Local anesthesia final exam questions d d d d d
with verified answers d d
Unexpected variation - d d d
Aberrant Innervation
d d d d d d d d d d d d d d d d d d d
Expected Variation - d d d
Accessory Innervation
d d d d d d d d d d d d d d d d d d d
Divided nerve. - d d d
Bifid
d d d d d d d d d d d d d d d d d d
Accessory to Mandibular Incisors -d d d d d
Cervical Nerve Plexus
d d d d d d d d d d d d d d d d d d d d
Hard tissue restricting flow of anesthesia -
d d d d d d d
Dense bone
d d d d d d d d d d d d d d d d d d d
Response to drug based on time of day. -
d d d d d d d d d
Diurnal Body Rhythms
d d d d d d d d d d d d d d d d d d d d
Soft tissue restriction to flow of anesthesia -
d d d d d d d d
Fascial Planes
d d d d d d d d d d d d d d d d d d d
Chemical barrier to anesthesia success -
d d d d d d
Inflammation
d d d d d d d d d d d d d d d d d d
Accessory innervation to mandibular teeth -
d d d d d d
Mylohyoid Nerve
d d d d d d d d d d d d d d d d d d d
Drug tolerance - d d d
Tachyphylaxis
d d d d d d d d d d d d d d d d d d
T or F: Devices used for delivery of local anesthetic solutions have very little impact on local
d d d d d d d d d d d d d d d d d
anesthesia failure. - d d d
True
d d d d d d d d d d d d d d d d d d
T or F: Dental hygiene procedures require less duration of anesthesia than restorative
d d d d d d d d d d d d d
procedures. - d d
False
d d d d d d d d d d d d d d d d d d
T or F: Needle bevel orientations are NOT considered critical to the success of any injection.
d d d d d d d d d d d d d d d d
- d
True
d d d d d d d d d d d d d d d d d d
T or F: IA nerve blocks may be unsuccessful when the needle penetration is lateral to the
d d d d d d d d d d d d d d d d d
sphenomandibular ligament. - d d d
1|Page
,d d d d d d d d d d d d d d d d d d False
T or F: A 25 gauge needle has less potential for deflection than a 27 gauge needle, although
d d d d d d d d d d d d d d d d d d
deflection is not a common cause for anesthetic failure. -
d d d d d d d d d d
True
d d d d d d d d d d d d d d d d d d
T or F: Nerve blocks typically require a similar volume of anesthetic solution to achieve
d d d d d d d d d d d d d d d
profound anesthesia. - d d d
False
d d d d d d d d d d d d d d d d d d
T or F: A pH lower than 3.3 can lead to failure of anesthesia because the solution is too
d d d d d d d d d d d d d d d d d d d
acidic. - d d
True
d d d d d d d d d d d d d d d d d d
T or F: Aberrant innervations are expected anatomical variations. -
d d d d d d d d d d
False
d d d d d d d d d d d d d d d d d d
T or F: Fibers from the GP nerve may provide accessory innervation to the palatal roots of
d d d d d d d d d d d d d d d d d
maxillary molars. - d d d
True
d d d d d d d d d d d d d d d d d d
T or F: PDL injections can overcome nearly all of the challenges that occur due to accessory
d d d d d d d d d d d d d d d d d
and aberrant innervation. -
d d d d
True
d d d d d d d d d d d d d d d d d d
The term ___________ is frequently used to describe the variable response to drugs during
d d d d d d d d d d d d d d
different times of a day. - d d d d d d
diurnal body rhythm
d d d d d d d d d d d d d d d d d d d d
The higher the gauge of a needle, the greater its __________ and deflection in tissues. -
d d d d d d d d d d d d d d d d
flexibility
d d d d d d d d d d d d d d d d d d
A cartridge of anesthesia WITH a vasoconstrictor should have a pH of no lower than _____. -
d
d d d d d d d d d d d d d d d d
3.3
d d d d d d d d d d d d d d d d d d
Tissue inflammation contributes to anesthetic failure because the pH of the tissue is
d d d d d d d d d d d d d
________ than normal, which limits the base molecules of the anesthesia. -
d d d d d d d d d d d d
lower
d d d d d d d d d d d d d d d d d d
The ________ of local anesthetic solution is affected by the size and location of the nerve
d d d d d d d d d d d d d d d d
membrane. - d d
recommended value
d d d d d d d d d d d d d d d d d d d
Dense bony prominences, shallow vestibules, dilacerations, and soft tissues such as ligaments
d d d d d d d d d d d
create ________ barriers to the success of anesthesia. -
d d d d d d d d d d
physical
d d d d d d d d d d d d d d d d d d
A term referring to the lack of redevelopment of profound anesthesia when subsequent
d d d d d d d d d d d d d
injections in the same appointment are administered. -
d d d d d d d d
Tachyphylaxis
d d d d d d d d d d d d d d d d d d
2|Page
, Tachyphylaxis is most likely to occur once anesthetized tissues have returned to d d d d d d d d d d d d
___________ of sensation. - d d d d
normal levels
d d d d d d d d d d d d d d d d d d d
_________ can deflect anesthetic solution away from ideal deposition sites, resulting in
d d d d d d d d d d d d
inadequate anesthesia. - d d d
Fascial Planes
d d d d d d d d d d d d d d d d d d d
Expected nerve variations are referred to as ____________ and some, such as overlapping
d d d d d d d d d d d d d
innervation from the opposite side, are fairly common. - d d d d d d d d d
accessory innervations
d d d d d d d d d d d d d d d d d d d
Inadequate anesthesia may typically be caused by all of the following EXCEPT:
d d d d d d d d d d d
a. volume of solution
d d d
b. pH of surrounding tissues
d d d d
c. quality of manufactured solutions
d d d d
d. anatomical variations -
d d d d
quality of manufactured solutions
d d d d d d d d d d d d d d d d d d d d d
Which of the following factors is MOST likely to correspond to anesthetic failures?
