WREB Local Anesthesia Study Guide
Questions and Answers Graded A+
What exits the foramen rotundum? - Corrrect AnswerMaxillary Branch of Trigeminal
Nerve
What exits the foramen ovale? - Corrrect AnswerMandibular Branch of Trigeminal Nerve
What exits the mandibular foramen? - Corrrect AnswerInferior Alveolar Nerve
Purpose of Myelin Sheath? - Corrrect AnswerProtective Covering for the nerves
What causes psychogenic pain? - Corrrect 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. - Corrrect AnswerPSA
Height of mucobuccal fold above second molar
Injection and landmarks for maxillary premolars - Corrrect AnswerMSA
Height of mucobuccal fold above second premolar
Injection and landmarks for maxillary incisors (facial) - Corrrect AnswerASA
Height of mucobuccal fold above canine
Injection and landmarks for mandibular molars - Corrrect 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 - Corrrect AnswerLB
,Mucous membrane distal and lateral to most posterior molar
Injection and landmarks for mandibular premolars/incisors, including pulpal - Corrrect
AnswerIncisive
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for mandibular premolars/incisors, tissue - Corrrect
AnswerMental
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for palate near molars - Corrrect AnswerGP
Anterior depression of GP foramen, lingual to second molar
Injection and landmarks for palate near anteriors - Corrrect AnswerNP
Just lateral to incisive papilla
Landmarks for AMSA - Corrrect AnswerHalfway between premolars and palatine suture.
Dose of IA - Corrrect Answer1.5-1.8ml
Dose of LB - Corrrect Answer.2-.3ml (stopper)
Dose of Mental/Incisive - Corrrect Answer.6ml
Dose of infiltrations - Corrrect Answer.6ml
Dose of NP - Corrrect Answer.4ml
Dose of GP - Corrrect Answer.4-.6ml
Dose of AMSA - Corrrect Answer.9-1.8ml
,but, with a 4% anesthetic it's .7-.9ml
Dose of PSA - Corrrect Answer.9-1.8ml
Dose of MSA - Corrrect Answer.9-1.2ml
Dose of ASA - Corrrect Answer.9-1.2ml
Nerve that innervates the soft palate? - Corrrect AnswerLesser palatine
Molar root not anesthetized by PSA - Corrrect AnswerMesiobuccal root of first molar
Types of topical - Corrrect AnswerEster-Benzocaine, tetracaine
Amide-Lidocaine
Ketone-Dyclonine
What happens during depolarization? - Corrrect AnswerSlow Na ion influx until firing
threshold is reached.
What happens during rapid depolarization? - Corrrect AnswerOnce firing threshold has
been reached (-50 to -55 mv) there is a rapid influx of Na ions.
What happens during repolariztion? - Corrrect 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? - Corrrect AnswerInhibits Na influx by displacing Ca
ion.
Esters (and Articaine) are metabolized by...
Excreted by.... - Corrrect AnswerPseudocholinesterase in blood plasma
Kidneys
, Amides are metabolized by...
Excreted by.... - Corrrect AnswerLiver (prilocaine in the lungs as well)
Kidneys (mostly unchanged)
Avoid esters (and articaine) if... - Corrrect AnswerPt's have atypical pseudocholinesterase
Sulfur allergy
Myasthinia Gravis
If there's methemoglobinemia... - Corrrect AnswerAvoid prilocaine and benzocaine.
If they're taking beta blockers... - Corrrect AnswerLimit or avoid vaso's
If they're taking phenothiazides.... - Corrrect AnswerDo not use 1:50,000 epi
If they're taking tricyclic antidepressants - Corrrect AnswerNo levo.
Volume in one carpule of LA - Corrrect Answer1.8ml
What is the function of Sodium Chloride in LA solutions? - Corrrect AnswerIsotonicity
What is the function of Sodium Bisulfite in LA solutions? - Corrrect AnswerAntioxidant
prevents biodegredation of LA (delays deterioration of epi)
Why use vaso? - Corrrect AnswerIncreases depth and duration of LA.
