CDCA Local Anesthesia Exam Review
Solved 100% Correct
a positive aspiration when administering a PSA is due to what? - ANSWER-aspirating
hemorrhage caused by injection
after an injection the patient complains of itching and their throat feeling swollen. what
treatment would you provide? - ANSWER-epinephrine
after the infraorbital injection, the patient's cheek turns white. what happened? -
ANSWER-blanching or vasoconstriction of blood vessels in the area
all arteries leading to the oral cavity receive blood from what? - 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)
amide onset and duration - ANSWER-fast onset and longer duration
Antero-posteriorly, the greater palatine foramen is located between the
___________________________. - ANSWER-middle oft he maxillary second molar
and the middle of the third molar in about 80-90% of patients.
are are possible causes of insufficient anesthesia? - ANSWER-1. poor operator
technique
2. insufficient amount
3. infection of an area
are esters or amides more likely for toxicity? - ANSWER-esters are more likely to cause
toxicity
are topical anesthetics absorbed well or poorly systemically? - ANSWER-poorly
blanching of the tissue following/during an injection is caused by what? - ANSWER-
vasospasm/vasoconstriction caused by epinephrine or brushing against autonomic
nerves stimulation vasospasm
do myelinated or un-myelinated nerves create faster impulse? - ANSWER-myelinated
(impulses jump from node to node -- node of ranvier)
due to the thickness of cortical bone, which is a good option for local anesthetic in the
mandibular arch during infiltrations? - ANSWER-Articaine (Septocaine) is sometimes
effective for mand. infiltrations (4% vs. 2% for lidocaine) due to the increased number of
molecules
, ester onset and duration - ANSWER-slow onset with short duration
hematomas are most common with which type of injection, and why? - ANSWER-PSA
due to nicking a vessel in the pterygoid plexus of veins
how does a self-aspirating syringe work? - ANSWER-when let off pressure, it aspriates
how long can you safely leave on a lidocaine patch? - ANSWER-15 minutes
how should a used needle be re-capped? - ANSWER-safely with the one-handed scoop
method
if a patient has liver disease, you would use caution with an amide anesthetic because:
- ANSWER-amides are broken down/metabolized in the liver
if you want hemostasis, what is your procedure of choice? - ANSWER-infiltration
immediately following a PSA the patient's face began to swell and obvious distention.
what would cause this? - ANSWER-**hematoma was not an option**
injecting too fast or acute infection
innervation to the soft palate is obtained with which nerve? - ANSWER-lesser palatine
nerve
lipid solubility of local anesthetics - ANSWER-the different structure of the various
anesthetics confers varying degrees of lipid solubility (the greater the lipid solubility of
the basic molecule the more potent it is)
lipophilic vs. hydrophyllic - ANSWER-lipophilic is lipid soluble and hydrophyllic is water
soluble
on what tissue is topical anesthetic least effective? - ANSWER-keratinized (palatal
tissue)
ongoing numbness on the anterior part of the tongue is caused by what nerve being
anesthetized? - ANSWER-lingual nerve
paresthesia is most common with which injection? - ANSWER-lingual when giving an IA
injection
post-op trismus is usually due to what? - ANSWER-trauma or hemorrhage -- avoidable
causes include multiple injections to same site, excessive volume to site, or
contaminated solutions
post-op tx for hematoma immediately is what? what is further tx? - ANSWER-pressure
immediately and ice later on/off, and analgesics
Solved 100% Correct
a positive aspiration when administering a PSA is due to what? - ANSWER-aspirating
hemorrhage caused by injection
after an injection the patient complains of itching and their throat feeling swollen. what
treatment would you provide? - ANSWER-epinephrine
after the infraorbital injection, the patient's cheek turns white. what happened? -
ANSWER-blanching or vasoconstriction of blood vessels in the area
all arteries leading to the oral cavity receive blood from what? - 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)
amide onset and duration - ANSWER-fast onset and longer duration
Antero-posteriorly, the greater palatine foramen is located between the
___________________________. - ANSWER-middle oft he maxillary second molar
and the middle of the third molar in about 80-90% of patients.
are are possible causes of insufficient anesthesia? - ANSWER-1. poor operator
technique
2. insufficient amount
3. infection of an area
are esters or amides more likely for toxicity? - ANSWER-esters are more likely to cause
toxicity
are topical anesthetics absorbed well or poorly systemically? - ANSWER-poorly
blanching of the tissue following/during an injection is caused by what? - ANSWER-
vasospasm/vasoconstriction caused by epinephrine or brushing against autonomic
nerves stimulation vasospasm
do myelinated or un-myelinated nerves create faster impulse? - ANSWER-myelinated
(impulses jump from node to node -- node of ranvier)
due to the thickness of cortical bone, which is a good option for local anesthetic in the
mandibular arch during infiltrations? - ANSWER-Articaine (Septocaine) is sometimes
effective for mand. infiltrations (4% vs. 2% for lidocaine) due to the increased number of
molecules
, ester onset and duration - ANSWER-slow onset with short duration
hematomas are most common with which type of injection, and why? - ANSWER-PSA
due to nicking a vessel in the pterygoid plexus of veins
how does a self-aspirating syringe work? - ANSWER-when let off pressure, it aspriates
how long can you safely leave on a lidocaine patch? - ANSWER-15 minutes
how should a used needle be re-capped? - ANSWER-safely with the one-handed scoop
method
if a patient has liver disease, you would use caution with an amide anesthetic because:
- ANSWER-amides are broken down/metabolized in the liver
if you want hemostasis, what is your procedure of choice? - ANSWER-infiltration
immediately following a PSA the patient's face began to swell and obvious distention.
what would cause this? - ANSWER-**hematoma was not an option**
injecting too fast or acute infection
innervation to the soft palate is obtained with which nerve? - ANSWER-lesser palatine
nerve
lipid solubility of local anesthetics - ANSWER-the different structure of the various
anesthetics confers varying degrees of lipid solubility (the greater the lipid solubility of
the basic molecule the more potent it is)
lipophilic vs. hydrophyllic - ANSWER-lipophilic is lipid soluble and hydrophyllic is water
soluble
on what tissue is topical anesthetic least effective? - ANSWER-keratinized (palatal
tissue)
ongoing numbness on the anterior part of the tongue is caused by what nerve being
anesthetized? - ANSWER-lingual nerve
paresthesia is most common with which injection? - ANSWER-lingual when giving an IA
injection
post-op trismus is usually due to what? - ANSWER-trauma or hemorrhage -- avoidable
causes include multiple injections to same site, excessive volume to site, or
contaminated solutions
post-op tx for hematoma immediately is what? what is further tx? - ANSWER-pressure
immediately and ice later on/off, and analgesics
