LOCAL ANESTHESIA CDCA EXAM Question and
Answer 2026 | Comprehensive Revision Notes &
Answer Key | A+ Verified
• hematomas are most common with which type of injection, and why?
-✓✓PSA due to nicking a vessel in the pterygoid plexus of veins
• what is the TX for a hematoma? -✓✓pressure, cold compresses on/off,
NSAIDS, and time.
• a positive aspiration when administering a PSA is due to what? -
✓✓aspirating hemorrhage caused by injection
• what are the three most common locations for hematomas to occur? -
✓✓1. PSA
2. IA
3. mental
• blanching of the tissue following/during an injection is caused by
what? -✓✓vasospasm/vasoconstriction caused by epinephrine or
brushing against autonomic nerves stimulation vasospasm
• the pterygomandibular space/triangle is bordered by what anatomical
structures? -✓✓ramus, lateral pterygoid muscle, and medial pterygoid
muscle
,• the pterygomandibular space/triangle is identified intra-orally by what?
-✓✓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 -✓✓1/2 to 2/3
• Antero-posteriorly, the greater palatine foramen is located between the
___________________________. -✓✓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? -
✓✓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? -✓✓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? -
✓✓myelinated (impulses jump from node to node -- node of ranvier)
• what is saltatory conduction? -✓✓the process of nerve impulses
jumping from nodes of ranvier along a myelinated nerve
, • what is the resting potential charges of a nerve? -✓✓inside is negative
and outside is positive
• what molecules are predominately outside/inside at resting potential? -
✓✓Na+ outside and K+ inside
• what is depolarization? -✓✓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? -✓✓blocks the
Na+ channels preventing depolarization
• what is the basic structure of anesthetics? -✓✓aromatic ring (lipid
soluble), intermediate chain (amide or ester configuration), and terminal
amine (able to ionize and become water soluble)
• lipophilic vs. hydrophyllic -✓✓lipophilic is lipid soluble and
hydrophyllic is water soluble
• what makes the terminal amine so important to the structure of local
anesthetic? -✓✓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)
Answer 2026 | Comprehensive Revision Notes &
Answer Key | A+ Verified
• hematomas are most common with which type of injection, and why?
-✓✓PSA due to nicking a vessel in the pterygoid plexus of veins
• what is the TX for a hematoma? -✓✓pressure, cold compresses on/off,
NSAIDS, and time.
• a positive aspiration when administering a PSA is due to what? -
✓✓aspirating hemorrhage caused by injection
• what are the three most common locations for hematomas to occur? -
✓✓1. PSA
2. IA
3. mental
• blanching of the tissue following/during an injection is caused by
what? -✓✓vasospasm/vasoconstriction caused by epinephrine or
brushing against autonomic nerves stimulation vasospasm
• the pterygomandibular space/triangle is bordered by what anatomical
structures? -✓✓ramus, lateral pterygoid muscle, and medial pterygoid
muscle
,• the pterygomandibular space/triangle is identified intra-orally by what?
-✓✓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 -✓✓1/2 to 2/3
• Antero-posteriorly, the greater palatine foramen is located between the
___________________________. -✓✓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? -
✓✓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? -✓✓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? -
✓✓myelinated (impulses jump from node to node -- node of ranvier)
• what is saltatory conduction? -✓✓the process of nerve impulses
jumping from nodes of ranvier along a myelinated nerve
, • what is the resting potential charges of a nerve? -✓✓inside is negative
and outside is positive
• what molecules are predominately outside/inside at resting potential? -
✓✓Na+ outside and K+ inside
• what is depolarization? -✓✓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? -✓✓blocks the
Na+ channels preventing depolarization
• what is the basic structure of anesthetics? -✓✓aromatic ring (lipid
soluble), intermediate chain (amide or ester configuration), and terminal
amine (able to ionize and become water soluble)
• lipophilic vs. hydrophyllic -✓✓lipophilic is lipid soluble and
hydrophyllic is water soluble
• what makes the terminal amine so important to the structure of local
anesthetic? -✓✓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)
