313 exam



cranium-  around the brain and protects it, consists of 8 plates which are seperated by sutures, these plates are:

  • parietal- top and part of sides
  • frontal- front of cranium
  • temporal- temple in front of ears
  • occipital- back of cranium
  • sphenoid- form base of cranium
  • ethmoid- lower front behind nose

face- front of skull

mandible- horse shape bone forming lower jaw, articulating with cranium at TMJ

maxilla- forms upper jaw

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cranial nerves

V th (5th) cranial nerve- trigeminal, divides into 3 nerve branches: opthalmic, maxillary and madibular

V11, (7th)  cranial nerve- facial- supplies muscles of facial expressions, sensory branches of front 2/3 rds of tongue, submanibular and sublingual salivary glands

1X (9th) cranial nerve- glossopharyngeal- supplies throat, prosteria 1/3rd sensory branches of tongue

X11 (12th) cranial nerve- hypoglossal- supplies muscles on the tongue

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upper maxillary nerves

anterior superior dental nerve- incisors, canine and buccal gum (123)

middle superior dental nerve- premolars and mesail of first molar and gum (456)

prosteria superior dental nerve- 2nd + 3rd molar and distal 1st molar and gum (678)

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nerves on palate

naso- palatine nerve - supplies palatal gum on incisors and canine

greater palatine nerve- supplies palatal gum of caine, premolars  and molars

two foramens- incisive and greater palatine

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nerves for lower teeth

inferior dental nerve- supplies all lower teeth

long buccal nerve- supplies buccal gum to molars (678)

mental nerve- supplies lower lip, chin and buccal gum of incisors, canine and pre-molars (12345)

lingual nerve- supplies lingual line of lower teeth, passesa through inner surface of mandible, supplies anterior 2/3rds of tongue and floor of mouth

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patient support

  • calm voice
  • standing next to patient
  • being quiet
  • monitorin patient
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topical anaesthesia- minimises pain when injecting

anaesthesia- loss of sensation, la produce loss of pain only

la blocks nervous impulses from source of stimilation so it doesn't reach barin.

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local infiltration + nerve block

local infiltration- it places la under mucosal surface of oral cavity, penetrates pores of alveolar bone

nerve block- anaesthetising main nerve trunk, either before enters bone or leaves it.

common nerve blocks-

  • inferior dental nerve,
  • mental nerve block
  • prosterior superior nerve block
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intra-ligamentary, intra-osseous, intrapulpal

intra-ligmaentary- causes deeper anaesthesia 

common syringe used is ligmaject, administered periodontal ligament around tooth, high force to be given, cartridge inclosed in plastic sheath incase it shatters

intra-osseous- given through alveolar bone

burs go through bone, needles placed i hole to administer la

intrapulpal- given into pulp of tooth, only used if other methods been unsuccessful 

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contents of la cartridge


  • anaesthetic- block electrical nerve transmission to brain
  • sterile water- carrying solution
  • buffering agents- maintain neutral PH
  • preservative- adequate shelf-life
  • vasoconstrictor- prolong action of la by closing blood vessels, so solution not carried away quickly


  • anaesthetic agent: lignospan, prilocaine, septanest or citanest
  • vasoconstrictors: adrenaline and felypressin

adrenaline avoided for heart conditions, HBP

felypressin avoided for pregnant may induce womb contractions or onset premature labour

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narrows blood vessels so solution not carried away too quickly, prolongs anaesthtic. gives time for procedure without pain.

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