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Illustrated Anatomy of the Head and Neck 5th Edition Fehrenbach Herring Test Bank

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Illustrated Anatomy of the Head and Neck 5th Edition Fehrenbach Herring Test Bank

ISBN-13: 978-0323396349

ISBN-10: 0323396348

 

 

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Illustrated Anatomy of the Head and Neck 5th Edition Fehrenbach Herring Test Bank

ISBN-13: 978-0323396349

ISBN-10: 0323396348

 

 

 

 

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Chapter 09: Anatomy of Local Anesthesia

Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition

 

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

 

  1. 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

 

  1. 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

 

  1. 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

 

  1. Which of the following local anesthetic nerve blocks uses the apex of the maxillary canine for a landmark during administration?
a. Infraorbital nerve block
b. Anterior superior alveolar nerve block
c. Middle superior alveolar nerve block
d. Posterior superior alveolar nerve block

 

 

ANS:   B

 

  Feedback
A The height of the mucobuccal fold at the apex of the maxillary first premolar is used as the injection site for the infraorbital nerve block.
B The height of the mucobuccal fold at the apex of the maxillary canine is used as the injection site for the anterior superior alveolar nerve block.
C The injection site for the middle superior alveolar nerve block is at the height of the mucobuccal fold at the apex of the maxillary second premolar.
D The injection site for the posterior superior alveolar nerve block is at the height of the mucobuccal fold at the apex of the maxillary second molar.

 

 

DIF:    Recall              REF:    p. 218              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

 

  1. When administering a local anesthetic agent to a patient’s teeth and their related dental structures, which three bones of the head and neck have the landmarks essential for clinically effective injection technique?
a. Maxillae, mandible, and temporal bones
b. Maxillae, mandible, and zygomatic bones
c. Maxillae, mandible, and palatine bones
d. Maxillae, mandible, and sphenoid bones

 

 

ANS:   C

 

  Feedback
A The temporal bone is NOT involved in either maxillary or mandibular injections.
B The zygomatic bone is NOT involved in either maxillary or mandibular injections.
C The maxillae, mandible, and palatine bones contain the foramina or alveolar processes, through which sensory nerves from dental structures travel. These bones also have external and internal landmarks that help the clinician identify target areas for needle placement.
D Sphenoid bone is NOT involved in either maxillary or mandibular injections.

 

 

DIF:    Comprehension                                  REF:    p. 211              OBJ:    3

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

 

  1. Only one injection is necessary when anesthetizing BOTH the right and left maxillary anterior palate and associated palatal gingival tissue. Pressure anesthesia during the nasopalatine local anesthetic nerve block is NOT helpful with patient comfort.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second statement is false.
d. The first statement is false; the second statement is true.

 

 

ANS:   C

 

  Feedback
A The first statement is true. Both nasopalatine nerves are anesthetized with one injection. The second statement is false. Pressure anesthesia is helpful in decreasing patient discomfort.
B Both the right and left nasopalatine nerves are anesthetized by the nasopalatine nerve block. Pressure anesthesia is helpful to decrease patient discomfort in this sensitive area. Thus the first statement is true, and the second statement is false.
C The first statement is true. Both nasopalatine nerves are anesthetized with one injection. The second statement is false. Pressure anesthesia is helpful in decreasing patient discomfort.
D The first statement is true. Both nasopalatine nerves are anesthetized with one injection. The second statement is false. Pressure anesthesia is helpful in decreasing patient discomfort.

 

 

DIF:    Application     REF:    p. 221              OBJ:    5

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

 

  1. Which of the following descriptions concerning the injection site for the anterior middle superior alveolar local anesthetic nerve block is CORRECT?
a. Approximately midway between the median palatine raphe and the palatal gingival margin of the maxillary premolars
b. Approximately10 mm medial and directly superior to the palatal gingival margin of the maxillary third molar, anterior to the depression of the greater palatine foramen
c. At the height of the mucobuccal fold at the apex of the maxillary canine
d. At the height of the mucobuccal fold at the apex of the maxillary first premolar

 

 

ANS:   A

 

  Feedback
A This injection site of approximately midway between the median palatine raphe and the palatal gingival margin of the maxillary premolars will allow penetration of the local anesthetic agent through the small pores of the maxilla of the hard palate, thus reaching the anterior to middle part of the superior dental nerve plexus.
B This is the injection site for the greater palatine nerve block.
C This is the injection site for the anterior superior alveolar nerve block.
D This is the injection site for the middle superior alveolar nerve block.