d d d d d d d d d d d d
a. Delivery devices
d d
b. Needle bevel orientation
d d d
c. Needle deflection
d d
d. Physical and chemical barriers -
d d d d d d
Physical and chemical barriers
d d d d d d d d d d d d d d d d d d d d d
Which of the following does NOT have an effect on the ability to achieve profound
d d d d d d d d d d d d d d d
anesthesia in the presence of inflammation? d d d d d
a. pHd
b. Choice of topical anesthetic
d d d d
c. Vascular injury
d d
d. An increase in cations -
d d d d d d
Choice of topical anesthetic
d d d d d d d d d d d d d d d d d d d d d
Which one of the following is the BEST procedure to follow in the presence of
d d d d d d d d d d d d d d d
inflammation?
a. Administer a larger volume of anesthetic.
d d d d d d
b. Select an injection that will provide conduction blockade on the nerve trunk away from the
d d d d d d d d d d d d d d d d
area of inflammation
d d
c. Infiltrate in several locations around the tooth.
d d d d d d d
d. Use an ester injectable drug -
d d d d d d d
Select an injection that will provide conduction blockade on the nerve trunk away
d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d
from the area of inflammation
d d d d
Inadequate anesthesia in the maxillary incisors is least likely caused by:
d d d d d d d d d d
3|Page
with verified answers d d
Unexpected variation - d d d
Aberrant Innervation
d d d d d d d d d d d d d d d d d d d
Expected Variation - d d d
Accessory Innervation
d d d d d d d d d d d d d d d d d d d
Divided nerve. - d d d
Bifid
d d d d d d d d d d d d d d d d d d
Accessory to Mandibular Incisors -d d d d d
Cervical Nerve Plexus
d d d d d d d d d d d d d d d d d d d d
Hard tissue restricting flow of anesthesia -
d d d d d d d
Dense bone
d d d d d d d d d d d d d d d d d d d
Response to drug based on time of day. -
d d d d d d d d d
Diurnal Body Rhythms
d d d d d d d d d d d d d d d d d d d d
Soft tissue restriction to flow of anesthesia -
d d d d d d d d
Fascial Planes
d d d d d d d d d d d d d d d d d d d
Chemical barrier to anesthesia success -
d d d d d d
Inflammation
d d d d d d d d d d d d d d d d d d
Accessory innervation to mandibular teeth -
d d d d d d
Mylohyoid Nerve
d d d d d d d d d d d d d d d d d d d
Drug tolerance - d d d
Tachyphylaxis
d d d d d d d d d d d d d d d d d d
T or F: Devices used for delivery of local anesthetic solutions have very little impact on local
d d d d d d d d d d d d d d d d d
anesthesia failure. - d d d
True
d d d d d d d d d d d d d d d d d d
T or F: Dental hygiene procedures require less duration of anesthesia than restorative
d d d d d d d d d d d d d
procedures. - d d
False
d d d d d d d d d d d d d d d d d d
T or F: Needle bevel orientations are NOT considered critical to the success of any injection.
