WREB LOCAL ANESTHESIA STUDY
GUIDE
What exits the foramen rotundum? - Correct Answers -Maxillary Branch of Trigeminal
Nerve
What exits the foramen ovale? - Correct Answers -Mandibular Branch of Trigeminal
Nerve
What exits the mandibular foramen? - Correct Answers -Inferior Alveolar Nerve
Purpose of Myelin Sheath? - Correct Answers -Protective Covering for the nerves
What causes psychogenic pain? - Correct Answers -Mental or emotional problems that
affect the experience of pain, there is no organic (medical) base for the pain.
Injection and landmarks for maxillary molars. - Correct Answers -PSA
Height of mucobuccal fold above second molar
Smaller Needle gauge equals _____________ (larger/smaller) lumen - Correct Answers
-Larger
Difference between block and filtration - Correct Answers -Block- anesthetic is
deposited close to main nerve trunk- cover a larger area.
Filtration- deposited near large terminal nerve endings.
Maxillary division of trigeminal nerve is... - Correct Answers -Sensory only
Injection and landmarks for maxillary premolars - Correct Answers -MSA
Height of mucobuccal fold above second premolar
Injection and landmarks for maxillary incisors (facial) - Correct Answers -ASA
Height of mucobuccal fold above canine
Injection and landmarks for mandibular molars - Correct Answers -IA
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 - Correct Answers -LB
Mucous membrane distal and lateral to most posterior molar
Injection and landmarks for mandibular premolars/incisors, including pulpal - Correct
Answers -Incisive
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for mandibular premolars/incisors, tissue - Correct Answers -
Mental
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for palate near molars - Correct Answers -GP
Anterior depression of GP foramen, lingual to second molar
Injection and landmarks for palate near anteriors - Correct Answers -NP
Just lateral to incisive papilla
Landmarks for AMSA - Correct Answers -Halfway between premolars and palatine
suture.
Dose of IA - Correct Answers -1.5-1.8ml
Dose of LB - Correct Answers -.2-.3ml (stopper)
Dose of Mental/Incisive - Correct Answers -.6ml
Dose of infiltrations - Correct Answers -.6ml
Dose of NP - Correct Answers -.4ml
Dose of GP - Correct Answers -.4-.6ml
Dose of AMSA - Correct Answers -.9-1.8ml
but, with a 4% anesthetic it's .7-.9ml
Dose of PSA - Correct Answers -.9-1.8ml
Dose of MSA - Correct Answers -.9-1.2ml
Dose of ASA - Correct Answers -.9-1.2ml
Nerve that innervates the soft palate? - Correct Answers -Lesser palatine
Molar root not anesthetized by PSA - Correct Answers -Mesiobuccal root of first molar
Types of topical - Correct Answers -Ester-Benzocaine, tetracaine
, Amide-Lidocaine
Ketone-Dyclonine
What happens during depolarization? - Correct Answers -Slow Na ion influx until firing
threshold is reached.
What happens during rapid depolarization? - Correct Answers -Once firing threshold
has been reached (-50 to -55 mv) there is a rapid influx of Na ions.
What happens during repolariztion? - Correct Answers -Na 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? - Correct Answers -Inhibits Na influx by displacing
Ca ion.
Esters (and Articaine) are metabolized by...
Excreted by.... - Correct Answers -Pseudocholinesterase in blood plasma
Kidneys
Amides are metabolized by...
Excreted by.... - Correct Answers -Liver (prilocaine in the lungs as well)
Kidneys (mostly unchanged)
Avoid esters (and articaine) if... - Correct Answers -Pt's have atypical
pseudocholinesterase
Sulfur allergy
Myasthinia Gravis
If there's methemoglobinemia... - Correct Answers -Avoid prilocaine and benzocaine.
If they're taking beta blockers... - Correct Answers -Limit or avoid vaso's
If they're taking phenothiazides.... - Correct Answers -Do not use 1:50,000 epi
If they're taking tricyclic antidepressants - Correct Answers -No levo.
Volume in one carpule of LA - Correct Answers -1.8ml
What is the function of Sodium Chloride in LA solutions? - Correct Answers -Isotonicity
What is the function of Sodium Bisulfite in LA solutions? - Correct Answers -Antioxidant
prevents biodegredation of LA (delays deterioration of epi)
Why use vaso? - Correct Answers -Increases depth and duration of LA.
