WREB LOCAL ANESTHESIA STUDY
GUIDE CORRECT 100%
What exits the foramen rotundum? - ANSWERMaxillary Branch of Trigeminal Nerve
What exits the foramen ovale? - ANSWERMandibular Branch of Trigeminal Nerve
What exits the mandibular foramen? - ANSWERInferior Alveolar Nerve
Purpose of Myelin Sheath? - ANSWERProtective Covering for the nerves
What causes psychogenic pain? - ANSWERMental or emotional problems that affect
the experience of pain, there is no organic (medical) base for the pain.
Injection and landmarks for maxillary molars. - ANSWERPSA
Height of mucobuccal fold above second molar
Injection and landmarks for maxillary premolars - ANSWERMSA
Height of mucobuccal fold above second premolar
Injection and landmarks for maxillary incisors (facial) - ANSWERASA
Height of mucobuccal fold above canine
Injection and landmarks for mandibular molars - ANSWERIA
Medial to internal oblique ridge, lateral to pterygomandibular raphe, at or above height
of coronoid notch
Injection and landmarks for buccal tissue of mandibular molars - ANSWERLB
Mucous membrane distal and lateral to most posterior molar
Injection and landmarks for mandibular premolars/incisors, including pulpal -
ANSWERIncisive
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for mandibular premolars/incisors, tissue - ANSWERMental
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for palate near molars - ANSWERGP
Anterior depression of GP foramen, lingual to second molar
Injection and landmarks for palate near anteriors - ANSWERNP
Just lateral to incisive papilla
Landmarks for AMSA - ANSWERHalfway between premolars and palatine suture.
,Dose of IA - ANSWER1.5-1.8ml
Dose of LB - ANSWER.2-.3ml (stopper)
Dose of Mental/Incisive - ANSWER.6ml
Dose of infiltrations - ANSWER.6ml
Dose of NP - ANSWER.4ml
Dose of GP - ANSWER.4-.6ml
Dose of AMSA - ANSWER.9-1.8ml
but, with a 4% anesthetic it's .7-.9ml
Dose of PSA - ANSWER.9-1.8ml
Dose of MSA - ANSWER.9-1.2ml
Dose of ASA - ANSWER.9-1.2ml
Nerve that innervates the soft palate? - ANSWERLesser palatine
Molar root not anesthetized by PSA - ANSWERMesiobuccal root of first molar
Types of topical - ANSWEREster-Benzocaine, tetracaine
Amide-Lidocaine
Ketone-Dyclonine
What happens during depolarization? - ANSWERSlow Na ion influx until firing threshold
is reached.
What happens during rapid depolarization? - ANSWEROnce firing threshold has been
reached (-50 to -55 mv) there is a rapid influx of Na ions.
What happens during repolariztion? - ANSWERNa begins to move with concentration
gradient out of cell, there is an absolute refactory period, Na continues to move out of
cell with help of sodium pump, there is a relative refactory period until resting state is
reached.
What does LA do to deporlariztion? - ANSWERInhibits Na influx by displacing Ca ion.
Esters (and Articaine) are metabolized by...
Excreted by.... - ANSWERPseudocholinesterase in blood plasma
Kidneys
, Amides are metabolized by...
Excreted by.... - ANSWERLiver (prilocaine in the lungs as well)
Kidneys (mostly unchanged)
Avoid esters (and articaine) if... - ANSWERPt's have atypical pseudocholinesterase
Sulfur allergy
Myasthinia Gravis
If there's methemoglobinemia... - ANSWERAvoid prilocaine and benzocaine.
If they're taking beta blockers... - ANSWERLimit or avoid vaso's
If they're taking phenothiazides.... - ANSWERDo not use 1:50,000 epi
If they're taking tricyclic antidepressants - ANSWERNo levo.
Volume in one carpule of LA - ANSWER1.8ml
What is the function of Sodium Chloride in LA solutions? - ANSWERIsotonicity
What is the function of Sodium Bisulfite in LA solutions? - ANSWERAntioxidant
prevents biodegredation of LA (delays deterioration of epi)
Why use vaso? - ANSWERIncreases depth and duration of LA.
Maximum carpules Articaine - ANSWER6 (A6, or Asics-the shoes)
Maximum carpules Prilocaine - ANSWER5 (depri5, P5)
Maximum carpules Mepivicaine - ANSWER2%=8
3%=5.5
Maximum carpules Lidocaine - ANSWER8 (L8, late)
Most common LA without vaso? - ANSWERMepivicaine 3%
If a pt. is allergic to red wine, what LA to give them? - ANSWERAnything plain (no vaso)
(you wouldn't want to put wine in vases! :).
On which oral tissue is topical anesthetic least effective? - ANSWERKeratinized
Why does infiltration work better on the maxilla as opposed to the mandible? -
ANSWERMandible has denser bone.
