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Flashcards in Local Anesthesia Review 1 Deck (36):
1

All of the following are TRUE about the definition of local anesthesia, EXCEPT:
a. it occurs in a circumscribed area
b. involves loss of sensation
c. occurs with a loss of consciousness

c. occurs with a loss of consciousness

2

Which of the following are IDEAL properties of a local anesthetic?
a. non-tissue irritating
b. low systemic toxicity
c. time onset - short
d. lasts long enough for the procedures
e. no permanent alteration of nerve structure
f. all of the above
g. a, b, d

f. all of the above

3

#1. A nerve is at -70mV in its resting state (electric potential). #2. During the slow depolarization stage, the interior of the nerve becomes slightly less negative.
a. both statements are true
b. both statements are false
c. #1 True; #2 False
d. #1. False; #2 True

a. both statements are true

4

Local anesthesia works in part by:
a. raising the firing threshold (need more than the 15mV change)
b. lowering the firing threshold (need less than the 15mV change)
c. it does not really affect the firing threshold
d. decreasing the permeability of the ion channels to Na+
e. a, d
f. b, d

e. a, d

5

The absolute refractory period is:
a. when the nerve can respond again to another stimulus right after an impulse
b. when the nerve cannot respond again to another stimulus right after an impulse
c. when the nerve can respond again to another stimulus right after an impulse but the stimulus must be stronger than normal

b. when the nerve cannot respond again to another stimulus right after an impulse

6

Effects of local anesthetic on the nerves include which of the following?
a. allows less sodium into the nerve interior
b. local currents do not develop and self perpetuating impulse propagation is stalled
c. an impulse that arrives at the blocked segment is unable to release its energy for its continued propagation
d. all of the above
e. b, c

d. all of the above

7

#1. Induction time is the time from deposition of the local anesthetic to complete conduction blockade. #2. Tachyphylaxis is a decreasing tolerance to a drug administered repeatedly.
a. both statements are true
b. both statements are false
c. #1 True; #2 False
d. #1. False; #2 True

c. #1 True; #2 False
*increasing

8

#1. The most widely accepted theory is the Specific Receptor Theory. #2. The above theory says, "Local anesthesia binds to specific receptors in the sodium channel.
a. both statements are true
b. both statements are false
c. #1 True; #2 False
d. #1. False; #2 True

a. both statements are true

9

The mechanism whereby Na+ gains access to the axoplasm of the nerve, thereby initiating an action potential that is altered by the local anesthesia is called:
a. conduction blockade
b. tachyphylaxis
c. induction time
d. none of the above

a. conduction blockade

10

Concerning the trigeminal nerve:
a. V2 is the mandibular division
b. V3 is the maxillary division
c. V1 is the maxillary division
d. V3 is the mandibular division

d. V3 is the mandibular division

(V1 ophthalmic, V2 maxillary)

11

The nasopalatine nerve:
a. supplies the palatal mucosa from canine to canine
b. supplies the palatal mucosa in the molar areas
c. supplies the buccal mucosa in the molar areas
d. supplies the pulps of the anterior teeth

a. supplies the palatal mucosa from canine to canine

12

The following are true about the MSA nerve, EXCEPT:
a. it supplies the maxillary premolars pulpal tissue unilaterally
b. it is present in 98% of the population
c. if it is not present, either the ASA or PSA supply the innervation

b. it is present in 98% of the population
(28%)

13

The following are branches of the inferior alveolar nerve, EXCEPT:
a. mental nerve
b. incisive nerve
c. long buccal nerve

c. long buccal nerve

14

#1. The maxillary bone is more dense than mandibular bone.
#2. Local anesthesia cannot diffuse thru maxillary bone.
a. both statements are true
b. both statements are false
c. #1 True; #2 False
d. #1. False; #2 True

b. both statements are false
(#1. Less, #2. Can)

