Deck 12: Maxillary Anesthesia

Question 1

Match the name of the maxillary injection to the landmarks of the injection site and/or the area that receives the anesthesia.Names of injections may be used more than once.

Foramen located at the junction of the maxillary alveolar process and palatine bone distal to the maxillary second molar

A)Anterior superior alveolar injection
B)Middle superior alveolar injection
C)Posterior superior alveolar injection
D)Infraorbital
E)Nasopalatine
F)Greater palatine

Answer 1

Greater palatine

Question 2

There is less variation in the anatomy of the mandibular anesthetic landmarks than there is in similar maxillary structures,thus making the mandibular injections more routine.Anesthesia in the maxillary arch usually does not require any troubleshooting of failure cases.

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

Answer 2

The first statement is false;the second statement is true.

Question 3

Practices to avoid when administering local anesthetic include which of the following?

A) Not using enough for patient comfort and hemostatic control
B) Overadministering of anesthesia
C) Administering anesthesia to a larger treatment area than can be completed in one visit
D) All options listed

Answer 3

All options listed

Question 4

What is a good reason not to use distracters when administering maxillary facial anesthesia?

A) The clinician needs her fingers for retraction of the upper lip.
B) Pulpal anesthesia may be blocked.
C) Movement may cause the anesthetic not to be placed at the target area.
D) All options listed.

Question 5

Match the name of the maxillary injection to the landmarks of the injection site and/or the area that receives the anesthesia.Names of injections may be used more than once.

Hard palate and overlying tissue of maxillary third molar to the first premolar

A)Anterior superior alveolar injection
B)Middle superior alveolar injection
C)Posterior superior alveolar injection
D)Infraorbital
E)Nasopalatine
F)Greater palatine

Question 6

Match the name of the maxillary injection to the landmarks of the injection site and/or the area that receives the anesthesia.Names of injections may be used more than once.

Pulpal anesthesia of maxillary central incisors

A)Anterior superior alveolar injection
B)Middle superior alveolar injection
C)Posterior superior alveolar injection
D)Infraorbital
E)Nasopalatine
F)Greater palatine

Question 7

Match the name of the maxillary injection to the landmarks of the injection site and/or the area that receives the anesthesia.Names of injections may be used more than once.

Bone overlying incisors,canine,premolars,and sometimes mesiobuccal root of the first molar,as well as upper lip,lower eyelid,and lateral aspect of the nose

A)Anterior superior alveolar injection
B)Middle superior alveolar injection
C)Posterior superior alveolar injection
D)Infraorbital
E)Nasopalatine
F)Greater palatine

Question 8

Match the name of the maxillary injection to the landmarks of the injection site and/or the area that receives the anesthesia.Names of injections may be used more than once.

Pulpal anesthesia of the mesiobuccal root of the maxillary first molar in 28% of the population

A)Anterior superior alveolar injection
B)Middle superior alveolar injection
C)Posterior superior alveolar injection
D)Infraorbital
E)Nasopalatine
F)Greater palatine

Question 9

What is the name of the type of injection that anesthetizes a larger area than the local infiltration because the local anesthetic agent is deposited near large nerve trunks?

A) Nerve block
B) Supraperiosteal
C) Topical
D) Palatine injections

Question 10

All of the following are strategies for when the clinician encounters bulky maxillary facial alveolar ridges EXCEPT one.Which one is the EXCEPTION?

A) Increase retraction
B) Move the needle injection site more superior
C) Utilize the palatal injections
D) All options listed

Question 11

Match the name of the maxillary injection to the landmarks of the injection site and/or the area that receives the anesthesia.Names of injections may be used more than once.

Pulpal anesthesia of the distobuccal root of the maxillary first molar

A)Anterior superior alveolar injection
B)Middle superior alveolar injection
C)Posterior superior alveolar injection
D)Infraorbital
E)Nasopalatine
F)Greater palatine

Question 12

Match the name of the maxillary injection to the landmarks of the injection site and/or the area that receives the anesthesia.Names of injections may be used more than once.

