LA HW CH12

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Fortis Institute, Scranton *

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101

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Medicine

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Jan 9, 2024

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NAME: _________________________________ Date:___________ Chapter 12 Injections for Maxillary Pain Control Match the following: 1. dental plexus _________ A. at nerve endings 2. deposition site _________ B. bruise 3. edema _________ C. passageway 4. eminence _________ D. swelling 5. field of anesthesia ________ E. piercing point 6. foramen _________ F. bony protrusion 7. hematoma _________ G. opening through bone 8. infiltration _________ H. nerves around teeth 9. needle pathway _________ I. target 10. penetration site _________ J. area numbed Short Answers: 11. The group of nerves innervating the pulp of the tooth, facial areas of the gingiva, periodontal ligament, and alveolus are called the ___________________________. 12. Although technically imprecise, injection techniques that provide limited soft tissue and pulpal anesthesia are frequently referred to as ________________________. 13. The facial bone of the maxilla is relatively _____________________ which allows for ease of diffusion of local anesthetics. 14. The optimum site of penetration for infiltration injections is at the __________________.

15. A bony ridge or __________________ can be palpated overlying the facial root of maxillary teeth. 16. The ASA nerve is the terminal branch of the _________________ division of the trigeminal nerve. 17. An anatomical variation that can complicate an MSA injection is the presence of a large __________________________ . 18. The PSA nerve branches from the maxillary nerve in the _________________________ prior to entering the infraorbital canal. 19. The pathway of the needle ____________________ the long axis of the tooth in an infiltration injection. 20. The deposition site for an infiltration injection is at the _____________ of the tooth. 21. The optimal site of penetration for an ASA injection is at the height of the mucobuccal fold _______________________ to the canine eminence. 22. The depth of penetration for an ASA injection is _______________________. 23. A minimum volume (in milliliters) of anesthetic solution needed to achieve anesthesia with an ASA injection is typically _______________________ . 24. The needle pathway of an MSA injection parallels the long axis of the ______________ .

25. The _____________________ nerve block is indicated for pain management of anterior and premolar teeth in one quadrant. 26. The needle pathway for an IO injection has been described as oriented along a line parallel to the ___________________________. 27. The PSA injection is indicated for pain management of _______________________ in one quadrant. 28. The optimum depth of insertion for a PSA injection is ____________________ . 29. The angle of insertion for the PSA injection is ____________ to the maxillary occlusal table and the midsagittal planes. 30. Soft tissue retraction for a PSA injection is both _______________________ to allow for good visibility.

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Multiple Choice: 31. Which of the following best explains why infiltration techniques are highly successful in the maxilla? A. Minimal penetration depths B. Ease of diffusion through bone C. Multiple nerves in the dental plexus D. Volumes of anesthetic delivered 32. Which one of the following is an anatomical barrier to the success of an infiltration technique? A. Inability to locate the apex of the tooth B. Syringe angulation C. Frenal attachments D. Large exostoses 33. In a typical adult, how far below the inferior orbital ridge is the location of IO deposition site? A. 8 to 10 mm B. 6 to 12 mm C. 2 to 4 mm D. 1 to 2 mm 34. Studies have demonstrated the absence of the MSA nerve in: A. ten to twenty-eight percent of individuals. B. fifteen to fifty percent of individuals. C. twenty-eight to fifty-two percent of individuals. D. fifty to seventy-two percent of individuals.

35. What anatomical feature may restrict the penetration site for an MSA injection? A. Canine eminence B. Low mucogingival junction C. Maxillary tuberosity D. Zygomaticoalveolar crest 36. Which nerve may provide accessory innervation to the palatal roots of the maxillary molars and to the premolars? A. MSA nerve B. IA nerve C. GP nerve D. IO nerve 37. Which of the following injections is not an alternate for an unsuccessful infiltration on a maxillary canine? A. IO B. ASA C. MSA D. PASA 38. When an infiltration injection is unsuccessful, it may be helpful to: A. change the length of the needle and repeat the injection. B. visualize, palpate, check radiographs, and reassess the technique. C. establish contact with bone before administering one cartridge of anesthetic solution. D. repeat the same injection and deposit more solution.

39. What is a typical minimum volume of anesthetic solution for an infiltration of tooth number 7? A. 0.4 ml B. 0.6 ml C. 1.8 ml D. 9.0 ml 40. What is a typical range of anesthetic solution volumes deposited for MSA nerve blocks? A. 0.4 to 0.9 ml B. 0.9 to 1.2 ml C. 1.2 to 1.8 ml D. 1.6 to 1.8 ml 41. Which of the following maxillary injection techniques has the highest risk of hematoma? A. ASA B. IO C. AMSA D. PSA 42. Which of the following is most likely to increase the risk of hematoma following a PSA nerve block? A. The needle is inserted too inferior to the posterior surface of the maxilla, contacting the IA artery. B. The needle penetrates the porous bony surface of the maxilla, piercing blood vessels in the pterygoid plexus of veins. C. A long needle is inserted, contacting the bony periosteum on the posterior surface of the maxilla. D. The needle is inserted deep and/or posterior to the deposition site on the posterior surface of the maxilla.

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43. Which injection will most easily remedy a cross-innervation to a central incisor? A. Infiltration over the same side central incisor B. Infiltration over the opposite side central incisor C. An ASA nerve block D. Bilateral ASA nerve blocks Figure Identification 44. Color in the field of anesthesia and list the structures anesthetized by an infiltration of #7.

45. Color in the field of anesthesia and list the structures anesthetized by an ASA nerve block. 46. Color in the field of anesthesia and list the structures anesthetized by an MSA nerve block.

47. Color in the field of anesthesia and list the structures anesthetized by an infraorbital nerve block. 48. Color in the field of anesthesia and list the structures anesthetized by a PSA nerve block.

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LA HW CH12

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