How would you best achieve homeostasis? - ANSWERUse 1:50k epi
GUIDE CORRECT 100%
What exits the foramen rotundum? - ANSWERMaxillary Branch of Trigeminal Nerve
What exits the foramen ovale? - ANSWERMandibular Branch of Trigeminal Nerve
What exits the mandibular foramen? - ANSWERInferior Alveolar Nerve
Purpose of Myelin Sheath? - ANSWERProtective Covering for the nerves
What causes psychogenic pain? - ANSWERMental or emotional problems that affect
the experience of pain, there is no organic (medical) base for the pain.
Injection and landmarks for maxillary molars. - ANSWERPSA
Height of mucobuccal fold above second molar
Injection and landmarks for maxillary premolars - ANSWERMSA
Height of mucobuccal fold above second premolar
Injection and landmarks for maxillary incisors (facial) - ANSWERASA
Height of mucobuccal fold above canine
Injection and landmarks for mandibular molars - ANSWERIA
Medial to internal oblique ridge, lateral to pterygomandibular raphe, at or above height
of coronoid notch
Injection and landmarks for buccal tissue of mandibular molars - ANSWERLB
Mucous membrane distal and lateral to most posterior molar
Injection and landmarks for mandibular premolars/incisors, including pulpal -
ANSWERIncisive
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for mandibular premolars/incisors, tissue - ANSWERMental
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for palate near molars - ANSWERGP
Anterior depression of GP foramen, lingual to second molar
Injection and landmarks for palate near anteriors - ANSWERNP
Just lateral to incisive papilla
Landmarks for AMSA - ANSWERHalfway between premolars and palatine suture.
,Dose of IA - ANSWER1.5-1.8ml
Dose of LB - ANSWER.2-.3ml (stopper)
Dose of Mental/Incisive - ANSWER.6ml
Dose of infiltrations - ANSWER.6ml
Dose of NP - ANSWER.4ml
Dose of GP - ANSWER.4-.6ml
Dose of AMSA - ANSWER.9-1.8ml
but, with a 4% anesthetic it's .7-.9ml
Dose of PSA - ANSWER.9-1.8ml
Dose of MSA - ANSWER.9-1.2ml
Dose of ASA - ANSWER.9-1.2ml
Nerve that innervates the soft palate? - ANSWERLesser palatine
Molar root not anesthetized by PSA - ANSWERMesiobuccal root of first molar
Types of topical - ANSWEREster-Benzocaine, tetracaine
Amide-Lidocaine
Ketone-Dyclonine
What happens during depolarization? - ANSWERSlow Na ion influx until firing threshold
is reached.
What happens during rapid depolarization? - ANSWEROnce firing threshold has been
reached (-50 to -55 mv) there is a rapid influx of Na ions.
What happens during repolariztion? - ANSWERNa begins to move with concentration
gradient out of cell, there is an absolute refactory period, Na continues to move out of
cell with help of sodium pump, there is a relative refactory period until resting state is
reached.
What does LA do to deporlariztion? - ANSWERInhibits Na influx by displacing Ca ion.
Esters (and Articaine) are metabolized by...
Excreted by.... - ANSWERPseudocholinesterase in blood plasma
Kidneys
, Amides are metabolized by...
Excreted by.... - ANSWERLiver (prilocaine in the lungs as well)
Kidneys (mostly unchanged)
Avoid esters (and articaine) if... - ANSWERPt's have atypical pseudocholinesterase
Sulfur allergy
Myasthinia Gravis
If there's methemoglobinemia... - ANSWERAvoid prilocaine and benzocaine.
If they're taking beta blockers... - ANSWERLimit or avoid vaso's
If they're taking phenothiazides.... - ANSWERDo not use 1:50,000 epi
If they're taking tricyclic antidepressants - ANSWERNo levo.
Volume in one carpule of LA - ANSWER1.8ml
What is the function of Sodium Chloride in LA solutions? - ANSWERIsotonicity
What is the function of Sodium Bisulfite in LA solutions? - ANSWERAntioxidant
prevents biodegredation of LA (delays deterioration of epi)
Why use vaso? - ANSWERIncreases depth and duration of LA.
Maximum carpules Articaine - ANSWER6 (A6, or Asics-the shoes)
Maximum carpules Prilocaine - ANSWER5 (depri5, P5)
Maximum carpules Mepivicaine - ANSWER2%=8
3%=5.5
Maximum carpules Lidocaine - ANSWER8 (L8, late)
Most common LA without vaso? - ANSWERMepivicaine 3%
If a pt. is allergic to red wine, what LA to give them? - ANSWERAnything plain (no vaso)
(you wouldn't want to put wine in vases! :).
On which oral tissue is topical anesthetic least effective? - ANSWERKeratinized
Why does infiltration work better on the maxilla as opposed to the mandible? -
ANSWERMandible has denser bone.
How would you best achieve homeostasis? - ANSWERUse 1:50k epi
