, Anatomy of Orofacial Structures 8th Edition Brand Test Bank
Chapter : Anatomical Considerations of Local Anesthesia
Brand/Isselhard: Anatomy of Orofacial Structures, 8th Edition
MULTIPLE CHOICE
1. The buccal bone of the maxilla is much less porous than that of the mandible. This makes it
easier for the anesthetic solution to penetrate the buccal bone of the maxilla and reach the
apices of the maxillary teeth.
a. Both statements are true.
b. The first statement is true; the second statement is false.
c. The first statement is false; the second statement is true.
d. Both statements are false.
ANS: C
The buccal bone of the maxilla is much more porous than that of the mandible.
REF: p. 373
OBJ: To understand the anatomy of the maxillary nerve as it relates to administration of local
anesthesia | To understand the anatomy associated with mandibular blocks
NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development,
including but not limited to: bones. TOP: BLOOM: Understanding
2. None of the following anesthetics can be used for mandibular supraperiosteal injections
EXCEPT one. Which one is the EXCEPTION?
a. Lidocaine
b. Articaine
c. Mepivacaine
d. Prilocaine
ANS: B
Only articaine effectively penetrates the mandibular bone. One cannot use lidocaine,
mepivacaine, or prilocaine which are the most common local anesthetic agents because they
do not effectively penetrate the denser mandibular bone.
REF: p. 379 OBJ: To understand the anatomy associated with mandibular blocks
NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,
including but not limited to: nerves. TOP: BLOOM: Remembering
3. All of the following are major concerns with nerve blocks EXCEPT one. Which one is the
EXCEPTION?
a. Bruising
b. Injecting into a blood vessel
c. Tearing a blood vessel
d. Puncturing a nerve
ANS: A
, Anatomy of Orofacial Structures 8th Edition Brand Test Bank
Anesthetic solution injected into a blood vessel continues on the path of that blood vessel.
Anesthetic delivered into the posterior alveolar vein travels into the facial vein and the
maxillary vein both leading into the internal jugular vein and then into the brachiocephalic
vein and eventually to the lungs and the heart where it is pumped all over the body. A patient
could therefore feel numbness in their toes, ears, or even fingers. If this anesthetic contained a
vasoconstrictor unwanted serious cardiovascular events could result. Everything from fainting
to a stroke or even a heart attack could occur.
REF: p. 375
OBJ: To understand the major concerns associated with different local anesthetic nerve blocks
NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,
including but not limited to: nerves. TOP: BLOOM: Remembering
4. A crossover effect is created when nerves and blood vessels do not stop at the midline because
some nerve branches crossover into an area innervated by another adjacent nerve.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are NOT related.
c. The statement is correct, but the reason is NOT correct.
d. The statement is NOT correct, but the reason is correct.
e. NEITHER the statement NOR the reason is correct.
ANS: A
If the crossover nerve comes from the right side at the midline, it innervates something on the
left side. Giving an anesthetic on the left side in this case does not work because the nerve that
crossed over from the right innervates this area. When dealing with anesthetics in the areas of
the central incisors it is sometimes necessary to anesthetize both sides due to this crossover
effect. Crossover nerves occur not only at the midline but between areas affected by different
nerve branches. A crossover N feR
efU ctScI
anNaG oB
lsT oc.cuCrOat the junction between areas adjacent to
each other but typically innervated by two different nerve branches. If one nerve block does
not affect the desired target area, a second nerve block (that normally serves the adjacent area)
might be required.
REF: p. 378
OBJ: To understand the anatomy of the maxillary nerve as it relates to administration of local
anesthesia
NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,
including but not limited to: nerves. TOP: BLOOM: Understanding
5. There are three palatal nerve blocks that provide anesthesia to the palatal periodontium and
gingiva; they affect only the lingual tissues.
a. Both statements are true.
b. The first statement is true; the second statement is false.
c. The first statement is false; the second statement is true.
d. Both statements are false.