 

 

DIF:    Comprehension                                  REF:    p. 223              OBJ:    3 | 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

 

  1. Which of the following local anesthetic nerve blocks when administered together would provide the GREATEST area of anesthesia to a maxillary quadrant?
a. Anterior superior alveolar, posterior superior alveolar, and greater palatine nerve blocks
b. Middle superior alveolar and greater palatine nerve blocks
c. Middle superior alveolar, posterior superior alveolar, and greater palatine nerve blocks
d. Anterior middle superior alveolar and posterior superior alveolar nerve blocks

 

 

ANS:   D

 

  Feedback
A The palatal tissue of the maxillary anteriors would NOT be anesthetized as well as the maxillary premolars if the middle superior alveolar nerve is present but is NOT being anesthetized.
B The pulp tissue of the maxillary anterior and posterior teeth, along with their associated facial tissue, would NOT be anesthetized.
C The pulp tissue of the maxillary anterior teeth and associated palatal tissue would NOT be anesthetized.
D Both the anterior middle superior alveolar and posterior superior alveolar nerve blocks when administered together will anesthetize the pulp tissue of the teeth and associated facial tissue, as well as the relevant palatal tissue thus providing the greatest area of anesthesia to the maxillary quadrant. However, this protocol is NOT without its possible setbacks due to the need for large amount of agent, slow onset, and rapid removal of anesthesia with the anterior middle superior alveolar block. In addition, the block does not provide a high enough level of hemostatic control.

 

 

DIF:    Application     REF:    pp. 211, 221    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

 

  1. Before periodontal scaling near the periodontal tissue clefting present on the facial surface of ALL the mandibular incisors of a patient, which local anesthetic block(s) would be the BEST to have administered bilaterally?
a. Infraorbital block
b. Incisive block
c. Mental block
d. Inferior alveolar block

 

 

ANS:   B

 

  Feedback
A The infraorbital block provides anesthesia for the maxillary anteriors and premolars, both pulpal and for the associated facial periodontium, and can be used bilaterally without complications but does NOT provide anesthesia for the mandibular incisors.
B The incisive block provides anesthesia for the mandibular anteriors and premolars, both pulpal and for the associated facial periodontium that would involve the periodontal tissue clefting, and can be used bilaterally without complications.
C The mental block provides anesthesia for the mandibular anteriors and premolars but only for the associated facial periodontium, and it can be used bilaterally without complications. However, it does NOT provide pulpal anesthesia for the mandibular incisors that may be sensitive to periodontal scaling.
D The inferior alveolar block provides anesthesia for the pulp tissue of ALL the mandibular teeth as well as for the associated facial periodontium of the mandibular anteriors and premolars, but it is NOT recommended to use bilaterally due to complications with swallowing.

 

 

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, 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

 

  1. Which local anesthetic nerve block would be necessary for a patient undergoing oral surgery on an edentulous left mandibular alveolar process in the area of the extracted molars?
a. Left buccal nerve block
b. Right buccal nerve block
c. Left mental nerve block
d. Right infraorbital nerve block

 

 

ANS:   A

 

  Feedback
A The left buccal nerve block anesthetizes the buccal gingival tissue of alveolar process in the area of the extracted mandibular molars.
B The right incisive nerve block anesthetizes ONLY the contralateral side of the alveolar process of the mandible.
C The left mental nerve block would anesthetize the facial gingival tissue of the alveolar process in the area of mandibular premolars and anterior teeth but NOT the edentulous area of the extracted mandibular molars.
D The infraorbital nerve block is used ONLY for maxillary arch anesthesia.

