WREB Local Anesthesia Study Guide Questions with Correct Answers 100% Verified By
Experts| 2025/2026 Latest Update
What exits the foramen rotundum? Maxillary Branch of Trigeminal Nerve
What exits the foramen ovale? Mandibular Branch of Trigeminal Nerve
What exits the mandibular foramen? Inferior Alveolar Nerve
Purpose of Myelin Sheath? Protective Covering for the nerves
What causes psychogenic pain? 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. PSA
Height of mucobuccal fold above second molar
Injection and landmarks for maxillary premolars MSA
Height of mucobuccal fold above second premolar
Injection and landmarks for maxillary incisors (facial) ASA
Height of mucobuccal fold above canine
Injection and landmarks for mandibular molars 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 LB
,Mucous membrane distal and lateral to most posterior molar
Injection and landmarks for mandibular premolars/incisors, including pulpal Incisive
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for mandibular premolars/incisors, tissue Mental
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for palate near molars GP
Anterior depression of GP foramen, lingual to second molar
Injection and landmarks for palate near anteriors NP
Just lateral to incisive papilla
Landmarks for AMSA Halfway between premolars and palatine suture.
Dose of IA 1.5-1.8ml
Dose of LB .2-.3ml (stopper)
Dose of Mental/Incisive .6ml
Dose of infiltrations .6ml
Dose of NP .4ml
,Dose of GP .4-.6ml
Dose of AMSA .9-1.8ml
but, with a 4% anesthetic it's .7-.9ml
Dose of PSA .9-1.8ml
Dose of MSA .9-1.2ml
Dose of ASA .9-1.2ml
Nerve that innervates the soft palate? Lesser palatine
Molar root not anesthetized by PSA Mesiobuccal root of first molar
Types of topical Ester-Benzocaine, tetracaine
Amide-Lidocaine
Ketone-Dyclonine
What happens during depolarization? Slow Na ion influx until firing threshold is reached.
What happens during rapid depolarization? Once firing threshold has been reached (-50 to -
55 mv) there is a rapid influx of Na ions.
What happens during repolariztion? 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? Inhibits Na influx by displacing Ca ion.
Esters (and Articaine) are metabolized by...
Excreted by.... Pseudocholinesterase in blood plasma
Kidneys
Amides are metabolized by...
Excreted by.... Liver (prilocaine in the lungs as well)
Kidneys (mostly unchanged)
Avoid esters (and articaine) if... Pt's have atypical pseudocholinesterase
Sulfur allergy
Myasthinia Gravis
If there's methemoglobinemia... Avoid prilocaine and benzocaine.
If they're taking beta blockers... Limit or avoid vaso's
If they're taking phenothiazides.... Do not use 1:50,000 epi
If they're taking tricyclic antidepressants No levo.
Volume in one carpule of LA 1.8ml
What is the function of Sodium Chloride in LA solutions? Isotonicity
Experts| 2025/2026 Latest Update
What exits the foramen rotundum? Maxillary Branch of Trigeminal Nerve
What exits the foramen ovale? Mandibular Branch of Trigeminal Nerve
What exits the mandibular foramen? Inferior Alveolar Nerve
Purpose of Myelin Sheath? Protective Covering for the nerves
What causes psychogenic pain? 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. PSA
Height of mucobuccal fold above second molar
Injection and landmarks for maxillary premolars MSA
Height of mucobuccal fold above second premolar
Injection and landmarks for maxillary incisors (facial) ASA
Height of mucobuccal fold above canine
Injection and landmarks for mandibular molars 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 LB
,Mucous membrane distal and lateral to most posterior molar
Injection and landmarks for mandibular premolars/incisors, including pulpal Incisive
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for mandibular premolars/incisors, tissue Mental
Mucobuccal fold at or just anterior to mental foramen
Injection and landmarks for palate near molars GP
Anterior depression of GP foramen, lingual to second molar
Injection and landmarks for palate near anteriors NP
Just lateral to incisive papilla
Landmarks for AMSA Halfway between premolars and palatine suture.
Dose of IA 1.5-1.8ml
Dose of LB .2-.3ml (stopper)
Dose of Mental/Incisive .6ml
Dose of infiltrations .6ml
Dose of NP .4ml
,Dose of GP .4-.6ml
Dose of AMSA .9-1.8ml
but, with a 4% anesthetic it's .7-.9ml
Dose of PSA .9-1.8ml
Dose of MSA .9-1.2ml
Dose of ASA .9-1.2ml
Nerve that innervates the soft palate? Lesser palatine
Molar root not anesthetized by PSA Mesiobuccal root of first molar
Types of topical Ester-Benzocaine, tetracaine
Amide-Lidocaine
Ketone-Dyclonine
What happens during depolarization? Slow Na ion influx until firing threshold is reached.
What happens during rapid depolarization? Once firing threshold has been reached (-50 to -
55 mv) there is a rapid influx of Na ions.
What happens during repolariztion? 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? Inhibits Na influx by displacing Ca ion.
Esters (and Articaine) are metabolized by...
Excreted by.... Pseudocholinesterase in blood plasma
Kidneys
Amides are metabolized by...
Excreted by.... Liver (prilocaine in the lungs as well)
Kidneys (mostly unchanged)
Avoid esters (and articaine) if... Pt's have atypical pseudocholinesterase
Sulfur allergy
Myasthinia Gravis
If there's methemoglobinemia... Avoid prilocaine and benzocaine.
If they're taking beta blockers... Limit or avoid vaso's
If they're taking phenothiazides.... Do not use 1:50,000 epi
If they're taking tricyclic antidepressants No levo.
Volume in one carpule of LA 1.8ml
What is the function of Sodium Chloride in LA solutions? Isotonicity
