CDCA Local Anesthesia Exam with all Correct & 100%
Verified Answers |Actual Complete Exam |Already
Graded A+
which has thicker cortical plate, maxillary or mandibular? ✔Correct Answer-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 Answer-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 Answer-PSA
due to nicking a vessel in the pterygoid plexus of veins
what is the TX for a hematoma? ✔Correct Answer-pressure, cold compresses on/off, NSAIDS,
and time.
a positive aspiration when administering a PSA is due to what? ✔Correct Answer-aspirating
hemorrhage caused by injection
what are the three most common locations for hematomas to occur? ✔Correct Answer-1. PSA
2. IA
3. mental
blanching of the tissue following/during an injection is caused by what? ✔Correct Answer-
vasospasm/vasoconstriction caused by epinephrine or brushing against autonomic nerves
stimulation vasospasm
the pterygomandibular space/triangle is bordered by what anatomical structures? ✔Correct
Answer-ramus, lateral pterygoid muscle, and medial pterygoid muscle
the pterygomandibular space/triangle is identified intra-orally by what? ✔Correct Answer-
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 Answer-1/2 to 2/3
, Antero-posteriorly, the greater palatine foramen is located between the
___________________________. ✔Correct Answer-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 Answer-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 Answer-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 Answer-myelinated
(impulses jump from node to node -- node of ranvier)
what is saltatory conduction? ✔Correct Answer-the process of nerve impulses jumping from
nodes of ranvier along a myelinated nerve
what is the resting potential charges of a nerve? ✔Correct Answer-inside is negative and
outside is positive
what molecules are predominately outside/inside at resting potential? ✔Correct Answer-Na+
outside and K+ inside
what is depolarization? ✔Correct Answer-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 Answer-blocks the Na+
channels preventing depolarization
what is the basic structure of anesthetics? ✔Correct Answer-aromatic ring (lipid soluble),
intermediate chain (amide or ester configuration), and terminal amine (able to ionize and
become water soluble)
lipophilic vs. hydrophyllic ✔Correct Answer-lipophilic is lipid soluble and hydrophyllic is water
soluble
what makes the terminal amine so important to the structure of local anesthetic? ✔Correct
Answer-this allows the local anesthetic to the both lipid soluble and water soluble at the
apporpriate times (ex: hydrophyllic for dilution and pH control; lipophyllic in order to penetrate
neuron cell membrane; hydrophyllic to block Na+ channels)
what is pKa and what does it do? ✔Correct Answer-the dissociation constant - this identifies
the pH at which the anesthetic exists in a 50/50 ratio of the ionized to non-ionized (hydrophyllic
to lipophyllic) molecules
Verified Answers |Actual Complete Exam |Already
Graded A+
which has thicker cortical plate, maxillary or mandibular? ✔Correct Answer-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 Answer-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 Answer-PSA
due to nicking a vessel in the pterygoid plexus of veins
what is the TX for a hematoma? ✔Correct Answer-pressure, cold compresses on/off, NSAIDS,
and time.
a positive aspiration when administering a PSA is due to what? ✔Correct Answer-aspirating
hemorrhage caused by injection
what are the three most common locations for hematomas to occur? ✔Correct Answer-1. PSA
2. IA
3. mental
blanching of the tissue following/during an injection is caused by what? ✔Correct Answer-
vasospasm/vasoconstriction caused by epinephrine or brushing against autonomic nerves
stimulation vasospasm
the pterygomandibular space/triangle is bordered by what anatomical structures? ✔Correct
Answer-ramus, lateral pterygoid muscle, and medial pterygoid muscle
the pterygomandibular space/triangle is identified intra-orally by what? ✔Correct Answer-
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 Answer-1/2 to 2/3
, Antero-posteriorly, the greater palatine foramen is located between the
___________________________. ✔Correct Answer-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 Answer-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 Answer-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 Answer-myelinated
(impulses jump from node to node -- node of ranvier)
what is saltatory conduction? ✔Correct Answer-the process of nerve impulses jumping from
nodes of ranvier along a myelinated nerve
what is the resting potential charges of a nerve? ✔Correct Answer-inside is negative and
outside is positive
what molecules are predominately outside/inside at resting potential? ✔Correct Answer-Na+
outside and K+ inside
what is depolarization? ✔Correct Answer-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 Answer-blocks the Na+
channels preventing depolarization
what is the basic structure of anesthetics? ✔Correct Answer-aromatic ring (lipid soluble),
intermediate chain (amide or ester configuration), and terminal amine (able to ionize and
become water soluble)
lipophilic vs. hydrophyllic ✔Correct Answer-lipophilic is lipid soluble and hydrophyllic is water
soluble
what makes the terminal amine so important to the structure of local anesthetic? ✔Correct
Answer-this allows the local anesthetic to the both lipid soluble and water soluble at the
apporpriate times (ex: hydrophyllic for dilution and pH control; lipophyllic in order to penetrate
neuron cell membrane; hydrophyllic to block Na+ channels)
what is pKa and what does it do? ✔Correct Answer-the dissociation constant - this identifies
the pH at which the anesthetic exists in a 50/50 ratio of the ionized to non-ionized (hydrophyllic
to lipophyllic) molecules
