Deck 9: Local Anesthetic Delivery Devices

Question 1

Match the following :

-Bevel

A) Winged or wingless
B) Angled tip of needle
C) Penetrating end of piston
D) Glass cylinder
E) 32 mm
F) Hollow part of needle
G) 22 mm
H) Aluminum cover on cylinder
I) Hub
J) Internal diameter of needle

Answer 1

Angled tip of needle

Question 2

Match the following :

-Cartridge

A) Winged or wingless
B) Angled tip of needle
C) Penetrating end of piston
D) Glass cylinder
E) 32 mm
F) Hollow part of needle
G) 22 mm
H) Aluminum cover on cylinder
I) Hub
J) Internal diameter of needle

Answer 2

Glass cylinder

Question 3

Match the following :

-End cap

A) Winged or wingless
B) Angled tip of needle
C) Penetrating end of piston
D) Glass cylinder
E) 32 mm
F) Hollow part of needle
G) 22 mm
H) Aluminum cover on cylinder
I) Hub
J) Internal diameter of needle

Answer 3

Aluminum cover on cylinder

Question 4

Match the following :

-Finger grips

A) Winged or wingless
B) Angled tip of needle
C) Penetrating end of piston
D) Glass cylinder
E) 32 mm
F) Hollow part of needle
G) 22 mm
H) Aluminum cover on cylinder
I) Hub
J) Internal diameter of needle

Question 5

Match the following :

-Gauge

A) Winged or wingless
B) Angled tip of needle
C) Penetrating end of piston
D) Glass cylinder
E) 32 mm
F) Hollow part of needle
G) 22 mm
H) Aluminum cover on cylinder
I) Hub
J) Internal diameter of needle

Question 6

Match the following :

-Harpoon

A) Winged or wingless
B) Angled tip of needle
C) Penetrating end of piston
D) Glass cylinder
E) 32 mm
F) Hollow part of needle
G) 22 mm
H) Aluminum cover on cylinder
I) Hub
J) Internal diameter of needle

Question 7

Match the following :

-Long needle

A) Winged or wingless
B) Angled tip of needle
C) Penetrating end of piston
D) Glass cylinder
E) 32 mm
F) Hollow part of needle
G) 22 mm
H) Aluminum cover on cylinder
I) Hub
J) Internal diameter of needle

Question 8

Match the following :

-Short needle

A) Winged or wingless
B) Angled tip of needle
C) Penetrating end of piston
D) Glass cylinder
E) 32 mm
F) Hollow part of needle
G) 22 mm
H) Aluminum cover on cylinder
I) Hub
J) Internal diameter of needle

Question 9

Match the following :

-Lumen

A) Winged or wingless
B) Angled tip of needle
C) Penetrating end of piston
D) Glass cylinder
E) 32 mm
F) Hollow part of needle
G) 22 mm
H) Aluminum cover on cylinder
I) Hub
J) Internal diameter of needle

Question 10

Match the following :

-Needle adaptor

A) Winged or wingless
B) Angled tip of needle
C) Penetrating end of piston
D) Glass cylinder
E) 32 mm
F) Hollow part of needle
G) 22 mm
H) Aluminum cover on cylinder
I) Hub
J) Internal diameter of needle

Question 11

The most common type of syringe used in dentistry is a disposable, breech-loading, self-aspirating, cartridge device.

Question 12

The large window of the syringe barrel should be positioned away from the clinician throughout the injection to prevent injury in the event the cartridge shatters during injection.

Question 13

The purpose of the harpoon on the piston is to engage the rubber stopper during injection to create a slightly positive pressure inside the cartridge during the aspiration test.

Question 14

A 25 gauge needle has a larger internal diameter than a 30 gauge needle.

Question 15

Dental cartridges in the United States contain a volume of 1.8 ml of solution, which means each stopper width displaces 0.2 ml of solution.

Question 16

Large air bubbles in a cartridge of anesthetic solution are a normal result of the manufacturing process and pose no risk for use.

Question 17

Anesthetic cartridges containing vasoconstrictors should be stored in the dark.

Question 18

Sodium chloride is added to local anesthetic solutions as a preservative for the vasoconstrictor drug.

Question 19

Sulfite is added to local anesthetic solutions as a preservative for the vasoconstrictor drug.

