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Local Anesthesia LECTURE FINAL
A patient may present with a bifid inferior alveolar nerve, in which case a second mandibular foramen is more superiorly placed. The second foramen may be detected by noting a doubled mandibular canal on a radiograph. Select one: 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. - d. The first statement is false; the second statement is true. Avoiding anesthesia of the facial nerve at the parotid salivary gland is important when administering an inferior alveolar block because it may result in transient facial paralysis if given incorrectly. Select one: 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. - a. Both the statement and reason are correct and related. Each of the following describes the buccal nerve associated with the buccal block EXCEPT one. Which one is the EXCEPTION? Select one: a. Afferent nerve b. Efferent nerve c. Serves skin of the cheek and molar region periodontal tissues d. Anterior border of the mandibular ramus is a landmark for the buccal block - b. Efferent nerve Identify the divisions of the sensory root that carry only afferent nerves to the teeth and associated tissue. Select one: a. Ophthalmic and mandibular nerves b. Ophthalmic and maxillary nerves c. Mandibular and maxillary nerves d. All options listed - b. Ophthalmic and maxillary nerves If the MSA nerve is not present, the area is innervated by the PSA, but mostly by the ASA. If the MSA nerve is present, there is communication between the PSA and the ASA. Select one: 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. -
a. Both statements are true. The coronoid notch is a landmark for the administration of which injection? Select one: a. Anterior superior alveolar nerve block b. Posterior superior alveolar nerve block c. Inferior alveolar nerve block d. Lingual nerve block - c. Inferior alveolar nerve block The lesser palatine foramen transmits the lesser palatine nerve and blood vessels to the soft palate and tonsils. Due to close proximity to the greater palatine foramen and its nerve, the patient's soft palate can become inadvertently anesthetized with the greater palatine block. Select one: 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. - a. Both statements are true. The maxillary tuberosity is a landmark for the administration of which injection? Select one: a. Anterior superior alveolar block b. Middle superior alveolar block c. Posterior superior alveolar block d. Inferior alveolar block - c. Posterior superior alveolar block The medial surface of the mandibular ramus is a landmark for the administration for which of the following? Select one: a. Incisive and inferior alveolar blocks b. Inferior alveolar block and Vazirani-Akinosi blocks c. Vazirani-Akinosi and the incisive blocks d. None of the above - b. Inferior alveolar block and Vazirani-Akinosi blocks The mental foramen is an important landmark to note intraorally and on a radiograph before administration of mental and incisive nerve blocks. The mental foramen can be as far posterior as the apex of the mandibular first molar or as far anterior as the apex of the mandibular canine. Select one: 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. - a. Both statements are true. What is the median palatine raphe? Select one:
a. Mylohyoid line b. Internal oblique line c. External oblique line d. Coronoid notch - c. External oblique line What is the specific name of the part of the mandible that forms the temporomandibular joint? Select one: a. Condyle b. Coronoid process c. Coronoid notch d. Mandibular notch - a. Condyle When the clinician administers an IO injection, which nerves are anesthetized? Select one: a. Posterior superior alveolar, middle superior alveolar, and ophthalmic nerves b. Posterior superior alveolar, middle superior alveolar, and infraorbital nerves c. Anterior superior alveolar, middle superior alveolar, and infraorbital nerves d. Some other combination of nerves - c. Anterior superior alveolar, middle superior alveolar, and infraorbital nerves Which area of the maxilla articulates with the other to form the anterior or major part of the hard palate? Select one: a. Zygomatic process b. Frontal process c. Palatine process d. Alveolar processes - c. Palatine process Which bones does the mandible have a movable articulation with? Select one: a. Maxillae b. Temporal bones c. Sphenoid bone d. Palatal bones - b. Temporal bones Which nerve carries sensory information for the maxillary sinuses, nasal cavity, and palate? Select one: a. First division of the trigeminal nerve b. Second division of the trigeminal nerve c. Third division of the trigeminal nerve d. Ophthalmic nerve - b. Second division of the trigeminal nerve Which nerve is anesthetized through localized diffusion of the local anesthetic agent through the tissue when administering an inferior alveolar block?