ANS: C
There are two palatal nerve blocks that provide anesthesia to the palatal periodontium and
gingiva (nasopalatine and greater palatine). Neither of these two blocks anesthetizes the pulp
of teeth nor the associated buccal periosteum and gingiva; only lingual tissues are affected.
REF: p. 378
, Anatomy of Orofacial Structures 8th Edition Brand Test Bank
OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks
NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,
including but not limited to: nerves. TOP: BLOOM: Understanding
6. The greater palatine nerve block anesthetizes all of the following EXCEPT one. Which one is
the EXCEPTION?
a. Anterior hard palate
b. The posterior lateral hard palate
c. Palatal gingiva
d. Periodontium of the maxillary posterior teeth
ANS: A
The nasopalatine nerve block anesthetizes the anterior hard palate.
REF: p. 378
OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks
NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,
including but not limited to: nerves. TOP: BLOOM: Remembering
7. The goal of local anesthesia is to block the innervation from the nerve branches as they try to
send their messages back to the brain through the nerves. To do this, the anesthetic solution
must reach the nerve branch somewhere between the targeted area to be anesthetized and the
nerve trunk.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are NOT related.
c. The statement is correct, but the reason is NOT correct.
d. The statement is NOT correct, but the reason is correct.
e. NEITHER the statement N NU
ORRS thI
eNreG
asToB
n.is C
coOrM
rect.
ANS: A
The closer the anesthetic is to the nerve trunk, the more area is affected by the anesthetic.
REF: p. 376
OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks
NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,
including but not limited to: nerves. TOP: BLOOM: Understanding
8. The auriculotemporal nerve may be anesthetized with a
a. Gow-Gates nerve block
b. Vazirani-Akinosi nerve block
c. buccal nerve block
d. mental block
ANS: A
The Vazirani-Akinosi nerve block may cover the same areas as the Gow-Gates except it does
not affect the auriculotemporal nerve. The buccal nerve block anesthetizes the buccal gingiva
and periodontium. The mental block provides anesthesia to the associated facial periodontium
and gingiva of the mandibular premolars and anterior teeth.
REF: p. 382
OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks
NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,
Chapter : Anatomical Considerations of Local Anesthesia
Brand/Isselhard: Anatomy of Orofacial Structures, 8th Edition
MULTIPLE CHOICE
1. The buccal bone of the maxilla is much less porous than that of the mandible. This makes it
easier for the anesthetic solution to penetrate the buccal bone of the maxilla and reach the
apices of the maxillary teeth.
a. Both statements are true.
b. The first statement is true; the second statement is false.
c. The first statement is false; the second statement is true.
d. Both statements are false.
ANS: C
The buccal bone of the maxilla is much more porous than that of the mandible.
REF: p. 373
OBJ: To understand the anatomy of the maxillary nerve as it relates to administration of local
anesthesia | To understand the anatomy associated with mandibular blocks
NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development,
including but not limited to: bones. TOP: BLOOM: Understanding
2. None of the following anesthetics can be used for mandibular supraperiosteal injections
EXCEPT one. Which one is the EXCEPTION?
a. Lidocaine
b. Articaine
c. Mepivacaine
d. Prilocaine
ANS: B
Only articaine effectively penetrates the mandibular bone. One cannot use lidocaine,
mepivacaine, or prilocaine which are the most common local anesthetic agents because they
do not effectively penetrate the denser mandibular bone.
REF: p. 379 OBJ: To understand the anatomy associated with mandibular blocks
NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,
including but not limited to: nerves. TOP: BLOOM: Remembering
3. All of the following are major concerns with nerve blocks EXCEPT one. Which one is the
EXCEPTION?
a. Bruising
b. Injecting into a blood vessel
c. Tearing a blood vessel
d. Puncturing a nerve
ANS: A
, Anatomy of Orofacial Structures 8th Edition Brand Test Bank
Anesthetic solution injected into a blood vessel continues on the path of that blood vessel.