GUIDE
What exits the foramen rotundum? - Correct Answers -Maxillary Branch of Trigeminal
Nerve
What exits the foramen ovale? - Correct Answers -Mandibular Branch of Trigeminal
Nerve
What exits the mandibular foramen? - Correct Answers -Inferior Alveolar Nerve
Purpose of Myelin Sheath? - Correct Answers -Protective Covering for the nerves
What causes psychogenic pain? - Correct Answers -Mental or emotional problems that
affect the experience of pain, there is no organic (medical) base for the pain.
Injection and landmarks for maxillary molars. - Correct Answers -PSA
Height of mucobuccal fold above second molar
Smaller Needle gauge equals _____________ (larger/smaller) lumen - Correct Answers
-Larger
Difference between block and filtration - Correct Answers -Block- anesthetic is
deposited close to main nerve trunk- cover a larger area.
Filtration- deposited near large terminal nerve endings.
Maxillary division of trigeminal nerve is... - Correct Answers -Sensory only
Injection and landmarks for maxillary premolars - Correct Answers -MSA
Height of mucobuccal fold above second premolar
Injection and landmarks for maxillary incisors (facial) - Correct Answers -ASA
Height of mucobuccal fold above canine
Injection and landmarks for mandibular molars - Correct Answers -IA
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 - Correct Answers -LB
Mucous membrane distal and lateral to most posterior molar
Injection and landmarks for mandibular premolars/incisors, including pulpal - Correct
Answers -Incisive
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for mandibular premolars/incisors, tissue - Correct Answers -
Mental
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for palate near molars - Correct Answers -GP
Anterior depression of GP foramen, lingual to second molar
Injection and landmarks for palate near anteriors - Correct Answers -NP
Just lateral to incisive papilla
Landmarks for AMSA - Correct Answers -Halfway between premolars and palatine
suture.
Dose of IA - Correct Answers -1.5-1.8ml
Dose of LB - Correct Answers -.2-.3ml (stopper)
Dose of Mental/Incisive - Correct Answers -.6ml
Dose of infiltrations - Correct Answers -.6ml
Dose of NP - Correct Answers -.4ml
Dose of GP - Correct Answers -.4-.6ml
Dose of AMSA - Correct Answers -.9-1.8ml
but, with a 4% anesthetic it's .7-.9ml
Dose of PSA - Correct Answers -.9-1.8ml
Dose of MSA - Correct Answers -.9-1.2ml
Dose of ASA - Correct Answers -.9-1.2ml
Nerve that innervates the soft palate? - Correct Answers -Lesser palatine
Molar root not anesthetized by PSA - Correct Answers -Mesiobuccal root of first molar
Types of topical - Correct Answers -Ester-Benzocaine, tetracaine
, Amide-Lidocaine
Ketone-Dyclonine
What happens during depolarization? - Correct Answers -Slow Na ion influx until firing
threshold is reached.
What happens during rapid depolarization? - Correct Answers -Once firing threshold
has been reached (-50 to -55 mv) there is a rapid influx of Na ions.
What happens during repolariztion? - Correct Answers -Na 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? - Correct Answers -Inhibits Na influx by displacing
Ca ion.
Esters (and Articaine) are metabolized by...
Excreted by.... - Correct Answers -Pseudocholinesterase in blood plasma
Kidneys
Amides are metabolized by...
Excreted by.... - Correct Answers -Liver (prilocaine in the lungs as well)
Kidneys (mostly unchanged)
Avoid esters (and articaine) if... - Correct Answers -Pt's have atypical
pseudocholinesterase
Sulfur allergy
Myasthinia Gravis
If there's methemoglobinemia... - Correct Answers -Avoid prilocaine and benzocaine.
If they're taking beta blockers... - Correct Answers -Limit or avoid vaso's
If they're taking phenothiazides.... - Correct Answers -Do not use 1:50,000 epi
If they're taking tricyclic antidepressants - Correct Answers -No levo.
Volume in one carpule of LA - Correct Answers -1.8ml
What is the function of Sodium Chloride in LA solutions? - Correct Answers -Isotonicity
What is the function of Sodium Bisulfite in LA solutions? - Correct Answers -Antioxidant
prevents biodegredation of LA (delays deterioration of epi)
Why use vaso? - Correct Answers -Increases depth and duration of LA.