Select one: a. Posterior superior alveolar nerve b. Anterior superior alveolar nerve c. Lingual nerve d. Mandibular nerve - c. Lingual nerve Which nerve is considered to be the most involved when a patient experiences paresthesia complications? Select one: a. Lingual nerve b. Posterior superior alveolar nerve c. Anterior superior alveolar nerve d. Inferior alveolar nerve - a. Lingual nerve Which nerve may also serve as an afferent nerve for the mandibular first molar? Select one: a. Anterior middle superior alveolar b. Mylohyoid c. Mental d. Lingual - b. Mylohyoid Which nerve provides sensory information for the teeth and associated tissue? Select one: a. V nerve b. Fifth cranial nerve c. Trigeminal nerve d. All options listed - d. All options listed Which nerve serves as an afferent nerve for the skin of the cheek? Select one: a. Infraorbital nerve b. Ophthalmic nerve c. Zygomaticofacial nerve d. Zygomaticotemporal nerve - c. Zygomaticofacial nerve Which nerve supplies innervation to the second and third maxillary molars? Select one: a. ASA b. MSA c. PSA d. Infraorbital - c. PSA Which nerve travels through the mandibular canal, exits the mandibular foramen, and innervates the mandibular teeth?
With which teeth will the clinician have a higher degree of success in achieving profound anesthesia with infiltration of local anesthetic? Select one: a. Maxillary teeth b. Mandibular anterior teeth c. Mandibular posterior teeth d. Equal success no matter the arch - a. Maxillary teeth All of the following are true of topical anesthetics used in dentistry EXCEPT one. Which one is the EXCEPTION? Select one: a. Lidocaine may contain preservatives such as the parabens that could induce an allergic response. b. Topical anesthetics are possible allergens. c. Benzocaine is a commonly used amide topical anesthetic that can contribute to an allergic reaction. d. Tetracaine can contribute to an allergic response. - c. Benzocaine is a commonly used amide topical anesthetic that can contribute to an allergic reaction. Best practices to prevent needle breakage include which of the following? Select one: a. Use a long, small-gauge needle b. Use good technique c. Bend needle for correct angulation d. All options listed - b. Use good technique Cardiovascular signs of toxicity of local anesthetic solution include which of the following? Select one: a. Myocardial depression b. Cardiac dysrhythmias c. Cardiotoxicity in pregnancy d. All options listed - d. All options listed Delayed signs and symptoms of an allergic reaction are more intense and serious. If skin reactions develop immediately following the injection, anaphylaxis may occur. Select one: 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. - d. The first statement is false; the second statement is true. How might overdose reactions be avoided? Select one: a. Know the anatomy.
b. Aspirate in two planes. c. Use 25- or 27-gauge needle. d. Administer drug slowly. e. All options listed. - e. All options listed. On reviewing the dental patient's health history and dental history, what would be a best practice in dealing with information that could adversely affect dental treatment? Select one: a. Tell the supervising dentist. b. Record the conditions in red as a medical alert on the patient's medical history. c. Document in the chart notes that you checked the patient's health history. d. Refer patient to a specialist. - b. Record the conditions in red as a medical alert on the patient's medical history. Recommended treatment of allergic reactions includes which of the following? Select one: a. 25- to 50-mg adult dose Benadryl for mild cutaneous reactions b. 1:1000 epinephrine for more serious reactions c. 60-mg methylprednisolone for severe allergic reactions d. All options listed - d. All options listed The preanesthetic patient assessment is the most important measure the dental hygienist can complete to prevent an allergic reaction. Patients who report they are susceptible to asthma, hay fever, and allergies to foods have an increased potential to develop an allergic response to medications. Select one: 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. - a. Both statements are true. What could cause a burning sensation during the administration of local anesthetic? Select one: a. Expired anesthetic solution b. Possible contamination with disinfecting solution c. Anesthetic placed in sunny window to warm gently d. All options listed - d. All options listed What documentation about local anesthesia should be recorded in the patient's chart? Select one: a. Postanesthetic instructions given to patient b. Type and dose of drug/drugs administered c. Patient's response to anesthesia d. Appropriate consultations or referrals e. All options listed - e. All options listed
c. Sheath needle before and immediately after injection Which of the following could be cause for pain during injection? Select one: a. Dull needle b. Barbed needle c. Rapid deposition d. All options listed - d. All options listed Which of the following could result if local anesthetic solution is inadvertently deposited in the parotid gland? Select one: a. Incomplete anesthesia of teeth b. Hematoma c. Facial paralysis d. All options listed - c. Facial paralysis According to the Centers for Disease Control and Prevention, which of the following conditions constitute occupational exposures in dentistry? Select one: a. Contact of mucous membrane with body fluids that are potentially infectious b. A percutaneous injury c. When skin that is chapped, abraded, or affected by dermatitis is exposed to blood or saliva d. All options listed - d. All options listed Always be sure to administer the appropriate volume of anesthetic for the area that can reasonably be completed during one appointment. On completion of one quadrant of nonsurgical periodontal treatment, the clinician can administer more anesthetic, even if the MRD has been reached. Select one: 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. - c. The first statement is true; the second statement is false. Dental hygienist-employer communication best practices include: Select one: a. Open discussion regarding the potential liabilities for dental personnel b. Brainstorming liability prevention strategies c. Writing or reviewing the office protocol d. All options listed - d. All options listed Due to the scope of practice for dentists, they are more at risk for litigation. Risk management identifies methods to negotiate the risk of legal actions associated with the delivery of oral care.
