4DD Dental Anesthesia 100-200 Dr Tung Leang
100. The area of injection mucobuccal fold between the mandible premolars is called
Mental Nerve Block
IAN Block
Long buccal Nerve block
101. Gow- Gate nerve block The trigeminal nerve is predominantly sensory, and motor nerve, who supplied for the three large trunks, originate from the ganglion. Which of the following nerves is supply related only sensory?
the maxillary nerves
σ the mandibular nerve
the lingual nerve
The infra-orbital nerve
102. The trigeminal nerve is the sensory fibres form the semilunar ganglion (the Gasserian ganglion). Where does these ganglion or Gasserian lie in the bottom of the following?
σ the middle cranial fossa
The posterior cranial fossa
σ the anterior cranial fossa
the roof of the cranial fossa
103. The maxillary nerve exclusively sensory, passes through the foramen rotundum to reach the pterygopalatine fossa, where it off a number of branches.How many branches will theses nerves passes through the sphenopalatine ganglion?
Two branches
Three branches
σ four branches
σ five branches
There two branches of maxillary nerve, which enter the sphenopalatine ganglion.
104. Which of the following nerves are entering the sphenopalatine ganglion?
The greater, the nasopalatine nerve and posterior nasal nerve twigs
σ The greater palatine nerve, and the posterior superior alveolar nerve
The greater palatine nerve, and the middle superior alveolar nerve
The greater palatine nerve, and the anterior superior alveolar nerve
105. The infraorbital nerve are supply for the front teeth both side left and right of the maxillary , especially for anterior superior alveolar nerve twigs and leave the trunk just before it exit of the infraorbital foramen and outside the foramen twigs to the skin between the nostril and eye.Which area is used for injection local anesthesia for these teeth?
At the apex between the canine and first premolar
At the apex between the second premolar and first molar
At the apex between the second and third molar
at the apex between the first and second molar
106. Nerve impulse travel in myelinated nerves by a process called what?
σ Domino effect
Salutatory conduction
σ Relative refractory
Nodes of Ranvier
107. Which portion of the nerve do local anesthetics work on?
Neuron
Dendrites
Nerve membrane
Myelinated sheath
Schawann cellS
108. What is one important way that local anesthetic drugs differ from all other drugs used in dentistry?
High potential of overdose
Route of administration
Rate of uptake into bloodstream
Action ceased when absorbed into bloodstream
Blood levels must be sufficient to exert effect
109. When procaine undergoes metabolic breakdown, the major metabolic product (metabolite) is what
σ Pseudocholinesterase
chloroprocaine
Succinylcholine
Succinylcholine
110. Biotransformation of amides take place where?
Liver
Kidney
Blood plasma
Spleen
Bloodstream
111. The concentration of epinephrine that is optimal for hemostasis is what?
1:5000
1:50,000
1:150,000
1:100,000
1:200,000
112. All of the following are reasons to include a vasoconstrictor, ECEPT one.Which one is the EXCEPTION?
Lower blood flow to injection site
Increase anesthetic blood levels
Increase duration of local anesthetic
Lower anesthetic toxicity
Improve field of vision for treatment
113. When it is necessary to administer more than one anesthetic drug, a safe total should be determined by not exceeding what?
The lower of the two maximum doses for the individual agents
The maximum dose of each drug being administered
25% of the maximum dose of each drug being administered
σ 35% of the maximum dose of each drug being administered
Dental work being done in many more than on quadran
114. One of the many proprietary names for lidocaine is what?
Xylocaine HCL
35%Polocaine
Sandonest HCL
Mepivacaine
Candicaine HCL
115. A healthy patient weighing 155 lbs has been given 2 cartridges of 2% lidocaine with epinephrine 1:100,000. How many MORE cartridges of 3% arestocaine can they have?
