Local Anesthesia Board Questions and Answers
Where does the mandibular nerve pass through How far do you insert the needle on an IANB? -
in the skull? - ANSWER -Foramen Ovale ANSWER -20-25 mm or 3/4 the length of
the needle
Trigeminal nerve (CN V) - ANSWER -V1
ophthalmic (sensory) What happens during depolarization? -
V2 maxillary (only sensory) ANSWER -Sodium channels open, Na goes
V3 mandibular (both) in and K goes out
-tries to get to +40 to have an action potential
Where nasopalatine nerve passes through -
ANSWER -Incisive Foramen What happens during repolarization? -
ANSWER -sodium channels close, Na goes
back out and K comess back in
Maxillary division of Trigeminal Nerve is - -60 to -90
ANSWER --V2
-Sensory
When do you aspirate? - ANSWER -Right
before anesthetic is to be deposited
Nerve NOT associated with the mandibular nerve
branch - ANSWER -Infraorbital nerve
Which local anesthetic is metabolized by
pseudocholinesterase? - ANSWER -Esters
The IANB anesthetizes which nerves -
ANSWER --inferior alveolar
-lingual nerve Topical anesthetics are least effective on? -
-mental nerve ANSWER -Keratinized tissues: masiticatory
mucosa, hard palate
-does not anesthetize the buccal nerve
What is true of topical anesthetics? -
Teeth that PSA innervates - ANSWER -1st, ANSWER -No systemic problems
2nd, and 3rd maxillary molars, but may not
innervate MB root of the maxillary 1st molar
Which has the highest occurrence of allergic
reactions? - ANSWER -Ester option;
What injection is needed to anesthetize linguals Benzocaine
of max anteriors - ANSWER -Nasopalatine
What is the significance of giving an amide
What injections are needed to anesthetize the anesthetic to a patient with cirrhosis? -
entire palate on one side - ANSWER - ANSWER -Due to amide anesthetics being
Greater Palatine and Nasopalatine metabolized by the liver
1/5
, Local Anesthesia Board Questions and Answers
What is the landmark for the IANB injection? -
ANSWER -Coronoid notch and the Antioxidant preventing biodegration of LA by
pterygomandibular raphe preventing oxidation of vasopressor by oxygen -
ANSWER -Sodium bisulfite
Psychogenic pain - ANSWER --No organic
base for the pain Actions of vasopressors - ANSWER -
-a mental pain thinking it's real but there is no Increase duration of LA, hemostasis, reduce
physical cause chance of toxicity, reduces chance of systemic
absorption
Max epi dose for normal and cardiac patients -
ANSWER -Normal- .2mg What would cause a dry cornea? -
Cardiac- .04mg ANSWER -Anesthetizing the facial nerve.
The facial nerve can be anesthetized if bone is
not contacted during the IANB and anesthetic
Max Levofedrin dose for normal and cardiac solution is deposited into the parotid gland.
patients - ANSWER -Normal- 1 mg Temporary bell's palsy would not allow the
Cardiac- .2mg patients eyelid to blink or close, which would
cause the dry eye.