Pulpal anesthesia of first and second maxillary premolars in a small percentage of the population

A)Anterior superior alveolar injection
B)Middle superior alveolar injection
C)Posterior superior alveolar injection
D)Infraorbital
E)Nasopalatine
F)Greater palatine

Question 13

What is the name of the type of injection that anesthetizes a small area of one or two teeth and the associated structures when the local anesthetic agent is deposited near the terminal nerve endings?

A) Nerve block
B) Supraperiosteal
C) Topical
D) Palatine injections

Question 14

Match the name of the maxillary injection to the landmarks of the injection site and/or the area that receives the anesthesia.Names of injections may be used more than once.

Height of mucobuccal fold above the first premolar

A)Anterior superior alveolar injection
B)Middle superior alveolar injection
C)Posterior superior alveolar injection
D)Infraorbital
E)Nasopalatine
F)Greater palatine

Question 15

Best practices for increasing patient comfort during the administration of maxillary injections include which of the following?

A) The needle should not be moved within the tissue.
B) The patient's upper lip should not be slightly jiggled for distraction.
C) There is no bony contact of the overlying sensitive periosteum with the needle.
D) All options listed

Question 16

Match the name of the maxillary injection to the landmarks of the injection site and/or the area that receives the anesthesia.Names of injections may be used more than once.

Hard palate and overlying soft tissue of the maxillary anterior teeth.

A)Anterior superior alveolar injection
B)Middle superior alveolar injection
C)Posterior superior alveolar injection
D)Infraorbital
E)Nasopalatine
F)Greater palatine

Question 17

Match the name of the maxillary injection to the landmarks of the injection site and/or the area that receives the anesthesia.Names of injections may be used more than once.

Upward 45 degrees to occlusal plane,inward and backward 45 degrees to the midsagittal plane

A)Anterior superior alveolar injection
B)Middle superior alveolar injection
C)Posterior superior alveolar injection
D)Infraorbital
E)Nasopalatine
F)Greater palatine

Question 18

Match the name of the maxillary injection to the landmarks of the injection site and/or the area that receives the anesthesia.Names of injections may be used more than once.

Slightly mesial to the canine eminence and at the height of the mucobuccal fold

A)Anterior superior alveolar injection
B)Middle superior alveolar injection
C)Posterior superior alveolar injection
D)Infraorbital
E)Nasopalatine
F)Greater palatine

Question 19

Match the name of the maxillary injection to the landmarks of the injection site and/or the area that receives the anesthesia.Names of injections may be used more than once.

Lateral to the incisive papilla

A)Anterior superior alveolar injection
B)Middle superior alveolar injection
C)Posterior superior alveolar injection
D)Infraorbital
E)Nasopalatine
F)Greater palatine

Question 20

In which order would you administer the maxillary injections?

A) Greater palatine,PSA
B) Infraorbital,PSA
C) PSA,MSA,ASA
D) Order of anesthetic is at the discretion of the clinician

Question 21

Where should the site for the MSA injection be if the patient is missing one of his premolars due to orthodontic treatment?

A) Halfway in the dental arch
B) Mesial to the existing premolar
C) Distal to the existing premolar
D) Use the infraorbital injection

Question 22

Which of the following are reasons for inadequate anesthesia?

A) Deposition of the solution superior to the apex of the tooth.
B) Dense bone covers the apices of the teeth as seen in children.
C) The apex of the tooth lies beneath the maxillary sinus.
D) All options listed.

Question 23

Which of the following describes the maxillary intraceptal injection?

A) Useful for hemostasis
B) Intraosseous injection
C) Can use higher concentration of vasoconstrictor
D) Usually administered after nerve block
E) All options listed

Question 24

What is the most common technique error associated with supraperiosteal,ASA,and MSA injections?

A) Incorrect fulcrum
B) Incorrect angulation of the syringe barrel and the needle
C) Incorrect target site and solution deposition
D) Incorrect aspiration

Question 25

Which of the following are best practices for the maxillary supraperiosteal injection technique?

A) The bevel orientation of the needle should be away from the bone.
B) The needle should be inserted parallel with the long axis of the tooth.
C) The needle tip is placed inferior to the apex of the selected tooth.
D) All options listed.

Question 26

How can the clinician correct the problem of hitting bone while administering the PSA injection?