 

 

DIF:    Application     REF:    pp. 230-231    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

 

  1. A restoration will be placed on the occlusal surface of the maxillary first premolar, but no rubber dam will be used. However, which of the following local anesthetic nerve blocks MUST be administered?
a. Anterior superior alveolar nerve block
b. Middle superior alveolar nerve block
c. Greater palatine nerve block
d. Inferior alveolar nerve block

 

 

ANS:   B

 

  Feedback
A The anterior superior alveolar nerve block will provide pulpal anesthesia to the maxillary canine and maxillary incisors but NOT the maxillary first premolar.
B The middle superior alveolar nerve block provides pulpal anesthesia to the maxillary premolars as well as the mesiobuccal root of the maxillary molar.
C The greater palatine nerve block does NOT provide pulpal anesthesia but ONLY palatal anesthesia to the maxillary first premolar.
D The inferior alveolar nerve block is used for mandibular arch, NOT maxillary arch.

 

 

DIF:    Application     REF:    pp. 213-214    OBJ:    3

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

 

  1. Which of the following local anesthetic nerve blocks anesthetizes the buccal gingival tissue of the maxillary first molar?
a. Infraorbital nerve block
b. Anterior superior alveolar nerve block
c. Buccal nerve block
d. Posterior superior alveolar nerve block

 

 

ANS:   D

 

  Feedback
A The infraorbital nerve block anesthetizes the maxillary incisors, canines, and premolars.
B The anterior superior alveolar nerve block anesthetizes maxillary anterior teeth.
C The buccal nerve block anesthetizes buccal gingival tissue of the mandibular molars.
D The buccal gingival tissue of maxillary molars is anesthetized by the posterior superior alveolar nerve block.

 

 

DIF:    Recall              REF:    pp. 211-212    OBJ:    5

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

 

  1. Which of the following complications can result from a greater palatine local anesthetic nerve block?
a. Cheek bite by patient
b. Anesthesia of the upper lip
c. Stimulation of the gag reflex
d. Hematoma in the infratemporal fossa

 

 

ANS:   C

 

  Feedback
A The greater palatine nerve block is administered on the palate and does NOT anesthetize the cheeks.
B The greater palatine nerve block is administered on the palate and does NOT anesthetize the upper lip.
C Stimulation of the gag reflex is a distinct possibility because of the proximity of the greater palatine nerve block to the lesser palatine nerve that may inadvertently anesthetize the soft palate.
D The greater palatine nerve block is administered on the palate and does NOT anesthetize the infratemporal fossa to allow for trauma that would induce a hematoma.

 

 

DIF:    Comprehension                                  REF:    p. 220              OBJ:    6

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

 

  1. Which of the following angulations of the needle MUST be followed during the administration of the posterior superior local anesthetic nerve block?
a. Superiorly at approximately 45 degrees and medially at approximately 90 degrees to the occlusal plane
b. Superiorly at approximately 90 degrees and medially at approximately 45 degrees to the occlusal plane
c. Superiorly at approximately 45 degrees and medially parallel to the occlusal plane
d. Superiorly at approximately 45 degrees and medially at approximately 45 degrees to the occlusal plane

 

 

ANS:   D

 

  Feedback
A The needle should NOT be at a 90-degree angle medially to the occlusal plane.
B The needle should NOT be at an approximately 90-degree angle superiorly to the occlusal plane.
C The needle should NOT be parallel to the occlusal plane.
D Both the superior and medial angulation of the needle to the injection site will be at an angle of approximately 45 degrees to the occlusal plane.

 

 

DIF:    Recall              REF:    p. 212              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

 

  1. Which of the following locations is the BEST injection site for the inferior alveolar local anesthetic nerve block?
a. Medial to the pterygomandibular fold
b. Lateral to the pterygomandibular fold
c. Superior to the pterygomandibular fold
d. Inferior to the pterygomandibular fold

 

 

ANS:   B

 

  Feedback
A The needle will NOT be in the pterygomandibular space lateral to the sphenomandibular ligament for the injection site if inserted medial to the pterygomandibular fold.
B Finding the pterygomandibular fold helps determine the anteroposterior positioning for needle insertion, which will be in the most posterior part of the pterygomandibular space when lateral to the pterygomandibular fold.
C Positioning the needle too high from being superior to the pterygomandibular fold will NOT ensure deposition of the local anesthetic agent in the CORRECT needle insertion site to achieve anesthesia.
D Positioning the needle too low from being inferior to the pterygomandibular fold will NOT ensure deposition of the local anesthetic agent in the CORRECT needle insertion site to achieve anesthesia.

