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62 Cards in this Set
- Front
- Back
what does he recommend for counting teeth where to start for maxilla?
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PM4 is the big one in the back count forward
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what is the tongue innervation?
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2 separate swellings on the pharyngeal floor, sensation of rostral 2/3rds (lingual branch mandibular nerve & a branch of the trigeminal nerve); taste sensation of rostral 2/3rd (chorda tympani, a branch of the facial nerve); sensation and taste of caudal 1/3rd (glossopharyngeal nerve & small extent the vagus nerve)
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what is the main blood supply to the tongue?
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lingual artery a branch of the external carotid artery (runs deep within the muscles) sublingual is not playing a big role...
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what is the total number of canine deciduous teeth?
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2X (3/3, 1/1, 3/3, 1/1, 3/3, 0/0)=28 total
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adult canine dental formula?
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2x (3/3,1/1, 4/4, 2/3, 0/0)= 42 TOTAL
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what is the feline total number of adult teeth?
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30= (2X 3/3, 1/1, 2/3, 1/1)
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what is the feline deciduous dental formula?
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26= 2X (3/3, 1/1, 3/2, 0/0)
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what are the lymph nodes of the head and neck?
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mandibular LN
retropharyneal LN prescapular LN parotid LN buccal LN |
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what are the major salivary glands in the dog and cat?
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parotid, mandibular, sublingual, zygomatic
(in cats also have lingual molar gland, but its not major) |
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what is the difference b/w deciduous teeth vs permanant?
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deciduous cheek teeth moph similiar to adult tooth that is one tooth distal (ex dec maxillary PM looks like adult M1)
dec are smaller in size but canines can still have long roots |
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what are some species differences?
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apices
crown differences |
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what does having an open apex mean for teeth
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they keep growing
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what are teh major 3 dental nerve blocks?
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infraorbital
inferior alveolar (2 ways to do it..intraoral and extraoral) mental |
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what does each type of dental nerve block do?
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infraorbital-- depends on diffusion caudally usually ST, bone, teeth of maxilla
inferior alveolar-- usually mandibular bone, ST, and dentition sometime the tongue mental-- usually bone, teeth & ST rostral to the PM2 |
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what are the 2 blocking agents that are used in dentistry?
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bupivicaine 5% and lidocaine2%
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what is the approx dose for each anesthetic agent per site for each species?
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- bupivicaine 5%= 0.1-0.5/site for dogs; 0.25-0.3ml/site cats
-lidocaine 2% = 1ml/site for dogs; 0.5ml/site for cats |
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how long does each anesthetic agent last and how long till it takes effect?
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- bupivicaine starts 15-30 post inj and lasts 3-10hrs
-lidocaine has rapid onset but only lasts 20-30 mins wout epi (with epi up to 2 hrs) |
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T/F lidocaine and bupivicaine are used as mutually exclusive agents?
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F mix 0.25 mls of each/kg /dose site
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what is the enormous list of things to ask as history for a dental exam?
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-vax hx
-other pets -deworm/hrt worm prevent -flea/tick prevent - vomit/diarrhea -coughing/sneezing - appetite -activity level -wt change -changes in behavior -changes in defecation/urinate(frequency) -hx of seizures -med hx-major illness/diagnosis -meds- rxns, current meds -sx/anesthetic hx- what surgeries any anesthetic complications -what is the reason for presentation |
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what are some dental specific questions to ask at hx?
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type of food (dry/wet/semi moist- change in preference)
toys (what kind hard or plush, preference and frequency of use) odor from the mouth (abnorm is it worsening) any abnormal discharge from mouth |
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specific dental hx questions continued -- has the owner noted ___
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dropping food, drooling, pain when openin mouth or eating, reluctance to opening mouth 9less yawning), rubbing the chin on the floor
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T/F homecare 1x/month for owners with pets is recommended
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WAY not frequently enough
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with an oral mass what hx questions do you ask?
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duration
change in size has it been aspirated or biopsied previously previous removal any bleeding from the mouth increase in halitosis or salivation difficulty eating |
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on an oral exam what do you do before looking in the mouth?
