Chapter 09: Anatomy of Local Anesthesia

Chapter 09: Anatomy of Local Anesthesia

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which of the following local anesthesia nerve blocks can be used during cosmetic restorative procedures because, after procedures are completed, the clinician can immediately and accurately access the patient’s smile line?

a.	Anterior superior alveolar nerve block
b.	Posterior superior alveolar nerve block
c.	Anterior middle superior alveolar nerve block
d.	Middle superior alveolar nerve block

 

 

ANS:   C

 

	Feedback
A	The anterior superior alveolar nerve block can cause anesthesia to the soft tissue of the patient’s lip and face.
B	The posterior superior alveolar nerve block can cause anesthesia to the soft tissue of the patient’s lip and face.
C	The anterior middle superior alveolar nerve block can anesthetize multiple maxillary teeth from the maxillary second premolar through the maxillary central incisor, ALL without causing the usual collateral anesthesia to the soft tissue of the patient’s lip and face as with most maxillary blocks near the alveolar process of the maxilla.
D	The middle superior alveolar nerve block can cause anesthesia to the soft tissue of the patient’s lip and face.

 

 

DIF:    Application     REF:    p. 216              OBJ:    2

TOP:    CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, II. C. Describe how to perform and/or assist with intraoral procedures | CDA: General Chairside, V. A. Oral Health Information

MSC:   NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.0 Performing Periodontal Procedures

 

2. Which of the following local anesthesia nerve blocks is usually NOT used bilaterally due to possible complications associated with swallowing and speech?

a.	Incisive nerve block
b.	Inferior alveolar nerve block
c.	Posterior superior alveolar nerve block
d.	Greater palatine nerve block

 

 

ANS:   B

 

	Feedback
A	The incisive nerve block anesthetizes teeth and tissue of the anterior and part of the most anterior part of the posterior mandible but does NOT affect speech and swallowing.
B	A bilateral inferior alveolar nerve block can cause complete anesthesia of the body of the tongue and floor of the mouth, resulting in speech and swallowing difficulties.
C	The posterior superior alveolar nerve block anesthetizes the teeth and periodontium, including buccal gingival tissue of the maxillary molars, but does NOT affect speech and swallowing.
D	The greater palatine nerve block anesthetizes the hard palate. Gagging by the patient may sometimes be a problem as the nearby lesser palatine nerve is also anesthetized that serves the soft palate is also anesthetized, but the patient’s speech is NOT usually affected by this block.

 

 

DIF:    Application     REF:    p. 224              OBJ:    2

TOP:    CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, II. C. Describe how to perform and/or assist with intraoral procedures | CDA: General Chairside, V. A. Oral Health Information

MSC:   NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.0 Performing Periodontal Procedures

 

3. As a result of a bicycle accident, a patient has suffered trauma to the right upper lip and maxillary right central incisor. Which of the following local anesthetic blocks may be used on the involved side when treating the injured tissue?

a.	Anterior superior alveolar, infraorbital, and incisive nerve blocks
b.	Infraorbital and nasopalatine nerve blocks
c.	Anterior superior alveolar, middle superior alveolar, and greater palatine nerve blocks
d.	Infraorbital, greater palatine, and Gow-Gates mandibular nerve blocks

 

 

ANS:   B

 

	Feedback
A	The incisive nerve block is used on the mandibular anterior teeth and premolars and does NOT provide any anesthesia to maxillary arch.
B	The infraorbital nerve block provides anesthesia to the maxillary facial tissue for the maxillary anteriors and the maxillary labial mucosa as well as providing anterior superior alveolar and middle superior alveolar nerve anesthesia that would anesthetize the pulp tissue of the maxillary central incisor and associated periodontium as well as nearby maxillary anteriors on the involved side. The nasopalatine nerve block anesthetizes the anterior hard palate and associated palatal gingival tissue.
C	The middle superior alveolar nerve block would NOT be the best choice for anesthetizing the maxillary anterior teeth since is associated mainly with anesthesia of pulp of the maxillary premolars and associated structures; additionally, the greater palatine nerve block is used ONLY for the posterior hard palate and associated palatal gingival tissue on one side.
D	The greater palatine nerve block is used for the posterior hard palate ONLY, and the Gow-Gates mandibular block is used to provide anesthesia to nerves that are part of the mandibular nerve or third division of the trigeminal nerve for the mandibular arch and NOT the maxillary arch.

 

 

DIF:    Application     REF:    p. 211              OBJ:    2

TOP:    CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, I. B. Preliminary Physical Examination | CDA: General Chairside, II. C. Describe how to perform and/or assist with intraoral procedures | CDA: General Chairside, V. A. Oral Health Information

MSC:   NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.0 Performing Periodontal Procedures

 

4. Orientation of the syringe for the anterior middle superior alveolar nerve block SHOULD be from the contralateral premolars. The angle of the needle SHOULD be placed at approximately 45 degrees to the injection site.

a.	Both statements are true.
b.	Both statements are false.
c.	The first statement is true; the second is false.
d.	The first statement is false; the second is true.

 

 

ANS:   A

 

	Feedback
A	The needle is placed at an approximately 45-degree angle to the injection site of the palate for the anterior middle superior alveolar nerve block.
B	The injection site for the anterior middle superior alveolar nerve block is approached from the contralateral maxillary premolars on the palate.
C	The anterior middle superior alveolar nerve block is achieved by approaching the site from the contralateral premolars and maintaining the needle at an approximately 45-degree angle to the injection site of the palate.
D	The anterior middle superior alveolar nerve block is achieved by approaching the site from the contralateral premolars and maintaining the needle at an approximately 45-degree angle to the injection site of the palate.

 

 

DIF:    Comprehension                                  REF:    p. 223              OBJ:    4

TOP:    CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, II. C. Describe how to perform and/or assist with intraoral procedures | CDA: General Chairside, V. A. Oral Health Information

MSC:   NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.0 Performing Periodontal Procedures