Question 1

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. )

Accepted Answer

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 2

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

Accepted Answer

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

Question 3

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

Accepted Answer

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 4

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.

Accepted Answer

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 5

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

Accepted Answer

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 6

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.

Accepted Answer

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

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. )

Accepted Answer

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

Question 8

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

Accepted Answer

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

Question 9

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.

Accepted Answer

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 10

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

Accepted Answer

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 11

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

Accepted Answer

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 12

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.

Accepted Answer

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 13

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. )

Accepted Answer

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 14

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. )

Accepted Answer

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

Question 15

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

Accepted Answer

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 16

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?

Accepted Answer

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 17

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. )

Accepted Answer

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

Exam 9: Anatomy of Local Anesthesia