Deck 36: Anatomical Considerations of Local Anesthesia

Question 1

None of the following anesthetics can be used for mandibular supraperiosteal injections EXCEPT one.Which one is the EXCEPTION?

A) Lidocaine
B) Articaine
C) Mepivacaine
D) Prilocaine

Answer 1

B
Only articaine effectively penetrates the mandibular bone.One cannot use lidocaine,mepivacaine,or prilocaine which are the most common local anesthetic agents because they do not effectively penetrate the denser mandibular bone.

Question 2

Maxillary nerve blocks anesthetize a smaller area of tissue than local infiltrations or supraperioteal injections.A local anesthetic is deposited in the vicinity of a major nerve trunk and it anesthetizes the area the nerve innervates from that point on.

A) Both statements are true.
B) The first statement is true;the second statement is false.
C) The first statement is false;the second statement is true.
D) Both statements are false.

Answer 2

C
Maxillary nerve blocks anesthetize a broader area of tissue than local infiltrations or supraperioteal injections.The maxillary branch of the fifth cranial nerve gives off the posterior superior alveolar branch in the area posterior and superior to the maxillary tuberosity.The remaining branch continues on to become the middle superior alveolar nerve branch.The middle superior alveolar nerve continues on to join with the anterior superior alveolar nerve.Both of these latter nerves also have branches that ascend upward to meet the infraorbital nerve which emerges from the infraorbital foramen.

Question 3

What are two ways to lessen the pain from injecting into tissue? (Select all that apply. )

A) Inject very slowly
B) Be sure the patient is calm
C) Have the patient tense his or her jaw muscles
D) Use pressure anesthesia

Answer 3

A,D
When injected slowly,the anesthesia solution is absorbed into the tissue and eliminates a burning sensation.Using pressure anesthesia requires putting pressure on the injection site prior to injecting the solution.A cotton-tipped applicator is applied to the injection site for 30 to 60 seconds before the injection,during the injection,and a few seconds after the injection.This causes nerve innervations to respond to the pressure long enough to cause a slight numb sensation.If the pressure is relieved in any way,there is an immediate recovery and the patient will feel the pain.

Question 4

All of the mandibular teeth are innervated by the inferior alveolar nerve.

Question 5

The greater palatine nerve block anesthetizes all of the following EXCEPT one.Which one is the EXCEPTION?

A) Anterior hard palate
B) The posterior lateral hard palate
C) Palatal gingiva
D) Periodontium of the maxillary posterior teeth

Question 6

All of the following are major concerns with nerve blocks EXCEPT one.Which one is the EXCEPTION?

A) Bruising
B) Injecting into a blood vessel
C) Tearing a blood vessel
D) Puncturing a nerve

Question 7

The buccal bone of the maxilla is much less porous than that of the mandible.This makes it easier for the anesthetic solution to penetrate the buccal bone of the maxilla and reach the apices of the maxillary teeth.

A) Both statements are true.
B) The first statement is true;the second statement is false.
C) The first statement is false;the second statement is true.
D) Both statements are false.

Question 8

The regional nerve block affects a much larger area and more teeth because it affects larger nerves.

A) Both statements are true.
B) The first statement is true;the second statement is false.
C) The first statement is false;the second statement is true.
D) Both statements are false.

Question 9

All of the following are reasons a Varizani-Akinosi nerve block may be used EXCEPT one.Which one is the EXCEPTION?

A) Trismus
B) Injury
C) Root canal
D) Temporomandibular joint dysfunction

Question 10

A crossover effect is created when nerves and blood vessels do not stop at the midline because some nerve branches crossover into an area innervated by another adjacent nerve.

A) Both the statement and the reason are correct and related.
B) Both the statement and the reason are correct but are NOT related.
C) The statement is correct,but the reason is NOT correct.
D) The statement is NOT correct,but the reason is correct.
E) NEITHER the statement NOR the reason is correct.