Question 20

Sodium chloride is added to local anesthetic solutions as a preservative for the anesthetic drug.

Question 21

The shelf life of a local anesthetic solution without a vasoconstrictor is approximately 24 months.

Question 22

The shelf life of a local anesthetic solution without a vasoconstrictor is approximately 12 months if stored in a dark container.

Question 23

The required color-coding band for lidocaine with 1:100,000 epinephrine is red and the band for lidocaine with 1:50,000 epinephrine is green.

Question 24

The term ________ refers to all equipment, materials, and devices used during the delivery of local anesthetic agents.

Question 25

The most common syringe design used in dentistry is the sterilizable, breech-loading, cartridge-type, ________ syringe.

Question 26

Pistol grip and pen-type syringes are used for ________ injections.

Question 27

A ________ device is a preprogrammed, electronic delivery system for the administration of local anesthetic injections.

Question 28

The ________ is the part of the piston inside the syringe barrel that penetrates the stopper.

Question 29

Clinicians hold the syringe with the index and middle fingers on the finger grip to balance and control the ________ of the syringe.

Question 30

Needles used in dentistry are identified by length and internal diameter, also called the ________ of the needle.

Question 31

Long needles in dentistry average ________ in length.

Question 32

Short needles in dentistry average ________ in length.

Question 33

Extra short needles in dentistry average ________ in length.

Question 34

Extra-short needles can be used when penetrations are shallow such as in ________ injections.

Question 35

Long needles are used when ________ sites are a greater distance from the penetration site such as with mandibular (IA or GG) nerve block injections.

Question 36

Cartridges in the United States contain a volume of ________ of solution.

Question 37

Sodium chloride provides for ________ tissue compatibility in anesthetic solutions.

Question 38

Distilled water is a ________ and serves as the majority component of local anesthetic solutions.

Question 39

4% prilocaine with 1:200,000 epinephrine has a ________ color-coded band on the cartridge.

Question 40

2% lidocaine plain has a ________ color-coded band on the cartridge.

Question 41

The standard aspirating syringe is designed to provide ________ for aspiration.

Question 42

Local anesthetic solutions with vasoconstrictors should be stored in the ________.

Question 43

The shelf life of a local anesthetic solution without a vasoconstrictor is ________.

Question 44

The shelf life of a local anesthetic solution with a vasoconstrictor is ________.

Question 45

Which of the following is not a feature of all CCLAD devices?

A) Precisely controls the rate of delivery of solutions
B) Correctly identifies the deposition site
C) Helps to reduce patient discomfort for palatal injections
D) Can reduce the incidence of adverse tissue reactions

Question 46

Which of the following statements is correct?

A) The standard aspirating syringe is designed to provide negative pressure on aspiration unlike the self-aspirating syringe.
B) The standard aspirating syringe is designed to provide negative pressure on aspiration similar to the self-aspirating syringe.
C) The standard aspirating syringe is designed to provide positive pressure on aspiration unlike the self-aspirating syringe.
D) Neither the standard nor the self-aspirating syringes provides negative pressure on aspiration.

Question 47

Which statement describes the correct method to ensure that the harpoon is seated in the stopper?

A) Press on the finger ring to ensure solution passes through the needle.
B) Pull back on the thumb, then the rubber stopper will retract.
C) Use firm hand pressure against the syringe ring.
D) Apply pressure on the needle cap.

Question 48

Which statement does not accurately describe a needle used for dental local anesthesia?

A) Sterile stainless steel for single-patient use
B) Identified by length and diameter
C) Plastic needle caps with standard color coding
D) Available in 25, 27, and 30 gauge

Question 49

Which of the following needle gauges used in dentistry has the largest lumen?

A) 23
B) 25
C) 27
D) 30

Question 50

Which of the following statements best describes the appropriate choice of needles for local anesthetic injections?

A) Use higher-gauge needles for injection techniques that require deep penetrations because the flexibility will allow for repositioning around soft tissue obstructions.
B) Use smaller gauge needles for injections that require deep penetrations because they are less flexible and the larger lumen provides for ease and accuracy of aspiration.
C) Use smaller gauge needles because they will cause less discomfort during injection compared to larger gauge needles.
D) All needles will work equally well for all injection techniques.