 

 

DIF:    Application     REF:    pp. 225-227    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

 

  1. When administering the inferior alveolar local anesthetic nerve block, it is important to contact bony medial surface of the mandibular ramus because this will decrease the risk of depositing a local anesthetic agent into the parotid salivary gland.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but NOT related.
c. The statement is correct, but the reason is NOT.
d. The statement is NOT correct, but the reason is correct.
e. NEITHER the statement NOR the reason is correct.

 

 

ANS:   A

 

  Feedback
A It is important to contact bony medial surface of the mandibular ramus to prevent too posterior of a penetration, which might result in deposition of local anesthetic agent into the parotid salivary gland, causing complications such as transient facial paralysis.
B It is important to contact bony medial surface of the mandibular ramus to prevent too posterior of a penetration, which might result in deposition of local anesthetic agent into the parotid salivary gland, causing complications such as transient facial paralysis.
C It is important to contact bony medial surface of the mandibular ramus to prevent too posterior of a penetration, which might result in deposition of local anesthetic agent into the parotid salivary gland, causing complications such as transient facial paralysis.
D It is important to contact bony medial surface of the mandibular ramus to prevent too posterior of a penetration, which might result in deposition of local anesthetic agent into the parotid salivary gland, causing complications such as transient facial paralysis.
E It is important to contact bony medial surface of the mandibular ramus to prevent too posterior of a penetration, which might result in deposition of local anesthetic agent into the parotid salivary gland, causing complications such as transient facial paralysis.

 

 

DIF:    Application     REF:    p. 227              OBJ:    3

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

 

  1. A 9-year-old child is having a restoration placed on the occlusal surface of the mandibular left first molar. Which of the following heights of the inferior alveolar local anesthetic nerve block injection sites should be followed during the pain control procedure?
a. Approximately 6 to 10 mm superior to the occlusal plane of the mandibular molars
b. Slightly inferior to the occlusal plane of the mandibular molars
c. At the same height as the occlusal plane of the mandibular molars
d. More than approximately 10 mm superior to the occlusal plane of the mandibular molars

 

 

ANS:   C

 

  Feedback
A This is the height for the injection site for inferior alveolar nerve block when it is administered to adults.
B An injection site’s height being inferior to the occlusal plane would NOT deposit the local anesthetic agent superior enough to anesthetize the inferior alveolar nerve.
C The height of the injection site is NOT as superior in children and even small adults due to the length of the mandibular ramus. The injection site should be the same height as the occlusal plane of the mandibular molars.
D Using a placement of approximately10 mm superior to the occlusal plane for the height of the injection site would be too superior for children and even for most average-sized adults.

 

 

DIF:    Application     REF:    p. 225              OBJ:    3

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

 

  1. Which of the following ligaments can act as a barrier to the inferior alveolar nerve block if mandibular bone is NOT contacted during the injection?
a. Sphenomandibular ligament
b. Temporomandibular ligament
c. Stylomandibular ligament
d. Anterior cruciate ligament

 

 

ANS:   A

 

  Feedback
A The sphenomandibular ligament can act as a barrier to the inferior alveolar nerve block if mandibular bone is NOT contacted during the injection since it runs from the angular spine of the sphenoid bone to the lingula of the mandibular foramen on the medial aspect of the mandible.
B The temporomandibular ligament is the major ligament for the temporomandibular joint but does NOT act as a barrier during the inferior alveolar nerve block.
C The stylomandibular ligament runs from the styloid process of the temporal bone to the angle of the mandible and separates the parotid and submandibular salivary glands but does NOT act as a barrier during the inferior alveolar nerve block.
D The anterior cruciate ligament (ACL) is one of the most important of four strong ligaments connecting the bones of the knee joint and can become injured.