A) The needle needs to be bent slightly in order to accomplish the necessary needle angulation.
B) The syringe needs to be farther away from the occlusal plane,thereby increasing the angle to more than 45 degrees.
C) The syringe needs to be closer to the occlusal plane,thereby reducing the angle to less than 45 degrees.
D) The patient most likely has a larger size skull,so a long needle should be utilized for patient comfort.

Question 27

What is the most common technique error associated with the infraorbital injection?

A) Incorrect fulcrum
B) Incorrect angulation of the syringe barrel and the needle
C) Incorrect target site and solution deposition
D) Incorrect aspiration

Question 28

When administering the PSA injection,what other nerve may inadvertently be anesthetized?

A) Infraorbital nerve
B) Greater palatine nerve
C) MSA nerve
D) Mandibular nerve

Question 29

What should the clinician do if she accidently positions the anesthetic needle against the periosteum and bony contact is made?

A) Withdraw the needle and reinsert it farther away from the periosteum.
B) Withdraw the needle and change it because it may be dull.
C) Withdraw the needle,apply more topical anesthetic,and select a different injection to perform first.
D) Without withdrawing the needle,move the needle slightly,aspirate,and attempt anesthesia again.

Question 30

Both the right nasopalatine nerve and the left nasopalatine nerve are anesthetized by the nasopalatine block.Only one injection is needed for both sides of the palate.

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

Question 31

Supraperiosteal injections are NOT recommended when there is (are):

A) close proximity to infection.
B) close proximity to inflammation.
C) several teeth to be anesthetized.
D) All options listed.

Question 32

Supraperiosteal injections are not recommended when several teeth in the quadrant need to be anesthetized because larger volumes of anesthetic would be provided and there is increased patient discomfort due to multiple penetrations.

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

Question 33

The PSA injection can be useful during maintenance or recare appointments.Many times the maxillary molars are the first teeth involved in periodontal disease.

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

Question 34

Which injection is commonly used when performing cosmetic dentistry on the maxillary anterior teeth?

A) ASA block
B) MSA block
C) AMSA block
D) Greater palatine block

Question 35

What is an important post-infraorbital injection procedure?

A) The clinician should check for a hematoma across the lower eyelid.
B) Maintain pressure and massage the solution into the infraorbital foramen for approximately 2 minutes to enhance anesthetic diffusion.
C) Maintain finger pressure on the infraorbital foramen during the injection to help keep the syringe toward the foramen.
D) All options listed.

Question 36

What should the clinician do if she notices excessive blanching of the palatal tissue during the AMSA block administration?

A) Slow down the deposition of anesthetic solution
B) Stop the deposition of anesthetic solution for a few seconds
C) All options listed
D) None of the options listed

Question 37

What technique is best when administering the AMSA block?

A) Disposable syringe
B) Nonaspirating syringe
C) Computer-controlled delivery device
D) Topical anesthetic and aspirating syringe

Question 38

Administering the PSA block first is a good way to introduce the patient to less discomfort with local anesthesia because the injection does not contact bone and there is a relatively small area of soft tissue into which the local anesthetic is deposited.

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

Question 39

Each of the following is a descriptionof the AMSA injection EXCEPT one.Which one is the EXCEPTION?

A) Palatal nerve block
B) Provides pulpal anesthesia
C) Provides soft tissue anesthesia
D) Provides anesthesia to the anterior teeth of one sextant

Question 40

The use of pressure anesthesia before,during,and after palatal injections to blanch the tissue is recommended to reduce patient discomfort.The overlying palatal tissue is dense and adheres firmly to the underlying bones of the palate.

A) Both the statement and reason are correct and related.
B) Both the statement and reason are correct but NOT related.
C) The statement is correct,but the reason is NOT.
D) The statement is NOT correct,but the reason is correct.

Question 41

Which statement describes the P-ASA block?

A) No anesthesia of upper lip and face
B) Anesthesia for the maxillary anterior teeth of one sextant
C) 3- to 4-minute deposition period
D) All options listed

Question 42

In patients who have a vaulted palate,the GP foramen appears closer to the midline.Conversely,in patients with a more shallow palate,the foramen appears closer to the dentition.

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