DTAS 122 Clinical Science I Exam 4 Study Guide 2023 PDF

**DTAS 122 Clinical Science I** **Exam 4 Study Guide** ***Please use this as a [guide] only for your studying. This OPTIONAL study guide may be completed and submitted by 8:00 am on Blackboard on the day of the exam for 5 extra credit points.*** [Oral Embryology & Histology (Ch 8)] - Embryolog...

**DTAS 122 Clinical Science I** **Exam 4 Study Guide** ***Please use this as a [guide] only for your studying. This OPTIONAL study guide may be completed and submitted by 8:00 am on Blackboard on the day of the exam for 5 extra credit points.*** [Oral Embryology & Histology (Ch 8)] - Embryology **Study of prenatal development through the stages of growth for the face, neck orofacial structures, and teeth** - Histology **Study of the structure and function of the tissues on a microscopic level** - Main weeks of development (including human face) Prenatal development Conception until birth Three stages Pre-implantation period First week Embryonic period Beginning of week 2 to the end of week 8 Fetal period Week 9 until birth Takes place during weeks 4 -12 of prenatal development All three embryonic layers involved Five processes Single frontonasal process Paired maxillary processes Paired mandibular processes Takes place during weeks 4 -12 of prenatal development All three embryonic layers involved Five processes Single frontonasal process Paired maxillary processes Paired mandibular processes Frontonasal process gives rise to upper face Forehead Bridge of nose Primary palate Nasal septum Structures related to medial nasal processes Placodes Otic placodes Nasal placodes Lens placod Maxillary process and midface formation Forms from adjacent swelling of mandibular arch Gives rise to: Upper lip Cheeks Secondary palate Posterior portion of maxilla Maxillary canines, posterior teeth, and associated tissues Zygomatic bones and portions of temporal bones - Primitive mouth **Primitive mouth Limited in depth by oropharyngeal membrane First event in facial development Disintegration of oropharyngeal membrane, resulting in increased depth of stomodeum** - Odontoblasts- **dentin forming** - Ameloblasts**- enamel forming** - Cementoblasts**- cementum forming** - Fibroblasts- **pulp forming** - Osteoclasts- - Dentin and types **Highly specialized calcified connective tissue Avascular** **Primary dentin** **Secondary dentin** **Continues to form throughout life** **Tertiary dentin (reparative, reactive)** **Forms quickly in localized areas in response to injury** - Endoderm **Epithelial linings of respiratory passages, digestive tract, and glandular organ cells** - Ectoderm **Skin Nervous system Other structures** - Mesoderm **Muscles Connective tissues Vessels supplying tissues and organs Other tissues** - CEJ **Calcified connective tissue** **Covers root of teeth** **Attaches teeth to alveolar bone by periodontal ligament** **No nerve or blood supply** **Continues to form throughout life of tooth** **Develops from dental sac** **Two types** **Acellular** **First layer deposited at DCJ** **-- primary cementum** **Does not contain cementocytes** **Covers entire root** **Width does not change** **Cellular** **Secondary cementum** **Last layers deposited over** **acellular cementum Deposited mainly at apical 1/3 of root** **Width changes throughout life** - Clinical crown - Periodontium consists of (and be able to label from a picture): **Supports the teeth in alveolar bone Composed of: Gingiva Cementum Alveolar bone Periodontal ligament** A diagram of a human tooth Description automatically generated - Pulp aspects (and be able to label from a picture): **Functions Nutritive Formative Sensory Protective Forms from dental papilla Involved in support, maintenance, and continued dentin formation Protective function due to ability to form secondary or tertiary dentin Connective tissue Two types of nerves Myelinated Regulated flow of blood in vessels Unmyelinated Responsible for perception of pain Pulp stones Calcified masses of dentin Can cause problems during endodontic therapy**  - Deposition- **LAYIN DOWN ADDING TISSUE** - Resorption **TAKING AWAY TISSUES** [Anesthesia/Pain Control (Ch 37)] - **Topical anesthetics and use** - ***Provides numbing to an area prior to an injection*** - **Temporary** - **Active ingredient: benzocaine or lidocaine** - **Forms:** - **[Ointment]: gel type 15-30 seconds** - **[Liquid]** - **[Spray]: applied to larger surface areas (for gag reflex)** - **[Patch]: provides anesthesia within 10 seconds, placed on injection site** - Local anesthesia - Cartridge information and ingredients - **Local anesthetic drug:** - **Depends on: procedure, health of the patient, dentist's preferences** - **Sodium chloride: makes solution isotonic with body tissues** - **Isotonic: solution that has the same salt concentration as cells and blood** - **Distilled water: supplies added volume of solution** - Color coding (specifically lidocaine) **blue** - Needle parts 1. **Threaded tip** **-needle** 1. **Harpoon** **-Locks into rubber stopper, aspiration** 1. **Piston rod** **-Pushes rubber stopper** 1. **Barrel of syringe** **-Holds cartridge in place** 1. **Finger grip** 2. **Finger bar** 3. **Thumb ring** - What gauge means (know the relationship between the number and size) - Aspirating - Larger gauge = Thinner needle - Smaller gauge = Thicker needle **Most common: 25, 27, 30** - Epinephrine - **Combined with anesthetic to slow the uptake of the anesthetic agent** - What ratios mean **Smaller ratio -\> higher percentage of vasoconstrictor** - Contraindications - **Vasoconstrictors may place strain on the heart** - **History of heart disease:** - **Unstable angina, recent MI, recent coronary artery bypass surgery, untreated/uncontrolled severe hypertension, congestive heart failure** - **Drug interactions:** ***\*Always confirm with the dentist the type of local anesthetic solution to be given and desired ratio of vasoconstrictor*** - Paresthesia **numbness lasting after the affects of local anesthetic solutions have worn off** - Oxygen (and tank color) - Nitrous - Tank color **green** - Uses - **Safe and effective** - **1844, Horace Wells (the first dentist) used this on his patients** - **70% of dentists use this** - **Stage I anesthesia/analgesia by using a combination of these gases** - Contraindications - **Pulmonary disorders/Emphysema: breathing difficulties, increased O2 may lower stimulus to breathe as often as necessary** - **Respiratory infections/Nasal obstruction: prevent breathing in** - **Pregnancy: Administer ONLY after 1^st^ trimester and ONLY with permission from OB** - **Psychiatric** - **Immune compromised disorder** - **Multiple sclerosis: breathing difficulties, increased O2 may lower stimulus to breathe as often as necessary** - **Frequent user of marijuana or hallucinogenic drugs** - **Middle ear blockage** - **Alcoholic or recovering alcoholic** - Amides: general information including how it is metabolized - **1940s** - **Metabolized by the *liver*** - Esther: general information including how it is metabolized - **Esters: primarily topical** - **Metabolized in the *plasma*** [Extra/Intra Oral Exam (PowerPoint, 28.2, pp 404-406)] - [Types of assessment] - Observation - **Movement, body structure, symmetry, color, texture, contour, form of structures/tissues** - Palpation **Note tenderness, texture, masses, changes in structure and temperature** - Auscultation - **TMJ clicking, slurred speech, hoarseness, breathing difficulties, clicking dentures** - Olfaction - **Alcohol, smoker, halitosis (caries/perio/GI issues), sweet/fruity breath (ketosis/diabetic acidosis)** - Types of palpation and examples - Digital - **use of a single finger** - **vestibule** - Bidigital **use of finger and thumb of same hand** **lips** - Bimanual **use of finger or fingers and thumb from each hand simultaneously** - Bilateral - **: two hands at the same time at corresponding structures** - **TMJ** - Leukoplakia **white** - Erythroplakia **red**