CDCA LOCAL ANESTHESIA EXAM
REVIEW QUESTIONS AND ANSWERS
which has thicker cortical plate, maxillary or mandibular? - Correct Answers -mandibular
(this decreased the amount of the local anesthesia molecules that can penetrate to
nerves during infiltration injections)
due to the thickness of cortical bone, which is a good option for local anesthetic in the
mandibular arch during infiltrations? - Correct Answers -Articaine (Septocaine) is
sometimes effective for mand. infiltrations (4% vs. 2% for lidocaine) due to the
increased number of molecules
hematomas are most common with which type of injection, and why? - Correct Answers
-PSA due to nicking a vessel in the pterygoid plexus of veins
what is the TX for a hematoma? - Correct Answers -pressure, cold compresses on/off,
NSAIDS, and time.
a positive aspiration when administering a PSA is due to what? - Correct Answers -
aspirating hemorrhage caused by injection
what are the three most common locations for hematomas to occur? - Correct Answers
-1. PSA
2. IA
3. mental
blanching of the tissue following/during an injection is caused by what? - Correct
Answers -vasospasm/vasoconstriction caused by epinephrine or brushing against
autonomic nerves stimulation vasospasm
the pterygomandibular space/triangle is bordered by what anatomical structures? -
Correct Answers -ramus, lateral pterygoid muscle, and medial pterygoid muscle
, the pterygomandibular space/triangle is identified intra-orally by what? - Correct
Answers -pterygoid hamulus (palpation), coronoid notch (palpation), and
pterygomandibular raphe (visual)
the mandibular foramen lies approx. __________________________ of the distance
from the anterior border of the ramus to the posterior border - Correct Answers -1/2 to
2/3
Antero-posteriorly, the greater palatine foramen is located between the
___________________________. - Correct Answers -middle oft he maxillary second
molar and the middle of the third molar in about 80-90% of patients.
all arteries leading to the oral cavity receive blood from what? - Correct Answers -
external carotid (most are direct or indirect branches from the maxillary artery with the
exception of the lingula -- this is a direct branch from the external carotid)
veins from the oral cavity will drain into what? - Correct Answers -internal jugular (both
internal and external drain into the brachiocephalic veins which drain to the superior
vena cava
do myelinated or un-myelinated nerves create faster impulse? - Correct Answers -
myelinated (impulses jump from node to node -- node of ranvier)
what is saltatory conduction? - Correct Answers -the process of nerve impulses jumping
from nodes of ranvier along a myelinated nerve
what is the resting potential charges of a nerve? - Correct Answers -inside is negative
and outside is positive
what molecules are predominately outside/inside at resting potential? - Correct Answers
-Na+ outside and K+ inside
what is depolarization? - Correct Answers -Na+ channels open , Na+ flows in reversing
polarity; K+ flows out to restore neutrality; the Na+ and K+ pumps restore polarity
(resting potential)
what is the mechanism of action for local anesthetics? - Correct Answers -blocks the
Na+ channels preventing depolarization
what nerve is responsible for facial paralysis? - Correct Answers -facial nerve
how does a self-aspirating syringe work? - Correct Answers -when let off pressure, it
aspriates
what are the MRD for a normal and cardiac compromised patient? - Correct Answers -
normal: 0.2mg
cardiac compromissed: 0.04mg
REVIEW QUESTIONS AND ANSWERS
which has thicker cortical plate, maxillary or mandibular? - Correct Answers -mandibular
(this decreased the amount of the local anesthesia molecules that can penetrate to
nerves during infiltration injections)
due to the thickness of cortical bone, which is a good option for local anesthetic in the
mandibular arch during infiltrations? - Correct Answers -Articaine (Septocaine) is
sometimes effective for mand. infiltrations (4% vs. 2% for lidocaine) due to the
increased number of molecules
hematomas are most common with which type of injection, and why? - Correct Answers
-PSA due to nicking a vessel in the pterygoid plexus of veins
what is the TX for a hematoma? - Correct Answers -pressure, cold compresses on/off,
NSAIDS, and time.
a positive aspiration when administering a PSA is due to what? - Correct Answers -
aspirating hemorrhage caused by injection
what are the three most common locations for hematomas to occur? - Correct Answers
-1. PSA
2. IA
3. mental
blanching of the tissue following/during an injection is caused by what? - Correct
Answers -vasospasm/vasoconstriction caused by epinephrine or brushing against
autonomic nerves stimulation vasospasm
the pterygomandibular space/triangle is bordered by what anatomical structures? -
Correct Answers -ramus, lateral pterygoid muscle, and medial pterygoid muscle
, the pterygomandibular space/triangle is identified intra-orally by what? - Correct
Answers -pterygoid hamulus (palpation), coronoid notch (palpation), and
pterygomandibular raphe (visual)
the mandibular foramen lies approx. __________________________ of the distance
from the anterior border of the ramus to the posterior border - Correct Answers -1/2 to
2/3
Antero-posteriorly, the greater palatine foramen is located between the
___________________________. - Correct Answers -middle oft he maxillary second
molar and the middle of the third molar in about 80-90% of patients.
all arteries leading to the oral cavity receive blood from what? - Correct Answers -
external carotid (most are direct or indirect branches from the maxillary artery with the
exception of the lingula -- this is a direct branch from the external carotid)
veins from the oral cavity will drain into what? - Correct Answers -internal jugular (both
internal and external drain into the brachiocephalic veins which drain to the superior
vena cava
do myelinated or un-myelinated nerves create faster impulse? - Correct Answers -
myelinated (impulses jump from node to node -- node of ranvier)
what is saltatory conduction? - Correct Answers -the process of nerve impulses jumping
from nodes of ranvier along a myelinated nerve
what is the resting potential charges of a nerve? - Correct Answers -inside is negative
and outside is positive
what molecules are predominately outside/inside at resting potential? - Correct Answers
-Na+ outside and K+ inside
what is depolarization? - Correct Answers -Na+ channels open , Na+ flows in reversing
polarity; K+ flows out to restore neutrality; the Na+ and K+ pumps restore polarity
(resting potential)
what is the mechanism of action for local anesthetics? - Correct Answers -blocks the
Na+ channels preventing depolarization
what nerve is responsible for facial paralysis? - Correct Answers -facial nerve
how does a self-aspirating syringe work? - Correct Answers -when let off pressure, it
aspriates
what are the MRD for a normal and cardiac compromised patient? - Correct Answers -
normal: 0.2mg
cardiac compromissed: 0.04mg
