Deck 9: Anatomy of Local Anesthesia

Question 1

As a result of a bicycle accident,a patient has suffered trauma to the right upper lip and maxillary right central incisor.Which of the following local anesthetic blocks may be used on the involved side when treating the injured tissue?

A)Anterior superior alveolar,infraorbital,and incisive nerve blocks
B)Infraorbital and nasopalatine nerve blocks
C)Anterior superior alveolar,middle superior alveolar,and greater palatine nerve blocks
D)Infraorbital,greater palatine,and Gow-Gates mandibular nerve blocks

Answer 1

B

Question 2

Before periodontal scaling near the periodontal tissue clefting present on the facial surface of ALL the mandibular incisors of a patient,which local anesthetic block(s)would be the BEST to have administered bilaterally?

A)Infraorbital block
B)Incisive block
C)Mental block
D)Inferior alveolar block

Answer 2

B

Question 3

Which of the following complications can occur during an incorrect administration of the inferior alveolar local anesthetic nerve block,resulting in inability to close the eyelid?

A)Motor function of the abducens nerve
B)Motor function of the facial nerve
C)Motor function of the oculomotor nerve
D)Sensory function of the facial nerve

Answer 3

B

Question 4

Which of the following local anesthetic nerve blocks when administered together would provide the GREATEST area of anesthesia to a maxillary quadrant?

A)Anterior superior alveolar,posterior superior alveolar,and greater palatine nerve blocks
B)Middle superior alveolar and greater palatine nerve blocks
C)Middle superior alveolar,posterior superior alveolar,and greater palatine nerve blocks
D)Anterior middle superior alveolar and posterior superior alveolar nerve blocks

Question 5

When administering the inferior alveolar local anesthetic nerve block,it is important to contact bony medial surface of the mandibular ramus because this will decrease the risk of depositing a local anesthetic agent into the parotid salivary gland.

A)Both the statement and the reason are correct and related.
B)Both the statement and the 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 6

Orientation of the syringe for the anterior middle superior alveolar nerve block SHOULD be from the contralateral premolars.The angle of the needle SHOULD be placed at approximately 45 degrees to the injection site.

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

Question 7

Which of the following local anesthetic nerve blocks uses the apex of the maxillary canine for a landmark during administration?

A)Infraorbital nerve block
B)Anterior superior alveolar nerve block
C)Middle superior alveolar nerve block
D)Posterior superior alveolar nerve block

Question 8

Which of the following local anesthesia nerve blocks can be used during cosmetic restorative procedures because,after procedures are completed,the clinician can immediately and accurately access the patient's smile line?

A)Anterior superior alveolar nerve block
B)Posterior superior alveolar nerve block
C)Anterior middle superior alveolar nerve block
D)Middle superior alveolar nerve block

Question 9

Which of the following ligaments can act as a barrier to the inferior alveolar nerve block if mandibular bone is NOT contacted during the injection?

A)Sphenomandibular ligament
B)Temporomandibular ligament
C)Stylomandibular ligament
D)Anterior cruciate ligament

Question 10

When administering a local anesthetic agent to a patient's teeth and their related dental structures,which three bones of the head and neck have the landmarks essential for clinically effective injection technique?

A)Maxillae,mandible,and temporal bones
B)Maxillae,mandible,and zygomatic bones
C)Maxillae,mandible,and palatine bones
D)Maxillae,mandible,and sphenoid bones

Question 11

Which of the following local anesthesia nerve blocks is usually NOT used bilaterally due to possible complications associated with swallowing and speech?

A)Incisive nerve block
B)Inferior alveolar nerve block
C)Posterior superior alveolar nerve block
D)Greater palatine nerve block

Question 12

Which local anesthetic nerve block would be necessary for a patient undergoing oral surgery on an edentulous left mandibular alveolar process in the area of the extracted molars?

A)Left buccal nerve block
B)Right buccal nerve block
C)Left mental nerve block
D)Right infraorbital nerve block

Question 13

Which of the following local anesthetic nerve blocks anesthetizes the buccal gingival tissue of the maxillary first molar?