Maximum carpules Articaine - Corrrect Answer6 (A6, or Asics-the shoes)
Maximum carpules Prilocaine - Corrrect Answer5 (depri5, P5)
Maximum carpules Mepivicaine - Corrrect Answer2%=8
3%=5.5
Questions and Answers Graded A+
What exits the foramen rotundum? - Corrrect AnswerMaxillary Branch of Trigeminal
Nerve
What exits the foramen ovale? - Corrrect AnswerMandibular Branch of Trigeminal Nerve
What exits the mandibular foramen? - Corrrect AnswerInferior Alveolar Nerve
Purpose of Myelin Sheath? - Corrrect AnswerProtective Covering for the nerves
What causes psychogenic pain? - Corrrect 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. - Corrrect AnswerPSA
Height of mucobuccal fold above second molar
Injection and landmarks for maxillary premolars - Corrrect AnswerMSA
Height of mucobuccal fold above second premolar
Injection and landmarks for maxillary incisors (facial) - Corrrect AnswerASA
Height of mucobuccal fold above canine
Injection and landmarks for mandibular molars - Corrrect 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 - Corrrect AnswerLB
,Mucous membrane distal and lateral to most posterior molar
Injection and landmarks for mandibular premolars/incisors, including pulpal - Corrrect
AnswerIncisive
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for mandibular premolars/incisors, tissue - Corrrect
AnswerMental
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for palate near molars - Corrrect AnswerGP
Anterior depression of GP foramen, lingual to second molar
Injection and landmarks for palate near anteriors - Corrrect AnswerNP
Just lateral to incisive papilla
Landmarks for AMSA - Corrrect AnswerHalfway between premolars and palatine suture.
Dose of IA - Corrrect Answer1.5-1.8ml
Dose of LB - Corrrect Answer.2-.3ml (stopper)
Dose of Mental/Incisive - Corrrect Answer.6ml
Dose of infiltrations - Corrrect Answer.6ml
Dose of NP - Corrrect Answer.4ml
Dose of GP - Corrrect Answer.4-.6ml
Dose of AMSA - Corrrect Answer.9-1.8ml
,but, with a 4% anesthetic it's .7-.9ml
Dose of PSA - Corrrect Answer.9-1.8ml
Dose of MSA - Corrrect Answer.9-1.2ml
Dose of ASA - Corrrect Answer.9-1.2ml
Nerve that innervates the soft palate? - Corrrect AnswerLesser palatine
Molar root not anesthetized by PSA - Corrrect AnswerMesiobuccal root of first molar
Types of topical - Corrrect AnswerEster-Benzocaine, tetracaine
Amide-Lidocaine
Ketone-Dyclonine
What happens during depolarization? - Corrrect AnswerSlow Na ion influx until firing
threshold is reached.
What happens during rapid depolarization? - Corrrect AnswerOnce firing threshold has
been reached (-50 to -55 mv) there is a rapid influx of Na ions.
What happens during repolariztion? - Corrrect 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? - Corrrect AnswerInhibits Na influx by displacing Ca
ion.
Esters (and Articaine) are metabolized by...
Excreted by.... - Corrrect AnswerPseudocholinesterase in blood plasma
Kidneys
, Amides are metabolized by...
Excreted by.... - Corrrect AnswerLiver (prilocaine in the lungs as well)
Kidneys (mostly unchanged)
Avoid esters (and articaine) if... - Corrrect AnswerPt's have atypical pseudocholinesterase
Sulfur allergy
Myasthinia Gravis
If there's methemoglobinemia... - Corrrect AnswerAvoid prilocaine and benzocaine.
If they're taking beta blockers... - Corrrect AnswerLimit or avoid vaso's
If they're taking phenothiazides.... - Corrrect AnswerDo not use 1:50,000 epi
If they're taking tricyclic antidepressants - Corrrect AnswerNo levo.
Volume in one carpule of LA - Corrrect Answer1.8ml
What is the function of Sodium Chloride in LA solutions? - Corrrect AnswerIsotonicity
What is the function of Sodium Bisulfite in LA solutions? - Corrrect AnswerAntioxidant
prevents biodegredation of LA (delays deterioration of epi)
Why use vaso? - Corrrect AnswerIncreases depth and duration of LA.
Maximum carpules Articaine - Corrrect Answer6 (A6, or Asics-the shoes)
Maximum carpules Prilocaine - Corrrect Answer5 (depri5, P5)
Maximum carpules Mepivicaine - Corrrect Answer2%=8
3%=5.5
