Deck 12: Maxillary Nerve Anesthesia

Question 1

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 of the above

Answer 1

All of the above

Question 2

MATCHING
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

Answer 2

Middle superior alveolar injection

Question 3

What is a good reason not to use distracters when administering maxillary 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 of the above.

Answer 3

Movement may cause the anesthetic not to be placed at the target area.

Question 4

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 5

MATCHING
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 6

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.

Question 7

MATCHING
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

Question 8

MATCHING
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 9

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 be slightly jiggled for distraction.
C) There is no bony contact of the overlying sensitive periosteum with the needle.
D) a and c
E) All of the above.

Question 10

What should the clinician do if she encounters bulky maxillary facial alveolar ridges?

A) Increase retraction
B) Move the needle injection site more superior
C) Utilize the palatal injections
D) a and b

Question 11

MATCHING
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 12

MATCHING
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 midsaggital plane

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

Question 13

MATCHING
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 14

MATCHING
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 15

MATCHING
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 16

MATCHING
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 17

MATCHING
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 18

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 19

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 20

MATCHING
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 21

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 22

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 if 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 23

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 of the above.

Question 24

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) Discontinue the administration of this block injection
D) a and b

Question 25

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 26

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 27

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 28

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 29

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 30

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 31

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 32

Which of the following are best practices for the maxillary 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 of the above.

Question 33

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 of the above.