question

unexpected variation

answer

aberrant innervation

question

expected variation

answer

accessory innervation

question

divided nerves

answer

bifid

question

accessory to mandibular incisors

answer

cervical nerve plexus

question

hard tissue restricting flow of anesthesia

answer

dense bone

question

response to drug based on time of day

answer

diurnal body rhythms

question

soft tissue restriction to flow of anesthesia

answer

inflammation

question

chemical barrier to anesthesia success

answer

fascial planes

question

accessory innervation to mandibular teeth

answer

mylohyoid nerve

question

drug tolerance

answer

tiachyphylaxis

question

Devices used for delivery of local anesthetic solutions have very little impact on local anesthesia failure True or False

answer

True they do have little impact

question

Dental hygiene procedures require less duration of anesthesia than restorative procedures True or false

answer

False They do not always require less

question

needle bevel orientations are not considered critical to the success of any injection True or False

answer

True they are not critical to success

question

I.A. nerve blocks may be unsuccessful when the needle penetration is lateral the the sphenomandibular ligament True or False

answer

FALSE it is not lateral to

question

a 25 gauge needle has less potential for deflection than a 27 gauge needle, although deflection is not a common cause for anesthetic failure True or false

answer

true 25 gauge do have less deflection than 27

question

nerve blocks typically require a similar volume of anesthetic solution to achieve profound anesthesia True or false

answer

False nerve blocks require more

question

a pH of lower than 3.3 can lead to failure of anesthesia because the solution is too acidic True or False

answer

True ph of lower than 3.3 lead to failure

question

aberrant innervations are expected anatomical variations True or False

answer

False accessory are expected aberrant are not

question

fibers from the greater palatine nerve may provide accessory innervation to the palatal roots of maxillary molars True or false

answer

true fibers provide innervation to molars

question

PDL injections can overcome nearly all of the challenges that occur due to accessory and aberrant innervation True or False

answer

True pdl injections do

question

the higher the gauge of a needle, the greater its what is

answer

flexibility and deflection in tissues is

question

a cartridge of anesthesia with a vasoconstrictor hsould have a pH of no lower than

answer

3.3

question

tissue inflammation contributes to less anesthetic failure because the pH of the tissue is what compared to normal

answer

less than normal

question

dense bony prominences, shallow vestibules, dilacerations, and soft tissues such as ligaments create what kind of barriers

answer

physical

question

tachyphylaxis is most likely to occur once anesthetized tissues have returned to what of sensations

answer

normal levels of sensations

question

inadequate anesthesia may typically be caused by all of the following except

answer

quality of manufactured solutions

question

which of the following factors is most likely to correspond to anesthetic failures

answer

physical and chemical barriers

question

which of the following does not have an effect on the ability to achieve profound anesthesia in the presence of inflammation

answer

choice of topical anesthetic

question

which of the following is the best procedure to follow in the presence of inflammation

answer

select an injectionthat will provide conduction blockade on the nerve trunk away from the area of inflammation

question

which of the following nerves is often considered most likely cause of accessory innervation to mandibular first molar

answer

mylohyoid

question

which of the following injection would least likely solve inadequate anesthesia on the palate root of tooth #3

answer

Facial infiltration

question

the gow gates is successful in providin ganesthesia for the mandibular molars in the presence of accessory innervation from the mylohyoid or lingual nerves because

answer

it anesthetizes the IA nerve trunk higher in the pterygomandibular space

question

mepivicaine plain solutions may be used for reinjection following the use of lidocaine 2% with epi for all of the following EXCEPT

answer

it is a strong vasodilator

question

True or False A patient with severe systemic disease is classified as ASA IV

answer

FALSE classified as ASA III

question

True or False If a patient is described as ASA III due to blood pressure levels, recommended dental treatment may be initiated provided that intraoperative monitoring of blood pressure is considered and the patients are referred to physicians within one month

answer

True ASA III dental treatment may be done but monitoring must be done also and physician must be seen within one month

question

True or Fale A score of 18 on Corah's Dental anxiety scale indicates mild fear

answer

False An 18 is high fear

question

True or false a pulse oximiter attached to the patient's finger may detect the presence of methemoglobinemia

answer

True pulse oximiters can detect methemoglobinemia

question

Following a relatively severe heart attack, how long should elective dental treatment be delayed?