15

The inferior alveolar nerve:
a. supplies the pulps and periodontal tissue of all mandibular teeth (unilaterally)
b. at the mental foramen, it turns into (splits into) the mental and incisive nerve
c. the above split occurs at the mental foramen
d. a & b
e. all of the above

e. all of the above

16

The three essential parts of the local anesthetic armamentarium are:
a. forceps, cartridge, cotton tip
b. syringe, cartridge, needle
c. needle, topical gel, hemostat

b. syringe, cartridge, needle

17

The most common type of syringe used is:
a. nondisposable, breech loading, metallic, cartridge type, aspirating
b. disposable, breech loading, plastic, cartridge type, self-aspirating
c. disposable, breech loading, metal, cartridge type, aspirating

a. nondisposable, breech loading, metallic, cartridge type, aspirating

18

The harpoon:
a. engages the rubber stopper in the cartridge so when negative pressure is applied we can aspirate.
b. is part of the needle that engages soft tissue
c. must be adjusted depending on the type of local anesthetic used
d. is essential for Captain Ahab to catch The Great White Whale!

a. engages the rubber stopper in the cartridge so when negative pressure is applied we can aspirate.

19

Disengagement of the harpoon from the stopper (plunger) is usually caused by:
a. a dull harpoon
b. too much negative pressure applied during aspiration
c. a, b
d. none of the above

c. a, b

20

The two most important characteristics of a needle that we use to CLASSIFY them by are:
a. hardness and gauge
b. gauge and length
c. length and elasticity

b. gauge and length

21

The two most common needle gauges we will use are:
a. 23 and 25
b. 25 and 27
c. 21 and 23

b. 25 and 27

22

Which of the following is FALSE about care and handling of the needle?
a. can use the same needle on more than one patient if family members
b. change the needle after 3 or 4 penetrations
c. use protective sheath when not in use
d. always be aware of the position of an uncovered tip
e. use proper scoop recapping technique and disposing in sharps container

a. can use the same needle on more than one patient if family members

23

#1. A BB size 1-2 mm bubble is from nitrogen gas and is considered normal. #2. A larger bubble with an extruded plunger (stopper) was probably frozen and should be discarded.
a. both statements are true
b. both statements are false
c. #1 True; #2 False
d. #1. False; #2 True

a. both statements are true

24

The following are considered contents of the cartridge except:
a. local anesthetic drug
b. vasopressor and preservative for it
c. alcohol
d. sodium chloride
e. distilled water

c. alcohol

25

The following are TRUE about the care and handling of cartridges except:
a. store in the original container at room temperature, in darkness
b. store in solution of alcohol
c. don't use cartridge warmers

b. store in solution of alcohol

26

When preparing your armamentarium, which of the following is the correct order:
a. attach the needle before loading the cartridge
b. attach the needle after loading the cartridge
c. the order does not matter

b. attach the needle after loading the cartridge

27

The following are true about sodium bisulfite except:
a. acts as a preservative and antioxidant
b. reacts with oxygen and oxidizes to bisulfate
c. bisulfate has a higher pH than bisulfite so the patient feels less burning

c. bisulfate has a higher pH than bisulfite so the patient feels less burning

(Lower pH and more burning)

28

True OR False
Leakage during an injection is usually from leaving needle on when changing cartridge where the puncture is ovoid and eccentric.

True

29

True OR False
If placing an additional cartridge in a syringe, it is best to remove the needle before placing in the new cartridge

True

30

True OR False
A needle should never be inserted to its hub as that is its weakest point and if it breaks there the soft tissue can cover it up.

True

31

True OR False
It is usually OK to bend a needle.

False

32

Most needle stick incidents occur when
a. recapping the needle
b. removing the needle from the syringe
c. withdrawing the needle from the tissue

a. recapping the needle

33

The following are true except:
a. most negative reactions from local anesthesia occur after 15 minutes
b. most negative reactions from local anesthesia occur in the first 5 to 10 minutes
c. the most common negative reaction to local anesthesia is syncope

a. most negative reactions from local anesthesia occur after 15 minutes

34

True OR False
Allergies to local anesthesia are relatively common.

False

(uncommon)

35

Slow injection is vital for the following two statements:
#1. Safety factor {in case in vessel, slow rate lessens chances of a serious reaction}
#2. Prevents solution from tearing the tissues, rapid injection
a. both statements are true
b. both statements are false
c. #1 True; #2 False
d. #1. False; #2 True

a. both statements are true

36

The best rate to give a full cartridge of anesthetic is:
a. from 1 to 2 minutes (we usually do 1 minute)
b. 30 seconds
c. rate is not really important
d. it can vary with the patient's weight

a. from 1 to 2 minutes (we usually do 1 minute)