What is trismus? - ANSWER -Limited
opening of mouth How to calculate amount of L.A. in solution -
ANSWER -1% solution = 10mg/ml X 1.8ml
= 18mg
Management of hematoma - ANSWER - 2% solution = 20mg/ml X 1.8ml = 36mg
Cold compression and pressure to bleeding site 3% solution = 30mg/ml X 1.8ml = 54 mg
How to calculate the amount of vasoconstrictor in
Management of trismus - ANSWER -Heat
therapy, saline rinses, asprin and jaw exercises solution - ANSWER -1:50,000= .02mg/ml x
1.8ml = .036mg
1:100,000= .01mg/ml x 1.8ml = .018mg
Hematoma can occur if needle penetrates into 1:200,000= .005mg/ml x 1.8ml = .009mg
the pterygoid plexus of veins during which
injection? - ANSWER -PSA
Cause of burning upon injection -
ANSWER -acidic pH of solution, injection
What needle should be used for infiltration? - too fast, cartridge being wiped with alcohol or
sterilizing solution
ANSWER -27g short
Volume of solution of a single cartridge of LA - Cause of needle breakage - ANSWER -
Bending needle, patient movement, going to the
ANSWER -1.7-1.8ml
hub
2/5
Where does the mandibular nerve pass through How far do you insert the needle on an IANB? -
in the skull? - ANSWER -Foramen Ovale ANSWER -20-25 mm or 3/4 the length of
the needle
Trigeminal nerve (CN V) - ANSWER -V1
ophthalmic (sensory) What happens during depolarization? -
V2 maxillary (only sensory) ANSWER -Sodium channels open, Na goes
V3 mandibular (both) in and K goes out
-tries to get to +40 to have an action potential
Where nasopalatine nerve passes through -
ANSWER -Incisive Foramen What happens during repolarization? -
ANSWER -sodium channels close, Na goes
back out and K comess back in
Maxillary division of Trigeminal Nerve is - -60 to -90
ANSWER --V2
-Sensory
When do you aspirate? - ANSWER -Right
before anesthetic is to be deposited
Nerve NOT associated with the mandibular nerve
branch - ANSWER -Infraorbital nerve
Which local anesthetic is metabolized by
pseudocholinesterase? - ANSWER -Esters
The IANB anesthetizes which nerves -
ANSWER --inferior alveolar
-lingual nerve Topical anesthetics are least effective on? -
-mental nerve ANSWER -Keratinized tissues: masiticatory
mucosa, hard palate
-does not anesthetize the buccal nerve
What is true of topical anesthetics? -
Teeth that PSA innervates - ANSWER -1st, ANSWER -No systemic problems
2nd, and 3rd maxillary molars, but may not
innervate MB root of the maxillary 1st molar
Which has the highest occurrence of allergic
reactions? - ANSWER -Ester option;
What injection is needed to anesthetize linguals Benzocaine
of max anteriors - ANSWER -Nasopalatine
What is the significance of giving an amide
What injections are needed to anesthetize the anesthetic to a patient with cirrhosis? -
entire palate on one side - ANSWER - ANSWER -Due to amide anesthetics being
Greater Palatine and Nasopalatine metabolized by the liver
1/5
, Local Anesthesia Board Questions and Answers
What is the landmark for the IANB injection? -
ANSWER -Coronoid notch and the Antioxidant preventing biodegration of LA by
pterygomandibular raphe preventing oxidation of vasopressor by oxygen -
ANSWER -Sodium bisulfite
Psychogenic pain - ANSWER --No organic
base for the pain Actions of vasopressors - ANSWER -
-a mental pain thinking it's real but there is no Increase duration of LA, hemostasis, reduce
physical cause chance of toxicity, reduces chance of systemic
absorption
Max epi dose for normal and cardiac patients -
ANSWER -Normal- .2mg What would cause a dry cornea? -
Cardiac- .04mg ANSWER -Anesthetizing the facial nerve.
The facial nerve can be anesthetized if bone is
not contacted during the IANB and anesthetic
Max Levofedrin dose for normal and cardiac solution is deposited into the parotid gland.
patients - ANSWER -Normal- 1 mg Temporary bell's palsy would not allow the
Cardiac- .2mg patients eyelid to blink or close, which would
cause the dry eye.
What is trismus? - ANSWER -Limited
opening of mouth How to calculate amount of L.A. in solution -
ANSWER -1% solution = 10mg/ml X 1.8ml
= 18mg
Management of hematoma - ANSWER - 2% solution = 20mg/ml X 1.8ml = 36mg
Cold compression and pressure to bleeding site 3% solution = 30mg/ml X 1.8ml = 54 mg
How to calculate the amount of vasoconstrictor in
Management of trismus - ANSWER -Heat
therapy, saline rinses, asprin and jaw exercises solution - ANSWER -1:50,000= .02mg/ml x
1.8ml = .036mg
1:100,000= .01mg/ml x 1.8ml = .018mg
Hematoma can occur if needle penetrates into 1:200,000= .005mg/ml x 1.8ml = .009mg
the pterygoid plexus of veins during which
injection? - ANSWER -PSA
Cause of burning upon injection -
ANSWER -acidic pH of solution, injection
What needle should be used for infiltration? - too fast, cartridge being wiped with alcohol or
sterilizing solution
ANSWER -27g short
Volume of solution of a single cartridge of LA - Cause of needle breakage - ANSWER -
Bending needle, patient movement, going to the
ANSWER -1.7-1.8ml
hub
2/5
