LOCAL ANESTHESIA UPDATED EXAM EVALUATION
QUESTIONS AND ANSWERS SURE A+
✔✔Which nerve block does not anesthetize the teeth?
a. mental nerve block
b. incisive nerve block
c. buccal nerve block
d. A and C
e. B and C - ✔✔d. A and C
incisive nerve block will anesthetize pulp of PM/canines/incisors, buccal mucous
membrane to mental foramen, lower lip, and skin of chin.
Mental and buccal do not. GP and nasopalatine also do NOT anesthetize the teeth.
✔✔What are the landmarks for the MSA nerve block?
a. mucobuccal fold, max 1st PM
b. mucobuccal fold, max 2nd PM
c. mucobuccal fold, max 2nd molar
d. incisive papilla - ✔✔b. mucobuccal fold, max 2nd PM
,✔✔Which of the following structures may not be anesthetized by the PSA nerve block?
a. MB root of max third molar
b. MB root of max second molar
c. MB root of max first molar
d. all of the above - ✔✔c. MB root of max first molar
✔✔Which injection can best anesthetize the max molars of a 5 y/o child while avoiding
side effects?
a. PSA Nerve block
b. ASA Nerve block
c. Infiltrations
d. all of the above - ✔✔c. Infiltrations
Infiltration is sufficient enough for providing anesthesia to primary teeth
nerve blocks increase risk of soft tissue injuries
✔✔The injection depth for the PSA nerve block is:
a. 5 mm
b. 8 mm
c. 16 mm
d. 30 mm - ✔✔c. 16 mm
✔✔Which of the following needles should be selected for an IA nerve block?
a. Long needle with smaller gauge
b. Short needle with larger gauge
c. Long needle with larger gauge
d. Short needle with smaller gauge - ✔✔a. Long needle with smaller gauge
Needle needs to be inserted 20-25 mm deep. Deep insertion requires "thicker" needle/
larger diameter.
✔✔Which of the following injections can potentially affect the patient's vision?
a. IAN
b. Gow gates
c. Max Nerve block (V2)
d. Mental nerve block - ✔✔b. Gow gates
Gow gates is mandibular injection.
,Can cause temporary paralysis of CN III, IV and VI.
IAN: paresthesia
V2: hematoma
Mental: hematoma
✔✔How deep can topical anesthetic be effective on tissues?
a. 2-3 mm
b. 3-4 mm
c. 4-5 mm
d. 6 mm and more - ✔✔a. 2-3 mm
If applied for 1 to 2 min, the topical anesthetic is effective for 2-3 mm of the skin surface.
Longer application will not provide deeper anesthesia but increase risk for adverse
effects.
✔✔What type of needle should be used for an inferior alveolar nerve block?
a. 27-gauge short
b. 25-gauge short
c. 27-gauge long
d. 30-gauge short - ✔✔c. 27-gauge long
Insertion depth for inferior alveolar is 20-25 mm. Need a long needle and never insert
needle to its hub.
✔✔During which nerve block is the pterygoid plexus more likely to get punctured?
a. MSA nerve block
b. ASA nerve block
c. PSA nerve block
d. Nasopalatine nerve block - ✔✔c. PSA nerve block
Pterygoid plexus of veins protects maxillary artery which could be punctured by a PSA
nerve block which could cause a hematoma.
✔✔Which of the following is the target area for the ASA nerve block?
a. area right above the infraorbital foramen
b. area of the canine fossa
c. posterior, superior and medial to the posterior border of the maxilla
d. Incisive foramen - ✔✔b. area of the canine fossa
IO: infraorbital foramen
MSA: apex of max 2nd PM
, PSA: posterior, superior and medial to the posterior
Nasopalatine: Incisive foramen
✔✔The clinician is drawing two imaginary lines: one that starts from the middle of the
first and second premolar to the medial palatine raphe; and another one that is parallel
to the mid palatine raphe halfway between the gingival margin and the midline of the
palate.
Which injection is the clinican performing?
a. Anterior Middle Superior Alveolar Nerve block
b. Greater palatine nerve block
c. Nasopalatine nerve block
d. Posterior superior alveolar nerve block - ✔✔a. Anterior Middle Superior Alveolar
Nerve block
Needle inserted on the hard palate to anesthetize pulp of max
incisors/canine/premolars.
✔✔If the area surrounding the mandibular incisors is not fully anesthetized by the
incisive nerve block, what should the clinician do?
a. Re-administer an incisive nerve block
b. Provide infiltrations at the desired site
c. Administer an inferior alveolar nerve block
d.Continue the procedure as the area will never be fully anesthetized - ✔✔b. Provide
infiltrations at the desired site
Could be from cross-innervation of the lower anteriors. Clinician should administer 0.9
ml infiltration labially and lingually.
