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DENTAL HYGIENE LOCAL ANESTHESIA
BOARD ACTUAL EXAM 2025-2026 QUESTIONS
AND CORRECT ANSWERS
Describe the polarization of a nerve cell:
at rest, inside of a cell is slightly (-) charged and outside is lightly (+) charged. ( mv) difference.
Describe the depolarization of a nerve cell:
when there is an influx of Na+ ions and it causes the cell to become depolarized with a (+) charge.
Describe the repolarization of a nerve cell:
begins immediately after depolarization with potassium (+) ions leaving the cell in order to restore equilibrium.
Myelinated nerves conduct impulses _________ with ________ energy.
faster; less
what do the nodes of ranvier on myelinated nerves allow for?
the passage of local anesthesia into the nerve cell.
what is the primary action of local anesthetics?
to block pain perception/transmission by decreasing permeability of sodium ions.
where does the biotransformation of esters occur?
in the pseudocholinesterase of blood plasma and is then excreted by the kidneys.
where does the biotransformation of amides occur?
in the liver and is then excreted by the kidneys.
which local anesthetic type is less likely to admit an allergic reaction?
amides
what is the safe does of a vasoconstricter in a healthy patient?
.2 mg
what is the safe does of a vasoconstricter for a cardiac compromised patient?
.04 mg
what is the advantage of using a vasoconstricter in local anesthetic?
they significantly delay absorption and removal of the local anesthetic solution thus they provide a much longer time for the completion of a procedure.
what is used as a preservative for epinephrine in local anesthetics?
sodium bisulfite
how much epinephrine does a carpule of 1/100,000 contain? with this information, what is the cardiac patient limit based on how much epinephrine is in each carpule?
.018 mg; two carpules of 1/100,000 because 2 x .018 = .036 mg
adrenalin (epinephrine) is naturally found in the body. where is it produced?
the adrenal glands
when should epinephrine not be used?
in a cocaine addict
where are topical local anesthetics not effective?
on keratinized tissue
AD
how far does topical anesthetic penetrate mucous membrane?
2-3 mm
what should we limit the placement of a 20% lidocaine patch to?
15 minutes
what are some examples of amide agents?
topical lidocaine, bupivicane, mepivocaine (carbocaine)
what is the shelf life of local anesthetic without epinephrine? with?
36 months; 18 months
the shelf life of a local anesthetic cartridge expires how long after the expiration date printed on the box?
one month
AD
how long are short needles?
20mm
how long are long needles?
32mm
what is the weakest portion of the needle?
the needle hub
what is the leading cause of needle breakage?
the sudden movement of patient
what helps to prevent the oxidation of epinephrine?
a nitrogen bubble in the cartridge
what is the safest method to cap a needle?
use one hand an a needle holder
inserting the need to the hub may...
cause breakage
what does the harpoon tip indicate?
that the syringe will aspirate
where do you dispose of used needles?
the sharps container
psychogenic pain
no organic reason for the pain
how do you calculate a patients weight in kg and lbs
if the weight is in pounds you will divide by 2.2 because there are 2.2 lbs in 1 kg. If it is in kg and you want to convert to pounds, you'll multiply by 2.2.
trigeminal nerve (V) branches v1 an v2 exit through what opening?
foramen rotundum
trigeminal nerve (V) branch v3 exits through what opening?
foramen ovale
which division of the trigeminal nerve is sensory only?
the second division (maxillary)
which division of the trigeminal nerve is both sensory and motor?
the third division (mandibular)
AD
maxillary anesthesia technique: how far from the free gingival crest should you locally infiltrate palatal tissue?
inject 5-10mm
maxillary anesthesia technique: where is the injection site of the local infiltration of buccal tissues and teeth?
the height of the mucobuccal fold
maxillary anesthesia technique: which injection anesthetizes the pterygoid plexus?
poster superior alveolar injection (PSA)
maxillary anesthesia technique: what is the needle penetration depth for an inferior alveolar injection?
2/3 of a long needle
maxillary anesthesia technique: what is the best injection for hemostasis?
PSA and IA
maxillary anesthesia technique: why are infiltration injections more successful in the maxillae?
because the bone is less dense
maxillary anesthesia technique: the blanching of the cheeks under the eye can be due to...
the vasoconstriction of local anesthetic
maxillary anesthesia technique: too _________ of an injection may cause discomfort to the patient.
rapid
maxillary anesthesia technique: slow injection rate =
less tissue tearing, less discomfort
maxillary anesthesia technique: what is the injection rate for local anesthetics?
1ml per minute
mandibular anesthesia technique: where is the long buccal injection penetration point?
at the mucous membrane distal to the last mandibular molar
mandibular anesthesia technique: what is the depth of needle penetration for an inferior alveolar injection?
approximately 2/3 length of a long needle
mandibular anesthesia technique: what are the landmarks for an inferior alveolar injection?
coronoid notch, pterygoid mandibular raphe, pterygoid mandibular raphe
mandibular anesthesia technique: what is the best injection for hemostasis?
local infiltration
mandibular anesthesia technique: why nerve causes numbness on one side of the tongue?
the lingual nerve
an ASA injection
what causes immediate sharp pain and immediate local anesthesia?
when a needle touches a nerve
if there is a local infection in an area of an injection the local anesthetic is...
less effective
what is the immediate severe reaction to excess local anesthesia?
a clonic seizure
what is the most severe reaction to local anesthesia?
anaphylaxis
what is the most common reaction to injections and local anesthesia?
syncope
when will most severe local anesthetic reactions occur?
within 5-10 minutes of the injection
what is the first sign of possible local anesthetic overdose?
drowsiness
most allergic reactions are to __________ local anesthetics.
ester
when should amides be used very cautiously?
if liver failure is reported on a health history
if you have an allergy to red wine, what should not be used?
epinephrine. instead use carbocaine 3% plain
what is used for the emergency treatment of anaphylaxis?
.5 to 1 cc (ml) of epinephrine
trigeminal nerve (V) branch v1 enters through what opening?
superior orbital fissure
trigeminal nerve (V) branch v2 enters through what opening?
*foramen rotundum
trigeminal nerve (V) branch v3 enters through what opening?
infratemporal fossa
what intervates the maxillary anterior teeth?
the anterior superior alveolar nerve
what innervates the maxillary posterior teeth?
the posterior superior alveolar nerve, and the middle superior alveolar nerve