answer

six months after a heart attack

question

Epinephrine is contraindicated in a patient with what

answer

uncontrolled hypothyroidism

question

a petient with chronic obstructive pulmonary disease requiring oxygen is classified as ASA what

answer

ASA IV

question

a patient with well-controlled NIDD is classified as

answer

ASA II

question

what is the maximum recommended dose of epinephrine for patients in category AMC III with cardiovascular disease

answer

0.04 mg

question

according to the 2007 AHA guidelines, which of the following conditions does not require antibiotic premedication for the prevention of infective endocarditis

answer

hemophillia

question

following a CVA or a TIA how long should elective dental treatment be delayed

answer

Six months after a stroke

question

Which of the following are initial signs and symptoms of methemoglobinemia

answer

gray cyanosis of mucous membranes, lips, nail beds

question

which of the following local anesthetic drugs may represent a relative contraindication for patients with compromised liver functions

answer

lidocaine

question

A patient with asthma is classified as ASA type

answer

Asthma is ASA II

question

a patient with congestive heart failure is classified as ASA type

answer

CHF is ASA III

question

patients with poorly controlled diabetes may have a relative contraindication to the use of

answer

epinephrine

question

nerve fiber that releases adrenaline

answer

adrenergic

question

smooth muscle contraction

answer

Alpha receptor

question

cardiac stimulation

answer

beta 1 receptor

question

smooth muscle relaxation

answer

beta 2 receptor

question

adrenal gland neurotransmitters

answer

catecholamines

question

adrenaline

answer

epinephrine is adrenaline

question

synthetic catecholamine

answer

levonordefrin is synthetic

question

vasoconstrictor not used in dentistry

answer

norepinepnrine is not used in dentistry

question

mimics sympathetic mediators

answer

sympathomimetic mimics

question

contains a nitrogen atom

answer

amide

question

body's management of a drug

answer

biotransformation

question

positively charged ion

answer

cation

question

pKa

answer

dissociation constant

question

removal of drug by kidneys

answer

elimination

question

50% of a drug is removed from circulation

answer

elimination half-life

question

identifies chemical natrure of local anesthetic drug

answer

intermediate chain

question

uncharged molecule

answer

neutral base

question

effect of local anesthetic drug on nerve membrane

answer

specific receptor theory

question

restricts vascular flow

answer

vasoconstrictor restricts vascular flow

question

which of the following is Not a desirable characteristic of local anesthetic drugs

answer

distributed easily

question

during normal nerve function which ion is easily displaced when a membrane is stimulated

answer

calcium is easily displaced

question

which portion of the local anesthetic molecule passes through the nerve membrane

answer

base

question

which percentage is bupivicaine found in

answer

0.5%

question

why do manufacturers manipulate the pKa's of local anesthetic drugs

answer

clnically useful onset time of anesthesia

question

what factor decreases the effectiveness of local anesthesia when tissues are inflamed

answer

inflammatoin causes a decrease in pH of surrounding tissues

question

what factors influences the shift of the neutral base form (RN) of local anesthetic molecules to the cation form (RNH+) whitin the axoplasm

answer

H+ ions are sufficently available in the axoplasm at a pH of 7.4

question

which portion of the local anesthetic molecule binds to receptor site inside the nerve membrane, preventing depolarization

answer

cation

question

prilocaine is biotransfomed by the

answer

liver, kidneys, and lungs

question

ester-type local anesthetic drugs are biotransformed in the

answer

blood by pseudocholinesterase

question

elimination of half life refers to the time it takes for half of the drug to be

answer

out of the circulation

question

MRD stands for

answer

maximum dose recommended that can be safely administered in most situations

question

what is the clnically safest available diluction of vasoconstrictor with lidocaine

answer

1:100,000

question

what is the primary site of biotransformation of lidocaine

answer

liver

question

what percentage is prilocaine

answer

4%

question

what percentage is procaine

answer

3%

question

what percentage of lidocaine is excreted by the kidneys unchanged

answer

10%

question

what is known for the sulfur ring

answer

bupivicaine

question

what is lidocaine's pregnancy factor

answer

pregnancy factor B

question

name the atom present in the ring structure of articaine that helps to make it more lipophilic

answer

sulfur

question

Mepivicaine is a weak or strong vasodilator

answer

weak vasodilator

question

what type is the shortest time for lido (%)

answer

Lidocaine 2% plain is the shortest

question

which formulation of articaine is correct

answer

4% articaine with 1:100,000 epi

question

the maximum recommended dose for lidocaine is

answer

300 mg per appointment

question

what is the target for the IA

answer

mandibular foramen

question

a minimum of what ml of anesthetic solution is required for an IA nerve block due to large diameter of the nerve