4.0
σ 4.2
σ 4.4
4.6
116. All of the following are ways of caring for a syringe EXCEPT one. Which one is the EXCEPTION?
σ Place in an ultrasonic bath
σ dismantle and lubricate every 5 uses
σ Sharpen or replace harpoon as needed
Rinse syringe of saliva and foreign matte
Clean with an ultrasonic instrument
117. In the dental office, the MOST important consideration when selecting a syringe type is the ability of the following:?
Delivery anesthetic solution to a patient
Aspirate
Accept a 30 gauge needle
σ Be cost effective
118. In local anesthetic dissociation, tissues with a low pH would have effect on base(RN) and cation(RNH+) in the solution?
A lower portion of RN and higher portion of RNH
A lower portion of RNH+ and a higher portion of RN
Rapid onset of local anesthetic
Increase duration of local anesthetic
Decrease potency of local anesthetic
119. After properly loading the cartridge into the syringe, a few drops of local anesthetic should be expelled. Why?
The ensure proper placement of the harpoon
To ensure free flow of the solution
The ensure the correct anesthetic has been used
To ensure the needle has not been barded
To ensure the ability to aspirate
120. The major factor influencing the ability to aspirate is what?
Gauge of the needle
Size of clinician hand’S
σ Site of injection
σ Size of thumb ring
Harpoon being sterile
121. All of the following methods will REDUCE the chance of needle breakage, EXCEPT one. Which one is the exception?
Establishing a firm hand rest
Using a larger gauge needle
Burying the needle to the hub
Minimizing the need for redirection in tissue
Not bedding the needle excessively
122. The antioxidant used to preserve epinephrine in a local anesthetic solution is?
Sodium bisulfate
Sodium bicarbonate
Sodium chloride
Sodium pentanol
Sodium hydrochloride
123. A small bubble of approximately 1 to 2 mm diameter will frequently be found in the local anesthetic cartridge. These bubbles are cause by what
The anesthetic solution being frozen
The cartridge was stored in a chemical disinfectant
Nitrogen gas being pumped in during manufacturing
σ Oxygen gas being trapped in the cartridge
σ Shaking the cartridge vigorously
124. Distilled water is added to the cartridge for what purpose?
To make the solution isotonic with the tissues of the body
To increase the safely and the duration of the anesthetic
To prevent the biodegradation of the vasopressor
To provide the volume of the solution
σ To prevent the probation of nerve impulses
125. Topical antiseptic does which of the following?
Numbs 2-3mm of tissue prior to injection
Makes patient more comfortable during initial penetration
Lessens the chance of inflammation or infection
Allows the clinician to practice their site of penetration
Reduces the risk of a local anesthetic overdose
126. What is the MOST important reason hemostats/cotton roll pliers are part of the armamentarium?
They are used to remove the Deptinpatch
They are used to place a cotton roll on the needle
They are used for the retrieval of a broken needle
They are used to place the plastic cap on the needle
They are used to unscrew the needle from the syringe
127. At what time are professionals MOST at risk for a needle stick?
Disassembly of syringe
Recapping
Assembling the syringe
Giving the injection
Unsheathing the needle
128. All of the following are acceptable ways of recapping a needle EXCEPT?
σ Carefully direction the cap over needle with fingers
σ Utilizing “Card” or other holding device
Performing the one handed scoop technique
Implementing cotton roll pliers or a hemostat
Securing cap with fingers on vertical syringe
129. Stacey, a 18 year old soccer player, arrives for extraction of teeth #4,12, and 20, and she is given 5 cartridges of 4% Articaine with epi 1:100,000.Her mother calls 3 hours following the appointment stating that Stacey appears cyanotic and sluggish. Her nail beds look dark and the blood in the extraction sites is chocolate brown. What is MOST likely the condition presented?
A typical plasma cholinesterase
Methemoglobinemia
Malignant hyperthermia
σ Local anesthetic overdose
Local anesthetic allergy
130. A patient with epilepsy is scheduled for root planning and scaling with local anesthetic today. What should the dental hygienist know about this condition?