Select one: 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; second statement is true. - c. The first statement is true; the second statement is false. How long does the qualified health care provider have to provide the employer with a written report? Select one: a. 10 days b. 15 days c. 1 month d. As long as necessary - b. 15 days In some states, the scope of dental hygiene practice for all dental hygiene treatment, including local anesthesia, requires the physical presence of a dentist. In other states, supervision laws do not require the physical presence of the dentist for dental hygiene treatment but do require it during the administration of local anesthesia. Select one: 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. - a. Both statements are true. Initially patients may decline the use of local anesthesia for nonsurgical periodontal procedures because they do not fully understand the benefits of its use. Select one: 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. NEITHER the statement NOR the reason is correct. - a. Both the statement and reason are correct and related. Striving to utilize all protocols to prevent injury from occurring is which category of prevention and management of injury? Select one: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Risk reduction protocol - a. Primary prevention The primary objective of providing dental hygiene care is to assist patients in preventing disease and maintaining oral health. With the delivery of these services, the dental hygienist may experience unanticipated and problematic outcomes. Select one: a. Both statements are true.
Whatever the situation may be, malpractice may be determined if the contractual obligations are not met by the dental hygienist. A dental hygienist may commit a negligent act during the administration of local anesthetics by causing paresthesia. Select one: 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. - a. Both statements are true. Which of the following are dental hygiene considerations? Select one: a. Confidentiality b. Meeting the standards set by other practitioners c. Informed consent d. All options listed - d. All options listed Which of the following factors may serve to decrease the risk of possible litigation? Select one: a. Minimizing misunderstandings b. Resolving problems as they arise c. Developing a one-on-one relationship with the patient to build trust and confidence d. All options listed - d. All options listed Which of the following is true regarding the best practice in obtaining informed consent? Select one: a. Clearly present only the benefits associated with the procedure. b. Ultimately, it is the patient's decision whether to accept a procedure or not. c. Presenting the risks of the procedure could possibly scare the patient into choosing not to have the procedure performed. d. Tweens and teenagers are capable of granting their own informed consent for treatment. - b. Ultimately, it is the patient's decision whether to accept a procedure or not. Which of the following legal issues pertain to the dental hygienist? Select one: a. Contractual obligation to the patient b. Assumption of own legal responsibility c. Accountability if the patient's periodontal status declines d. All options listed - d. All options listed A dental hygienist does not necessarily need to purchase his/her own liability insurance because he/she is typically covered under the umbrella of the supervising dentist's professional liability insurance. Select one: True False - False
A dental hygienist may be charged with malpractice if he/she induces harm to the patient or if a breach of duty exists. Select one: True False - True All dental facilities that employ more than 15 people must have a postexposure management protocol for occupational exposures. Select one: True False - False Any dental history regarding a patient's psychologic state as related to injections or nervousness is subjective and should not be included in dental notes. Select one: True False - False Any refusal of treatment by the patient and a brief statement documenting the discussion of risks associated with refusal of treatment should be documented in the patient record. Select one: True False - True Due to the high standards of the dental hygiene curriculum, the licensed dental hygienist is prepared for any experience within the dental office. Select one: True False - False For a percutaneous injury, details of the incident report should include the depth of the wound, the gauge of the needle, and whether fluid was injected. Select one: True False - True Most states require the dental hygienist to apply for a local anesthesia license or certificate in addition to the regular dental hygiene license to legally administer local anesthetics. Select one: True False - True
According to Malamed, what kinds of needles are most likely to break? Select one: a. 30-gauge short or ultrashort needles b. 25-gauge long needles c. Short needles, no matter the gauge d. Long needles, no matter the gauge - a. 30-gauge short or ultrashort needles Because of the cost of the "needleless" injection, what is an alternative cost-effective anesthetic that will produce results similar to those of the needleless injection? Select one: a. Computer-controlled anesthetic b. Topical anesthetic c. Articaine d. All options listed - b. Topical anesthetic Established local anesthetic syringe criteria include which of the following? Select one: a. Disposable and packaged in sterile containers b. Lightweight and simple to use c. Able to withstand repeated use and sterilization d. All options listed - d. All options listed In dentistry, the pressure-type syringe is used for providing anesthetic for periodontal ligament injections. It provides reliable anesthesia for one tooth in the mandible. Select one: 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. - a. Both