**Incisive nerve is part of the inferior alveolar nerve.
✔✔Topical anesthetics are mainly used in dentistry for which purpose?
a. To numb the tissue surface before an injection
b. To calm the patient
c. To numb the facial nerves
d. To prevent overdose - ✔✔a. To numb the tissue surface before an injection
✔✔Which of the following is the brand of articane?
a. Xylocaine
b. Marcaine
c. Carbocaine
QUESTIONS AND ANSWERS SURE A+
✔✔Which nerve block does not anesthetize the teeth?
a. mental nerve block
b. incisive nerve block
c. buccal nerve block
d. A and C
e. B and C - ✔✔d. A and C
incisive nerve block will anesthetize pulp of PM/canines/incisors, buccal mucous
membrane to mental foramen, lower lip, and skin of chin.
Mental and buccal do not. GP and nasopalatine also do NOT anesthetize the teeth.
✔✔What are the landmarks for the MSA nerve block?
a. mucobuccal fold, max 1st PM
b. mucobuccal fold, max 2nd PM
c. mucobuccal fold, max 2nd molar
d. incisive papilla - ✔✔b. mucobuccal fold, max 2nd PM
,✔✔Which of the following structures may not be anesthetized by the PSA nerve block?
a. MB root of max third molar
b. MB root of max second molar
c. MB root of max first molar
d. all of the above - ✔✔c. MB root of max first molar
✔✔Which injection can best anesthetize the max molars of a 5 y/o child while avoiding
side effects?
a. PSA Nerve block
b. ASA Nerve block
c. Infiltrations
d. all of the above - ✔✔c. Infiltrations
Infiltration is sufficient enough for providing anesthesia to primary teeth
nerve blocks increase risk of soft tissue injuries
✔✔The injection depth for the PSA nerve block is:
a. 5 mm
b. 8 mm
c. 16 mm
d. 30 mm - ✔✔c. 16 mm
✔✔Which of the following needles should be selected for an IA nerve block?
a. Long needle with smaller gauge
b. Short needle with larger gauge
c. Long needle with larger gauge
d. Short needle with smaller gauge - ✔✔a. Long needle with smaller gauge
Needle needs to be inserted 20-25 mm deep. Deep insertion requires "thicker" needle/
larger diameter.
✔✔Which of the following injections can potentially affect the patient's vision?
a. IAN
b. Gow gates
c. Max Nerve block (V2)
d. Mental nerve block - ✔✔b. Gow gates
Gow gates is mandibular injection.
,Can cause temporary paralysis of CN III, IV and VI.
IAN: paresthesia
V2: hematoma
Mental: hematoma
✔✔How deep can topical anesthetic be effective on tissues?
a. 2-3 mm
b. 3-4 mm
c. 4-5 mm
d. 6 mm and more - ✔✔a. 2-3 mm
If applied for 1 to 2 min, the topical anesthetic is effective for 2-3 mm of the skin surface.
Longer application will not provide deeper anesthesia but increase risk for adverse
effects.
✔✔What type of needle should be used for an inferior alveolar nerve block?
a. 27-gauge short
b. 25-gauge short
c. 27-gauge long
d. 30-gauge short - ✔✔c. 27-gauge long
Insertion depth for inferior alveolar is 20-25 mm. Need a long needle and never insert
needle to its hub.
✔✔During which nerve block is the pterygoid plexus more likely to get punctured?
a. MSA nerve block
b. ASA nerve block
c. PSA nerve block
d. Nasopalatine nerve block - ✔✔c. PSA nerve block
Pterygoid plexus of veins protects maxillary artery which could be punctured by a PSA
nerve block which could cause a hematoma.
✔✔Which of the following is the target area for the ASA nerve block?
a. area right above the infraorbital foramen
b. area of the canine fossa
c. posterior, superior and medial to the posterior border of the maxilla
d. Incisive foramen - ✔✔b. area of the canine fossa
IO: infraorbital foramen
MSA: apex of max 2nd PM
, PSA: posterior, superior and medial to the posterior
Nasopalatine: Incisive foramen
✔✔The clinician is drawing two imaginary lines: one that starts from the middle of the
first and second premolar to the medial palatine raphe; and another one that is parallel
to the mid palatine raphe halfway between the gingival margin and the midline of the
palate.
Which injection is the clinican performing?
a. Anterior Middle Superior Alveolar Nerve block
b. Greater palatine nerve block
c. Nasopalatine nerve block
d. Posterior superior alveolar nerve block - ✔✔a. Anterior Middle Superior Alveolar
Nerve block
Needle inserted on the hard palate to anesthetize pulp of max
incisors/canine/premolars.
✔✔If the area surrounding the mandibular incisors is not fully anesthetized by the
incisive nerve block, what should the clinician do?
a. Re-administer an incisive nerve block
b. Provide infiltrations at the desired site
c. Administer an inferior alveolar nerve block
d.Continue the procedure as the area will never be fully anesthetized - ✔✔b. Provide
infiltrations at the desired site
Could be from cross-innervation of the lower anteriors. Clinician should administer 0.9
ml infiltration labially and lingually.
**Incisive nerve is part of the inferior alveolar nerve.
✔✔Topical anesthetics are mainly used in dentistry for which purpose?
a. To numb the tissue surface before an injection
b. To calm the patient
c. To numb the facial nerves
d. To prevent overdose - ✔✔a. To numb the tissue surface before an injection
✔✔Which of the following is the brand of articane?
a. Xylocaine
b. Marcaine
c. Carbocaine