Anesthetic delivered into the posterior alveolar vein travels into the facial vein and the
maxillary vein both leading into the internal jugular vein and then into the brachiocephalic
vein and eventually to the lungs and the heart where it is pumped all over the body. A patient
could therefore feel numbness in their toes, ears, or even fingers. If this anesthetic contained a
vasoconstrictor unwanted serious cardiovascular events could result. Everything from fainting
to a stroke or even a heart attack could occur.
REF: p. 375
OBJ: To understand the major concerns associated with different local anesthetic nerve blocks
NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,
including but not limited to: nerves. TOP: BLOOM: Remembering
4. A crossover effect is created when nerves and blood vessels do not stop at the midline because
some nerve branches crossover into an area innervated by another adjacent nerve.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are NOT related.
c. The statement is correct, but the reason is NOT correct.
d. The statement is NOT correct, but the reason is correct.
e. NEITHER the statement NOR the reason is correct.
ANS: A
If the crossover nerve comes from the right side at the midline, it innervates something on the
left side. Giving an anesthetic on the left side in this case does not work because the nerve that
crossed over from the right innervates this area. When dealing with anesthetics in the areas of
the central incisors it is sometimes necessary to anesthetize both sides due to this crossover
effect. Crossover nerves occur not only at the midline but between areas affected by different
nerve branches. A crossover N feR
efU ctScI
anNaG oB
lsT oc.cuCrOat the junction between areas adjacent to
each other but typically innervated by two different nerve branches. If one nerve block does
not affect the desired target area, a second nerve block (that normally serves the adjacent area)
might be required.
REF: p. 378
OBJ: To understand the anatomy of the maxillary nerve as it relates to administration of local
anesthesia
NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,
including but not limited to: nerves. TOP: BLOOM: Understanding
5. There are three palatal nerve blocks that provide anesthesia to the palatal periodontium and
gingiva; they affect only the lingual tissues.
a. Both statements are true.
b. The first statement is true; the second statement is false.
c. The first statement is false; the second statement is true.
d. Both statements are false.
ANS: C
There are two palatal nerve blocks that provide anesthesia to the palatal periodontium and
gingiva (nasopalatine and greater palatine). Neither of these two blocks anesthetizes the pulp
of teeth nor the associated buccal periosteum and gingiva; only lingual tissues are affected.
REF: p. 378
, Anatomy of Orofacial Structures 8th Edition Brand Test Bank
OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks
NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,
including but not limited to: nerves. TOP: BLOOM: Understanding
6. The greater palatine nerve block anesthetizes all of the following EXCEPT one. Which one is
the EXCEPTION?
a. Anterior hard palate
b. The posterior lateral hard palate
c. Palatal gingiva
d. Periodontium of the maxillary posterior teeth
ANS: A
The nasopalatine nerve block anesthetizes the anterior hard palate.
REF: p. 378
OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks
NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,
including but not limited to: nerves. TOP: BLOOM: Remembering
7. The goal of local anesthesia is to block the innervation from the nerve branches as they try to
send their messages back to the brain through the nerves. To do this, the anesthetic solution
must reach the nerve branch somewhere between the targeted area to be anesthetized and the
nerve trunk.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are NOT related.
c. The statement is correct, but the reason is NOT correct.
d. The statement is NOT correct, but the reason is correct.
e. NEITHER the statement N NU
ORRS thI
eNreG
asToB
n.is C
coOrM
rect.
ANS: A
The closer the anesthetic is to the nerve trunk, the more area is affected by the anesthetic.
REF: p. 376
OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks
NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,
including but not limited to: nerves. TOP: BLOOM: Understanding
8. The auriculotemporal nerve may be anesthetized with a
a. Gow-Gates nerve block
b. Vazirani-Akinosi nerve block
c. buccal nerve block
d. mental block
ANS: A
The Vazirani-Akinosi nerve block may cover the same areas as the Gow-Gates except it does
not affect the auriculotemporal nerve. The buccal nerve block anesthetizes the buccal gingiva
and periodontium. The mental block provides anesthesia to the associated facial periodontium
and gingiva of the mandibular premolars and anterior teeth.
REF: p. 382
OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks
NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,