answer

1.5 ml of solution for the IA

question

True or False lingual is usually given with IA

answer

False lingual only given when needed

question

True or False Buccal is usually given with IA

answer

False buccal only given when needed

question

the depth of insertion for a mental nerve block is typically how many mm

answer

4-6mm

question

the optimum site of penetration for infiltration injections is at the

answer

hight of the mucobuccal fold closest to the tooth apex being anesthetized

question

the deposition site for an infiltration injection is where

answer

at the apex of the tooth

question

an anatomical variation that can complicate an MSA injection is the presence of a large

answer

zygomaticoalveolar crest

question

the optimal site of penetration for an ASA injectin is at the hight of the mucobuccal fold what to the canine eminence

answer

anterior to the canine eminence

question

the needle pathway of an MSA injection parallels the long axis of the

answer

maxillary second premolar

question

which of the folowing is an anatomical barrier to the success of an infiltration technique

answer

large exostoses

question

studies have demonstrated the absence of the MSA nerve in

answer

50-72% of individuals

question

what anatomical feature may restrict the penetratoin site for an MSA injection

answer

zygomaticoalveolar crest may restrict penetration

question

True of False the rate of deposition of a solution for all palatal injections should be 0.4ml over 40 seconds

answer

False the rate should Not be .4 over 40 seconds

question

True or False The gate control theory suggests that pressure anesthesia blocks the stimulation of non nociceptive fibers

answer

FALSE blocks the response of nociceptive fibers

question

True or False for palatal injections, if swelling or blanching occurs, withdraw the needle and choose another penetratin site

answer

FALSE slow it down to stop blanching and swelling

question

True or False the penetration site for a GP injection is in the fossa located anterior to the GP foramen

answer

True gp injection is in the fossa located anterior to the gp foramen

question

the two-step method for pre-anesthesia for palatal injections includes a one-minute application of topical anesthesia and

answer

firm pressure for a subsequent minute

question

which statement correctly describes a precaution when using 4% local anesthetic for a palatal injection

answer

reduce total volumes by 50%

question

which one of the folowing is the most important consideration for palatal local anesthetic procedures

answer

adminster solutions slowly

question

which of the following best describes the nerves anesthetized by AMSA nerve block

answer

ASA, MSA, NP, GP nerves all anesthetized by AMSA

question

the field of anesthesia for an AMSA nerve block includes

answer

pulpal anesthesia of the cental and lateral incisors, canine, premolar, and palatal tissue to the midline through the molars; and frequently the buccal periodontium of the pulpally affected teeth

question

terminal fibers of the GP nerve overlap the

answer

nasopalatine nerves

question

which statement best describes the penetration site for GP

answer

slightly anterior to the greater palatine foramen

question

the two most important safety steps in the delivery of local anesthetic agents are

answer

rate of delivery and aspiration

question

True or False smaller gauge used for deep penetration because of less flexible and larger lumen provides for ease of accuracy

answer

TRUE smaller gauge better for deep penetratin and larger lumen provides ease of accuracy

question

True or False Heat causes sediment in cartridge

answer

True heat causes sediment

question

true or false a cartridge with bubbles should be disgaurded

answer

true bubbles hsould be thrown out

question

what injection deposits local anesthetic near larger terminal nerve branches

answer

field block

question

what injection deposits local anesthetic near major nerve trunks at a greater distance from the area of treatment, which provides wider areas of anesthesia

answer

nerve block

question

what is the primary reason a needle bevel is oriented toward bone during injection

answer

to reduce trauma to periosteum when bone is contacted

question

which statment describes the correct positioning of the long window of the syringe

answer

toard the clinician to permit visibility through the injection

question

which stament best describes why retractoin of tissue keeping th etissue taut is important during injection

answer

it allows for ease of needle penetration and establishes a point of stability for the syringe

question

which stament correctly describes a false-negative aspiration

answer

rotating the syringe slightly a quarter turn and reaspirating will release the bevel from a vessel wall

question

glass cylinder

answer

cartridge

question

32 mm

answer

long needle

question

22mm

answer

short needle

question

holloow part of needle

answer

lumen

question

aspiratoin and administer slowly is most important true or false

answer

true aspiration and administer slowly

question

the strength of nerve impulses weakens as the energy transfers from one section of nerve membranes to the next true or false

answer

false

question

the electrical potential of a nerve axoplasm in the resting state is approximately -70 mV true or false

answer

true approx. -70

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