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symmetry of face.head, lips
palpate muscles of mast (temp & masster- atrophy, sym, pain on palp) check the ears for signs of extern ear canal dz (palp the vert & horizontal canal for pain, swelling, thickening) check the eyes (for signs of orbital or periorb dz, normal eyelid close, retropulse eyes to check for mass, check PLR) check nose (discharge, airflow, norm architec) palp face (swell, ) palp mandibular body (swell) palp the sublingual area for masses palp salivary glands and regional LNs (sym, enlarge, pain, texture) palpare trachea from larynx to tracheal inlet (really important for patients prone to trach collapse) NOW YOU CAN LOOK IN THE MOUTH |
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when doing an oral exam and your FINALLY looking in the mouth what do you look for?
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exam mucosa for color, CRT, ulceration, masses,
occlusion look for fractured teeth (canine & max PM4 most in dogs, canine most common in cats) gingivitis, ginigval recession (root exposure), loose teeth missing teeth, oral masses, range of motion of mandible, tongue function sublingual FB/mass, resorptive lesion of cats (mandibullar PM3 tooth most commonly affected) |
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how do you do an assessment of periodontal dz?
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patient must be anesthetized
measure periodontal pocket measure ginigval recession determine attachment loss grade gingivitis severity determine if there is any furcation involvement radoigraphs will help to determine what tx are possible |
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what is periodontal pocket depth rankings
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0-3 0- not at all 3- all the way through
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T/F there are some animals w/o sulcus
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pathogen free animals
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what are the 4 ways to determine if a tooth has endodontic dz?
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obvious crown fracture with pulp exposure
pulpitis transillumination radiographically |
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what is the difference between favorable and unfavorable fracture lines in ghe mandible?
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favorable / line because the muscle forces that open the jaw are going -> holding it together
unfavorable \ pulls -> pulling frontal portion downward |
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tape muzzles should leave how much space in the mouth
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enough to get the tongue out 5-10mm
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T/F sticky side of tape goes down then sticky side of tape goes down in a tape muzzle
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F non sticky side to skin sticy to sticky sides
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what is the difference between interdental wiring and interfragmentary wiring
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interfragmentary holds 1 tooth to the other
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what is home care for canine bonding splinting?
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brush splint 2 X/day
rinse with a 0.12% chlorhexadine rinse 2X day keeping the patient face clean and changing tape muzzle frequently |
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treatment failure is due to what with bonding splinting?
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appliance fails, periodonatal dz at site of fracture or under splint, if fracture site is not stable, if blood supply to the segment of the mandible is interrupted
teeth at the site of fracture develop periodontal dz |
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how oftern to you recheck the bonding splint and what are the factors that affect it
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recheck- will always depend on severity of the fx, willingness/ability of client to make recheck appts
diff & quality of reduction ability of owner to do proper home care 2 weeks- oral exam and tape muzzle placement 4weeks- as above + sedate & radiograph 8wks- sedate and rad - remove interdental wiring & splint if fx healed well, interfragmentary wire may need to be removed if showing signs of increased lucency around the wire |
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what is high rise syndrome in cats
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cats not landing on their feet but on their heads with mandibular & maxillary fx etc
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oral findings on a car with high rise syndrome
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symphyseal separation, fx or lux canine teeth, hard palate fx along palantine median suture, fx palatal root of max fourth premolar teeth, tongue laceration/trauma
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Who gets symphyseal separations and why?
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Cats, trauma (high rise syndrome and HBC)
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What are some tips on repairing symphyseal separations?
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Clip and prep chin
Flush and debride symphysis and ST trauma Extract loose/Fx incisors Close oral ST 1st before placing wire Small incision over cd portion of symph through skin on chin 22 g wire largest in cat Use 18-20g needle to pass wire through, always start from small skin incision moving orally Ideal oral placement of needle is through the top of labial frenulum behind canine tooth, try not to trap st Once wire is around mandibles twist until tight enough that there is little movement at symph, leave at least 5-6 twists when you cut wire, you can push twisted wire back through skin incision so not sticking out of cat's jaw Leave to close by 2nd intention |
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What are some TMJ problems?