Question 51

Which of the following is not correct when comparing a 25 gauge needle with a 30 gauge needle?

A) Permits better aspiration
B) Has the same comfort level
C) Has a smaller internal diameter and breaks more easily
D) Allows less deflection during deeper penetrations

Question 52

What is the most likely cause of an extruded stopper on a cartridge?

A) Freezing during shipping or storage
B) Pressure and expansion caused by overheating
C) Cartridge was overfilled during manufacturing
D) Oxidation of sodium bisulfate creating gas in the cartridge

Question 53

How much anesthetic solution is delivered when four stopper widths are deposited?

A) 0.4 ml
B) 0.6 ml
C) 0.8 ml
D) 7.2 ml

Question 54

What is the amount of anesthetic solution delivered in two stopper widths?

A) 0.4 ml
B) 0.6 ml
C) 0.8 ml
D) 7.2 ml

Question 55

Small bubbles visible in cartridges of local anesthetic are the result of:

A) Air bubbles trapped during manufacturing
B) Overheating in cartridge warmers
C) Contamination from storing cartridges in antiseptic solutions
D) Oxidation of the vasoconstrictor in solutions

Question 56

A local anesthetic solution that has been overheated during shipping and handling will:

A) Have small and large bubbles from the gas produced by heating
B) Appear cloudy and/or sediment may be visible
C) Have incompletely filled cartridges due to evaporation
D) Have mostly broken cartridges in the container

Question 57

Which of the following contents in the cartridge is the preservative for epinephrine?

A) Sodium chloride
B) Nitrogen gas
C) Methylparaben
D) Sodium bisulfite

Question 58

Which of the following contents in the cartridge provides isotonic tissue compatibility?

A) Sodium chloride
B) Distilled water
C) Preservative
D) Sodium bisulfite

Question 59

Which cartridge has a green band in the required ADA color-coding system?

A) 3% mepivacaine plain
B) 4% prilocaine, 1:200,000 epinephrine
C) 2% lidocaine plain
D) 2% lidocaine, 1:50,000 epinephrine

Question 60

Which cartridge has a yellow band in the required ADA color-coding system?

A) 3% mepivacaine, 1:20,000 levonordefrin
B) .5% bupicavaine, 1:200,000 epinephrine
C) 4% articaine, 1:100,000 epinephrine
D) 4% prilocaine, 1:200,000 epinephrine

Question 61

Which of the following does not meet OSHA standards to prevent needlestick injuries?

A) Placing needle in a cap in a cardboard card
B) One-handed scoop into needle cap
C) Passing the syringe to an assistant to cap
D) Capping a needle in an upright holder

Question 62

Identify the labeled components for the devices shown in the figures below:
-Components of a syringe
A. ________
B. ________
C. ________
D. ________
E. ________
F. ________
G. ________
H. ________

Question 63

Identify the labeled components for the devices shown in the figures below:
-Components of a needle
A. ________
B. ________
C. ________
D. ________
E. ________
F. ________

Question 64

Identify the labeled components for the devices shown in the figures below:
-Components of a dental local anesthetic cartridge
A. ________
B. ________
C. ________
D. ________

Question 65

List the armamentarium appropriate for dental local anesthesia injections.

Question 66

Discuss advantages of CCLAD devises for local anesthesia.

Question 67

What are the factors that clinicians use to determine the selection of needles for local anesthetic injections?

Question 68

What information is listed on the mylar label of a cartridge?

Question 69

What is the OSHA standard for the prevention of needlestick injuries?

Question 70

What is the appropriate response if a needlestick or other puncture injury occurs?

Question 71

The clinician has reached the deposition site for an inferior alveolar injection. In order to perform an aspiration test, the clinician pulls backwards with his or her thumb and is unable to aspirate. The clinician tells the patient that he or she needs to withdraw the syringe and then carefully withdraws.

-What is the first thing the clinician needs to do after withdrawing the syringe to ensure safety?

Question 72

The clinician has reached the deposition site for an inferior alveolar injection. In order to perform an aspiration test, the clinician pulls backwards with his or her thumb and is unable to aspirate. The clinician tells the patient that he or she needs to withdraw the syringe and then carefully withdraws.

-Provide possible reasons the clinician was unable to aspirate.