A)Infraorbital nerve block
B)Anterior superior alveolar nerve block
C)Buccal nerve block
D)Posterior superior alveolar nerve block

Question 14

Which of the following locations is the BEST injection site for the inferior alveolar local anesthetic nerve block?

A)Medial to the pterygomandibular fold
B)Lateral to the pterygomandibular fold
C)Superior to the pterygomandibular fold
D)Inferior to the pterygomandibular fold
E)NEITHER the statement NOR the reason is correct.

Question 15

A restoration will be placed on the occlusal surface of the maxillary first premolar,but no rubber dam will be used.However,which of the following local anesthetic nerve blocks MUST be administered?

A)Anterior superior alveolar nerve block
B)Middle superior alveolar nerve block
C)Greater palatine nerve block
D)Inferior alveolar nerve block

Question 16

Only one injection is necessary when anesthetizing BOTH the right and left maxillary anterior palate and associated palatal gingival tissue.Pressure anesthesia during the nasopalatine local anesthetic nerve block is NOT helpful with patient comfort.

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 17

A 9-year-old child is having a restoration placed on the occlusal surface of the mandibular left first molar.Which of the following heights of the inferior alveolar local anesthetic nerve block injection sites should be followed during the pain control procedure?

A)Approximately 6 to 10 mm superior to the occlusal plane of the mandibular molars
B)Slightly inferior to the occlusal plane of the mandibular molars
C)At the same height as the occlusal plane of the mandibular molars
D)More than approximately 10 mm superior to the occlusal plane of the mandibular molars

Question 18

Which of the following descriptions concerning the injection site for the anterior middle superior alveolar local anesthetic nerve block is CORRECT?

A)Approximately midway between the median palatine raphe and the palatal gingival margin of the maxillary premolars
B)Approximately10 mm medial and directly superior to the palatal gingival margin of the maxillary third molar,anterior to the depression of the greater palatine foramen
C)At the height of the mucobuccal fold at the apex of the maxillary canine
D)At the height of the mucobuccal fold at the apex of the maxillary first premolar

Question 19

Which of the following angulations of the needle MUST be followed during the administration of the posterior superior local anesthetic nerve block?

A)Superiorly at approximately 45 degrees and medially at approximately 90 degrees to the occlusal plane
B)Superiorly at approximately 90 degrees and medially at approximately 45 degrees to the occlusal plane
C)Superiorly at approximately 45 degrees and medially parallel to the occlusal plane
D)Superiorly at approximately 45 degrees and medially at approximately 45 degrees to the occlusal plane

Question 20

Which of the following complications can result from a greater palatine local anesthetic nerve block?

A)Cheek bite by patient
B)Anesthesia of the upper lip
C)Stimulation of the gag reflex
D)Hematoma in the infratemporal fossa

Question 21

Which of the following statements can be CORRECTLY used when discussing the "lingual shock" some patients may experience when administering an inferior alveolar local anesthetic block?

A)Occurs when the needle passes by the mylohyoid nerve
B)Patient may make involuntary movements
C)Reactions only include a slight opening of the eyes
D)Reactions made by the patient continue until anesthesia wears off

Question 22

From the following list of complications involving the eyelid,nose,and upper lip,select the MOST common ones associated with the infraorbital nerve block.(Select all that apply. )

A)Hematoma
B)Stimulation of the gag reflex
C)Tingling
D)Numbness

Question 23

From the following list of oral cavity landmarks,select those that need to be noted before administering a clinically effective inferior alveolar nerve block.(Select all that apply. )

A)Occlusal plane
B)Maxillary tuberosity
C)Pterygomandibular fold
D)Coronoid notch

Question 24

Which of the following local anesthesia nerve blocks would benefit from using a topical anesthetic-laced long cotton tip applicator to palpate the injection site as if it were the needle and syringe? (Select all that apply. )

A)Posterior superior alveolar block
B)Inferior superior alveolar block
C)Greater palatine block
D)Nasopalatine block

Question 25

There is ONLY one type of local anesthetic injection used commonly in dentistry,the nerve block.The type of injection used for a given dental procedure is determined by the type and length of the procedure.