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TMJ luxation
Open mouth jaw locking TMJ ankylosis |
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What are the presenting complaints w/ oral tumors?
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Pytalism
Bleeding from oral cavity Oral mal odor Loss of teeth Nasal or ocular discharge Decreased apetite Change in eating or drinking Change in toy preference Pawing at face Swelling on face |
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What are clinical signs of oral tumors?
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Wt loss
Incr size of mandibular and prescap LN Loose or missing teeth Areas of swelling ulcerations or mass Thickening of mandib body Pain on opening jaw or palp Decreased tongue function Fractured mandible Decr nasal airflow (Unilateral) Decr retropulsion of the eye Exopthalmos |
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What are preoperative diagnostics for an oral mass?
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CBC/Biochem
Thoracic rads +/- LN aspirate +/- mass aspirate +/- abdominal US +/- clotting profile/BMBT +/- urinalysis |
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What are intraoperative diagnostics?
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Perform complete oral exam 1st
Note location of mass (w/ respect to a tooth or other anatomical location/photo or diag) Note size of mass (LWH) Rad area of interest prior to biopsy (MRI or CT scan may be helpful) |
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Radiographic findings of benign oral masses:
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Less likely bone involvement
Tooth displacement Teeth firmly attached Ventral cortex of mand intact w/ min displacement or thickening EXPANSION Narrow transition zone |
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What are rad finding of malignant oral masses?
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Bone +/- tooth involvement
Tooth destruction or missing teeth Loose teeth Cortical lysis (bony spicules resulting in sunburst) INFILTRATION Large transition zone Moth eaten bone and possible ST proliferation |
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How to best determine what kind of biopsy to take.
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Rads
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What is one thing you may have to do to get a decent biopsy?
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May have to make incision through mucosa/gingiva elevate tissue to obtain representative sample
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What should you remember about histopath results of the mass?
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To view the results in light of the clinical picture and rad findings
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***What are the most common canine oral tumors that are malignant?
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Melanoma
SCC Fibrosarcoma/Osteosarcoma |
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***What are the most common canine oral tumors that are benign?
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Epulidies
-peripheral odontogenic fibroma - non invasive, (2 types: fibrodentinus, osseodentinus) -Acanthomatous ameloblastoma Invasive |
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What is the most common feline malignant oral tumor?
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99% SCC
someties fibrosarcoma |
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What are treatment options for oral masses?
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Surgical
Radiation therapy Chemotherapy Combos of above Palliation |
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What is postop care for oral mass?
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Pain management (Fentanyl patches, Tramadol, Buprenorphine for cats, NSAIDs as needed)
Ice pack surgical site 4x/d 10-15 min for 48hrs then switch to warm compresses Tape muzzle for mandibulectomy Feeding tubes for cats Soft food and no toys for few wks eColar as needed ABx if warranted Eye lube if palpebral closure affected by facial nerve damage |
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What is one thing you may have to do to get a decent biopsy?
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May have to make incision through mucosa/gingiva elevate tissue to obtain representative sample
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What should you remember about histopath results of the mass?
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To view the results in light of the clinical picture and rad findings
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***What are the most common canine oral tumors that are malignant?
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Melanoma
SCC Fibrosarcoma/Osteosarcoma |
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***What are the most common canine oral tumors that are benign?
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Epulidies
-peripheral odontogenic fibroma - non invasive, (2 types: fibrodentinus, osseodentinus) -Acanthomatous ameloblastoma Invasive |
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What is the most common feline malignant oral tumor?
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99% SCC
someties fibrosarcoma |
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What are treatment options for oral masses?
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Surgical
Radiation therapy Chemotherapy Combos of above Palliation |
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What is postop care for oral mass?
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Pain management (Fentanyl patches, Tramadol, Buprenorphine for cats, NSAIDs as needed)
Ice pack surgical site 4x/d 10-15 min for 48hrs then switch to warm compresses Tape muzzle for mandibulectomy Feeding tubes for cats Soft food and no toys for few wks eColar as needed ABx if warranted Eye lube if palpebral closure affected by facial nerve damage |