the insertion of the lateral pterygoid muscle

At what height should the needle penetrate for a Gow-Gates Mandibular Nerve Block?

Just below maxillary MP cusp of the 2nd molar

Where is the site of penetration for a Gow-Gates Mandibular Nerve Block?

Penetrate just distal to the maxillary 2nd molar

Which area is anesthetized by the Gow-Gates Mandibular Nerve Block?

Mandibular teeth to the midline

Which structures are anesthetized by the Gow-Gates Mandibular Nerve Block?

Buccal mucoperiosteum and mucous membranes on the side of injection and Anterior two thirds of the tongue and floor of the oral cavity

What is a contraindication for the Gow-Gates Mandibular Nerve Block?

Patients with infection or acute inflammation in the area of injection

What is the aspiration rate for the Gow-Gates Mandibular Nerve Block?

2%

What is the success rate of the Gow-Gates Mandibular Nerve Block with experience?

Greater than 95%

What type of canals does the Gow-Gates Mandibular Nerve Block provide successful anesthesia for?

Bifid IAN and bifid mandibular canals

What is a disadvantage of the Gow-Gates Mandibular Nerve Block?

Lingual and lower lip anesthesia is uncomfortable for many patients

What contributes to the longer time of onset of anesthesia with the Gow-Gates Mandibular Nerve Block?

The distance of the nerve trunk from the deposition site

What is a challenge associated with the Gow-Gates Mandibular Nerve Block technique?

The presence of a learning curve

What is not a potential complication of a Gow-Gates Mandibular Nerve Block?

Paresthesia

What nerves are anesthetized by the Vazirani-Akinosi Closed Mouth Block?

Inferior alveolar, incisive, mental, lingual, mylohyoid

Which structures are anesthetized by the Vazirani-Akinosi Closed Mouth Block?

Mandibular teeth to the midline

What soft tissues and periosteum are anesthetized by the Vazirani-Akinosi Closed Mouth Block?

Lingual soft tissues and periosteum

Which area is anesthetized by the Vazirani-Akinosi Closed Mouth Block in front of the mental foramen?

Buccal mucoperiosteum and mucous membrane

What is a contraindication for the Vazirani-Akinosi Closed Mouth Block?

Patients who may bite themselves

What is an indication for the Vazirani-Akinosi Closed Mouth Block?

Inability to visualize IANB landmarks, Limited mandibular opening

Where is the area of insertion for the Vazirani-Akinosi technique?

Mandibular medial soft tissue

What is a potential complication of the Vazirani-Akinosi Closed Mouth Block?

Patients may bite themselves

What is a major advantage of the Vazirani-Akinosi Closed Mouth Block technique?

It is relatively atraumatic

What is a benefit of the Vazirani-Akinosi Closed Mouth Block technique ?

Lower aspiration rate (<10%) than with the inferior alveolar nerve block (10-15%)

What is a disadvantage of the Vazirani-Akinosi Closed Mouth Block technique?

Difficult to visualize the path of the needle and the depth of insertion

What is a potential complication of the Vazirani-Akinosi Closed Mouth Block?

Trauma to the periosteum

What is the primary indication for a Mental Nerve Block?

Soft tissue biopsies

What is a contraindication for a Mental Nerve Block?

Infection in the area of injection

What area is anesthetized by a Mental Nerve Block?

Buccal mucous membrane anterior to the mental foramen to the midline and the skin of the lower lip

What is the amount of local anesthesia in one carpule of 2% Lidocaine with 1:100000 epinephrine?

34mg of Lidocaine and 0.017mg of epinephrine

What is the limit of vasoconstrictor for a cardiac patient when using local anesthesia?

0.04mg

What is the amount of vasoconstrictor in one carpule of 2% Lidocaine with 1:100000 epinephrine?

0.017mg of epinephrine

Test your knowledge of the nerves anesthetized during an inferior alveolar nerve block with this quiz. Identify the specific nerves and areas of anesthesia for the mandibular teeth, tongue, and oral cavity.

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