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

Question 26

Which of the following procedures may allow for LESS discomfort when anesthetizing the palate of a patient with the anterior middle superior alveolar block? (Select all that apply. )

A)Topical anesthetic
B)Pressure anesthesia
C)Computer-controlled local anesthetic delivery device
D)Bidirectional rotation needle insertion technique
E)Philtrum near the upper lip
F)None of the above

Question 27

Which of the following local anesthetic nerve blocks can be involved in the spread of infection to the cavernous sinus?

A)Anterior superior alveolar nerve block
B)Inferior alveolar nerve block
C)Posterior superior alveolar nerve block
D)Infraorbital nerve block

Question 28

Which of the following local anesthetic nerve blocks MAINLY uses an extraoral landmark on the face when locating the injection site?

A)Inferior alveolar nerve block
B)Infraorbital nerve block
C)Posterior superior alveolar nerve block
D)Mental nerve block
E)NEITHER the statement NOR the reason is correct.

Question 29

Palatal anesthesia usually involves anesthesia of the soft and hard tissue of the periodontium of the palatal area such as the gingival tissue,periodontal ligament,and alveolar process.Palatal anesthesia usually does NOT provide any pulpal anesthesia to the maxillary teeth or associated facial or buccal gingival tissue.

A)Both statements are true.
B)Both statements are false.
C)The first statement is true;the second is false.
D)The first statement is false;the second is true.
E)NEITHER the statement NOR the reason is correct.

Question 30

From the following list,select those statements that can be used CORRECTLY when discussing paresthesia from the administration of local anesthesia and its progression over time.(Select all that apply. )

A)Possibly abnormal area sensation
B)Possible burning or prickling
C)Usually occurs with infections
D)Usually occurs with nonsurgical procedures
E)Mandibular notch

Question 31

When troubleshooting incomplete anesthesia following an inferior alveolar local anesthetic nerve block on a patient,the clinician notes a doubled mandibular canal on an intraoral radiograph.What is present with this patient,and how can clinically effective anesthesia be achieved? (Select all that apply. )

A)More superiorly placed second mandibular foramen exists.
B)More inferiorly placed second mandibular foramen exists.
C)The local anesthetic agent needs to be deposited more inferiorly to the usual anatomic landmarks.
D)The local anesthetic agent needs to be deposited more superiorly to the usual anatomic landmarks.
E)Prepuncture technique with needle bevel

Question 32

From the following list,select those that are anatomic factors involved in providing MORE clinically effective maxillary arch anesthesia than mandibular arch anesthesia.(Select all that apply. )

A)Thinner facial cortical plate over teeth
B)Less variation exists in anatomy
C)More variation exists in anatomy
D)Thicker facial cortical plate over teeth

Question 33

The dental professional MUST know the location of certain adjacent soft tissue structures,such as major blood vessels and glandular tissue,so as to make sure to allow for injecting these structures.

A)Both the statement and the reason are correct and related.
B)Both the statement and the 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 34

Which of the following are included in the linear relationship noted on the face that can assist with the CORRECT administration of the infraorbital block? (Select all that apply. )

A)Ipsilateral supraorbital notch
B)Pupil of the eye looking forward
C)Midpoint of the infraorbital notch
D)Posterior superior alveolar foramina

Question 35

There MUST never be an injection through an area with an abscess,cellulitis,or osteomyelitis so as to prevent the spread of dental infection.

A)Both the statement and the reason are correct and related.
B)Both the statement and the 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 36

Less variation exists in the anatomy of the maxillae and palatine bones and associated nerves with respect to local anesthetic landmarks as compared with similar mandibular structures,making the maxillary injections less routine and usually with the need for any troubleshooting of failure cases.

A)Both the statement and the reason are correct and related.
B)Both the statement and the 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 37

From the following list of oral cavity landmarks,select those that need to be noted before administering a clinically effective posterior superior alveolar nerve block.(Select all that apply. )

A)Mucobuccal fold
B)Coronoid notch
C)Maxillary first molar
D)Maxillary tuberosity