statements are true. It is recommended that the clinician know the location of the uncovered needle tip at all times. Why? Select one: a. To prevent needle injury to the patient b. To prevent needle injury to the clinician c. To prevent accidental needle contamination d. All options listed - d. All options listed Larger-gauge needles provide less tissue deflection during significant needle penetration because of the greater rigidity of larger gauge needles. Select one: 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. - a. Both the statement and reason are correct and related. Long needles are required for which of the following? Select one: a. Inferior alveolar block injection b. Gow-Gates mandibular block injection c. Infraorbital block injection d. All options listed - d. All options listed Manufacturer recommendations for the routine maintenance of reusable syringes include: Select one: a. Thorough cleaning and sterilization after use on each patient b. Never dismantling the syringe c. Disposing of syringes with bent harpoons d. Lubrication of the piston after every autoclave run - a. Thorough cleaning and sterilization after use on each patient On what factor should the clinician base the choice of the needle length? Select one: a. Type of anesthetic to be used b. Amount of tissue that needs to be penetrated c. Patient tolerance and comfort level d. Angle of the bevel - b. Amount of tissue that needs to be penetrated Patient comfort can be increased by the sharpness of the bevel. The bevel of the needle should be turned toward the bone. Select one: 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. - a. Both statements are true. Since the syringe was introduced in 1921, what has been the single most important improvement in dental local anesthetic? Select one: a. The addition of the breech-loading window for visibility b. The addition of the aspirating harpoon c. The elimination of the needle d. The computer-controlled anesthetic devices - b. The addition of the aspirating harpoon Small bubbles (1-2 millimeters) trapped in the anesthetic cartridge are harmless because they are produced by nitrogen gas bubbled into the solution during the manufacturing process. Select one: a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related.
c. The first statement is true; the second statement is false. d. The first statement is false; the second statement is true. - d. The first statement is false; the second statement is true. Various colors are used by manufacturers to indicate the gauge and length of needles. There are no uniform guidelines for the color of needle shields. Select one: 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. - c. The first statement is true; the second statement is false. What does the presence of an extruded anesthetic cartridge stopper without a large bubble mean? Select one: a. The anesthetic has expired. b. The anesthetic has gotten too warm. c. The anesthetic has been frozen. d. The anesthetic cartridge has been placed in disinfecting solution. - d. The anesthetic cartridge has been placed in disinfecting solution. What is a possible advantage of using the computer-controlled syringe? Select one: a. It offers precise control of anesthetic flow and pressure. b. It has automatic aspiration. c. The rotational needle insertion minimizes needle deflection. d. All options listed - d. All options listed What is a possible disadvantage of using the self-aspirating syringe? Select one: a. Insecurity of the clinician accustomed to the harpoon-type syringe. b. Harpoon disengagement may occur more easily during aspiration. c. Discoloration of the plastic from autoclaving frequently. d. It is rust resistant. - a. Insecurity of the clinician accustomed to the harpoon-type syringe. What is an advantage of using the pressure-type syringe over the conventional type of syringe? Select one: a. It achieves negative pressure for an aspiration without a harpoon. b. It utilizes a lightweight wand designed for ergonomic control. c. It administers a 0.2-mL dosage of anesthetic. d. It is more successful than block anesthetic. - c. It administers a 0.2-mL dosage of anesthetic. What is indicated by the presence of bubbles larger than 2 mm in diameter and located within the anesthetic cartridge? Select one:
a. The anesthetic has expired. b. The anesthetic has gotten too warm. c. The anesthetic has been frozen. d. The anesthetic cartridge has been placed in disinfecting solution. - c. The anesthetic has been frozen. What is one disadvantage of using a smaller syringe? Select one: a. It is not comfortable or versatile enough to fit everyone in the dental office. b. A small portion of the anesthetic remains in the cartridge and is not usable. c. The cost of having multiple size syringes is prohibitive. d. The patients notice a difference in comfort levels. - b. A small portion of the anesthetic remains in the cartridge and is not usable. What is produced when the thumb ring of a syringe is pulled back by the clinician, causing retraction of the rubber stopper? Select one: a. Positive aspiration b. Negative aspiration c. Negative pressure d. None of the above - c. Negative pressure What is the name of a plastic, single-use or partially disposable syringe that utilizes a retractable plastic sheath that locks over the needle upon removal from tissue? Select one: a. Plastic breech-loading syringe b. Safety syringe c. Jet injector syringe d. Pressure syringe - b. Safety syringe What is the name of the component of the syringe that can easily be unscrewed and inadvertently disposed of during needle removal? Select one: a. Finger grip b. Needle adaptor c. Harpoon d. Piston - b. Needle adaptor What is the weakest part of the needle? Select one: a. The shaft b. The hub c. The bevel d. The smaller gauge - b. The hub What should the clinician do if the harpoon becomes disengaged during aspiration?