Question 11

The auriculotemporal nerve may be anesthetized with a

A) Gow-Gates nerve block
B) Vazirani-Akinosi nerve block
C) buccal nerve block
D) mental block

Question 12

There are three palatal nerve blocks that provide anesthesia to the palatal periodontium and gingiva;they affect only the lingual tissues.

A) Both statements are true.
B) The first statement is true;the second statement is false.
C) The first statement is false;the second statement is true.
D) Both statements are false.

Question 13

Which block can cause a hematoma? (Select all that apply. )

A) Anterior superior alveolar nerve block
B) Posterior superior alveolar nerve block
C) Infraorbital nerve block
D) Gow-Gates nerve block

Question 14

The goal of local anesthesia is to block the innervation from the nerve branches as they try to send their messages back to the brain through the nerves.To do this,the anesthetic solution must reach the nerve branch somewhere between the targeted area to be anesthetized and the nerve trunk.

A) Both the statement and the reason are correct and related.
B) Both the statement and the reason are correct but are NOT related.
C) The statement is correct,but the reason is NOT correct.
D) The statement is NOT correct,but the reason is correct.
E) NEITHER the statement NOR the reason is correct.

Question 15

What is the most commonly used mandibular block?

A) The Gow-Gates nerve block
B) Posterior superior alveolar nerve block
C) Middle superior alveolar nerve block
D) Inferior alveolar nerve block

Question 16

Most dental procedures only require a facial supraperiosteal injection EXCEPT one of the following.Which one is the EXCEPTION?

A) Composite resin restoration
B) Periodontal debridement
C) Extraction
D) Periodontal surgery

Question 17

To anesthetize the maxillary premolars and their associated bone,the following procedure would be used:

A) Middle superior alveolar nerve block
B) Nasopalatine nerve block
C) Buccal nerve block
D) Gow-Gates block

Question 18

Infiltration anesthesia affects

A) teeth only
B) the peridontium only
C) teeth and peridontium
D) the gingiva only

Question 19

Which of the following preexisting medical conditions should be considered before making decisions concerning anesthesia? (Select all that apply. )

A) High blood pressure
B) Glaucoma
C) Kidney and liver disease
D) Diabetes

Question 20

Vasoconstrictors contain preservatives to increase effectiveness.

A) Both the statement and the reason are correct and related.
B) Both the statement and the reason are correct but are NOT related.
C) The statement is correct,but the reason is NOT correct.
D) The statement is NOT correct,but the reason is correct.
E) NEITHER the statement NOR the reason is correct.

Question 21

MATCHING
Match the area with the procedure used to anesthetize it:
a.Local infiltration
b.Anterior superior alveolar nerve block
c.Gow-Gates nerve block
d.Nasopalatine nerve block
Small soft tissue area

Question 22

The nerve exits the tooth at the root apex.

Question 23

There are five maxillary nerve blocks delivered from the facial side.

Question 24

It is necessary to have a good understanding of the root's width in order to properly perform supraperiosteal injections.

Question 25

MATCHING
Match the area with the procedure used to anesthetize it:
a.Local infiltration
b.Anterior superior alveolar nerve block
c.Gow-Gates nerve block
d.Nasopalatine nerve block
Hard and soft tissues of the palatal periodontium and gingiva of the six anterior teeth

Question 26

A mental block affects the facial periodontium and gingiva of the mandibular premolars and anterior teeth to the midline.

Question 27

Manual pressure is applied at the injection site during use of a mental block.

Question 28

MATCHING
Match the area with the procedure used to anesthetize it:
a.Local infiltration
b.Anterior superior alveolar nerve block
c.Gow-Gates nerve block
d.Nasopalatine nerve block
Maxillary anterior teeth

Question 29

The injection site for maxillary injections is not directly above the target area but one-half tooth distal to the target.

Question 30

MATCHING
Match the area with the procedure used to anesthetize it:
a.Local infiltration
b.Anterior superior alveolar nerve block
c.Gow-Gates nerve block
d.Nasopalatine nerve block
Auriculotemporal nerves