d d d d d d d d d d d d d d d d
- d
True
d d d d d d d d d d d d d d d d d d
T or F: IA nerve blocks may be unsuccessful when the needle penetration is lateral to the
d d d d d d d d d d d d d d d d d
sphenomandibular ligament. - d d d
1|Page
,d d d d d d d d d d d d d d d d d d False
T or F: A 25 gauge needle has less potential for deflection than a 27 gauge needle, although
d d d d d d d d d d d d d d d d d d
deflection is not a common cause for anesthetic failure. -
d d d d d d d d d d
True
d d d d d d d d d d d d d d d d d d
T or F: Nerve blocks typically require a similar volume of anesthetic solution to achieve
d d d d d d d d d d d d d d d
profound anesthesia. - d d d
False
d d d d d d d d d d d d d d d d d d
T or F: A pH lower than 3.3 can lead to failure of anesthesia because the solution is too
d d d d d d d d d d d d d d d d d d d
acidic. - d d
True
d d d d d d d d d d d d d d d d d d
T or F: Aberrant innervations are expected anatomical variations. -
d d d d d d d d d d
False
d d d d d d d d d d d d d d d d d d
T or F: Fibers from the GP nerve may provide accessory innervation to the palatal roots of
d d d d d d d d d d d d d d d d d
maxillary molars. - d d d
True
d d d d d d d d d d d d d d d d d d
T or F: PDL injections can overcome nearly all of the challenges that occur due to accessory
d d d d d d d d d d d d d d d d d
and aberrant innervation. -
d d d d
True
d d d d d d d d d d d d d d d d d d
The term ___________ is frequently used to describe the variable response to drugs during
d d d d d d d d d d d d d d
different times of a day. - d d d d d d
diurnal body rhythm
d d d d d d d d d d d d d d d d d d d d
The higher the gauge of a needle, the greater its __________ and deflection in tissues. -
d d d d d d d d d d d d d d d d
flexibility
d d d d d d d d d d d d d d d d d d
A cartridge of anesthesia WITH a vasoconstrictor should have a pH of no lower than _____. -
d
d d d d d d d d d d d d d d d d
3.3
d d d d d d d d d d d d d d d d d d
Tissue inflammation contributes to anesthetic failure because the pH of the tissue is
d d d d d d d d d d d d d
________ than normal, which limits the base molecules of the anesthesia. -
d d d d d d d d d d d d
lower
d d d d d d d d d d d d d d d d d d
The ________ of local anesthetic solution is affected by the size and location of the nerve
d d d d d d d d d d d d d d d d
membrane. - d d
recommended value
d d d d d d d d d d d d d d d d d d d
Dense bony prominences, shallow vestibules, dilacerations, and soft tissues such as ligaments
d d d d d d d d d d d
create ________ barriers to the success of anesthesia. -
d d d d d d d d d d
physical
d d d d d d d d d d d d d d d d d d
A term referring to the lack of redevelopment of profound anesthesia when subsequent
d d d d d d d d d d d d d
injections in the same appointment are administered. -
d d d d d d d d
Tachyphylaxis
d d d d d d d d d d d d d d d d d d
2|Page
, Tachyphylaxis is most likely to occur once anesthetized tissues have returned to d d d d d d d d d d d d
___________ of sensation. - d d d d
normal levels
d d d d d d d d d d d d d d d d d d d
_________ can deflect anesthetic solution away from ideal deposition sites, resulting in
d d d d d d d d d d d d
inadequate anesthesia. - d d d
Fascial Planes
d d d d d d d d d d d d d d d d d d d
Expected nerve variations are referred to as ____________ and some, such as overlapping
d d d d d d d d d d d d d
innervation from the opposite side, are fairly common. - d d d d d d d d d
accessory innervations
d d d d d d d d d d d d d d d d d d d
Inadequate anesthesia may typically be caused by all of the following EXCEPT:
d d d d d d d d d d d
a. volume of solution
d d d
b. pH of surrounding tissues
d d d d
c. quality of manufactured solutions
d d d d
d. anatomical variations -
d d d d
quality of manufactured solutions
d d d d d d d d d d d d d d d d d d d d d
Which of the following factors is MOST likely to correspond to anesthetic failures?
d d d d d d d d d d d d
a. Delivery devices
d d
b. Needle bevel orientation
d d d
c. Needle deflection
d d
d. Physical and chemical barriers -
d d d d d d
Physical and chemical barriers
d d d d d d d d d d d d d d d d d d d d d
Which of the following does NOT have an effect on the ability to achieve profound
d d d d d d d d d d d d d d d
anesthesia in the presence of inflammation? d d d d d
a. pHd
b. Choice of topical anesthetic
d d d d
c. Vascular injury
d d
d. An increase in cations -
d d d d d d
Choice of topical anesthetic
d d d d d d d d d d d d d d d d d d d d d
Which one of the following is the BEST procedure to follow in the presence of
d d d d d d d d d d d d d d d
inflammation?
a. Administer a larger volume of anesthetic.
d d d d d d
b. Select an injection that will provide conduction blockade on the nerve trunk away from the
d d d d d d d d d d d d d d d d
area of inflammation
d d
c. Infiltrate in several locations around the tooth.
d d d d d d d
d. Use an ester injectable drug -
d d d d d d d
Select an injection that will provide conduction blockade on the nerve trunk away
d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d
from the area of inflammation
d d d d
Inadequate anesthesia in the maxillary incisors is least likely caused by:
d d d d d d d d d d
3|Page