Epilepsy is a relative contraindication to ester type anesthetics
In low doses local anesthetic is an anti-convulsant
The patient should be pre-medicated prio to treatmen
Epilepsy is an absolute contraindication to amide type anesthetics
Oxygen should be available to deliver in an emergency.
131. A patient attends for an extraction of a lower molar tooth. Following the administration of an inferior alveolar nerve block only, the patient complains of pain during the procedure.Which one of the following nerves is the most likely to be responsible for the perception of this pain?
σ Facial nerve
Incisive nerve
Long buccal nerve
Marginal mandibular
Mental nerve
132. Which one of the following local anesthetic agents (at the correct dosage) is the most likely to provide the most prolonged analgesia?
Articaine
σ Bupivacaine
Lidocaine (lignocaine)
Mepivacaine
Prilocaine
133. Which of the following local anesthetics is used exclusively for its good surface activity and low toxic potential?
Cocaine
σ Benzocaine
Bupivacaine
Procaine
Lidocaine
134. Which of the following drugs can cause methemoglobinnemia when used in larger doses for regional anesthesia?
Cocaine
Lidocaine
Bupivacaine
Procaine
Prilocaine
135. Epinephrine added to a solution of lidocaine for local anesthesia will:?
Cause cyanosis locally
σ Increase the risk of convulsion
Increase the duration of local anesthesia
Increase the absorption of lidocaine
Decrease the heart rate when absorbed
136. Vasoconstrictor in local anesthetic(LA) solution is used to ?
Reduces toxic effects of LA
Decreases depth & duration LA.
Increases bleeding
σ Increases toxic effects of LA
137. Reducing agent local anesthetics solution is ?
σ Methyl paraben
Sodium metabisulphite
Thymol
Adrenaline
Ringer lactate
138. Needle used for infiltration is ?
30 gauge
25 gauge
27 gauge
16 gauge
18 gauge
139. When injecting Local anesthetic solution in maxilla on buccal side. Which of the following technique is used?
Sub periosteal
Supra periosteal
Sub mucosal
Intra osseous
Intra septal
140. Most common complication of posterior Superior alveolar nerve block is:?
Trismus
Hematoma
Infection
Facial palsy
Blanching of the area
141. Disto buccal root of upper 1st molar is supplied by:?
Middle superior alveolar nerve
Posterior superior alveolar nerve
Infra orbital nerve
Mental nerve
Buccal nerve
142. Which of 2 nerves blocked when injection is given in pterygo mandibular space?
Buccal & lingual nerve
Lingual & inferior alveolar nerve
Buccal & inferior alveolar nerveBuccal & inferior alveolar nerveBuccal & inferior alveolar nerve
Buccal nerve & infra orbital nerve
Inferior alveolar & posterior superior alveolar nerve
143. Blanching at the site of injection is caused by:?
Increased tissue tension
Local effects of reducing agent in LA solution
Decreased tissue tension
Infection at the site of injection
Warm LA solution
144. What are the local anesthetic produce for:?
σ analgesia, amnesia, loss of consciousness
Blocking pain sensation without loss of consciousness
Alleviation of anxiety and pain with an altered level of consciousness
a stupor or somnolent state
145. A good local anesthetic agent shouldn’t cause:?
σ Local irritation and tissue damage
σ systemic toxicity
σ Fast onset and long duration of action
σ Vasodilation
146. Most local anesthetic agents is consist of :?
Lipophilic group (frequently an aromatic ring)
Intermediate chain (commonly including an ester or amide)
σ amino group
All of the above
147. Which one of the following groups is responsible for the duration of the local anesthetic action?
Intermediate chain
Lipophilic group
Ionizable group
Nonionize group
148. Indicate the local anesthetic agent, which has a shorter duration of action:?
Lindocaine
Procaine
Bupivacaine
Articaine
149. Which one of the following groups is responsible for the potency and the toxicity of local anesthetic?
Inonizable group
Intermediate chain
Lipophylic group
Non Ionize group
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