 

 

DIF:    Comprehension                                  REF:    p. 230              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

 

  1. Which of the following complications can occur during an incorrect administration of the inferior alveolar local anesthetic nerve block, resulting in inability to close the eyelid?
a. Motor function of the abducens nerve
b. Motor function of the facial nerve
c. Motor function of the oculomotor nerve
d. Sensory function of the facial nerve

 

 

ANS:   B

 

  Feedback
A The abducens nerve is NOT in the area of the inferior alveolar nerve block and affects movement of the eye, NOT the eyelid.
B The facial nerve provides motor innervation to the muscles of facial expression and can result in the inability to close the eyelid with an incorrect administration of the inferior alveolar nerve block. This can occur with a deeper injection into the parotid salivary gland that contains the facial nerve, causing temporary anesthesia of the nerve and its related structures. This is considered transient facial paralysis. To prevent this complication, the needle needs to contact the medial surface of the mandibular ramus.
C The oculomotor nerve affects movement of the eye, NOT the eyelid.
D The sensory part of the facial nerve does NOT move the eyelid.

 

 

DIF:    Application     REF:    p. 230              OBJ:    6

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

 

  1. Which of the following local anesthetic nerve blocks can be involved in the spread of infection to the cavernous sinus?
a. Anterior superior alveolar nerve block
b. Inferior alveolar nerve block
c. Posterior superior alveolar nerve block
d. Infraorbital nerve block

 

 

ANS:   C

 

  Feedback
A There is less risk of spread of infection to the cavernous sinus with the anterior superior alveolar nerve block than with the posterior superior alveolar nerve block.
B There is less risk of spread of infection to the cavernous sinus with the inferior alveolar nerve block than with the posterior superior alveolar nerve block.
C The posterior superior alveolar nerve block is administered close to the pterygoid plexus of veins, which communicate with the cavernous sinus. If the needle becomes contaminated, this increases the risk for infection in the area, which can then spread.
D There is less risk of spread of infection to the cavernous sinus with the infraorbital nerve block than with the posterior superior alveolar nerve block.

 

 

DIF:    Comprehension                                  REF:    pp. 212-213     OBJ:    6

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

 

  1. Which of the following local anesthetic nerve blocks MAINLY uses an extraoral landmark on the face when locating the injection site?
a. Inferior alveolar nerve block
b. Infraorbital nerve block
c. Posterior superior alveolar nerve block
d. Mental nerve block

 

 

ANS:   B

 

  Feedback
A The inferior alveolar nerve block is administered at the mandibular foramen on the medial surface of the mandibular ramus. The coronoid notch is used to help locate the injection site and can be palpated intraorally.
B Palpation of the infraorbital rim on the facial surface is used to help locate the infraorbital foramen for the infraorbital nerve block; thus, an extraoral landmark of the face is used when locating the injection site. In addition, extraoral pressure is applied to the infraorbital foramen during the injection.
C It is NOT necessary to palpate any extraoral structure to administer the posterior superior alveolar nerve block.
D It is NOT necessary to palpate any extraoral structure to administer the mental nerve block. Instead, the mental foramen is palpated intraorally.

 

 

DIF:    Comprehension                                  REF:    p. 217              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

 

  1. There MUST never be an injection through an area with an abscess, cellulitis, or osteomyelitis so as to prevent the spread of dental infection.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but NOT related.
c. The statement is correct, but the reason is NOT.
d. The statement is NOT correct, but the reason is correct.
e. NEITHER the statement NOR the reason is correct.

 

 

ANS:   A

 

  Feedback
A Both the statement and the reason are correct and related. There MUST never be an injection through an area with an abscess, cellulitis, or osteomyelitis so as to prevent the spread of dental infection; this is considered a needle tract infection.
B Both the statement and the reason are correct and related. There MUST never be an injection through an area with an abscess, cellulitis, or osteomyelitis so as to prevent the spread of dental infection; this is considered a needle tract infection.
C Both the statement and the reason are correct and related. There MUST never be an injection through an area with an abscess, cellulitis, or osteomyelitis so as to prevent the spread of dental infection; this is considered a needle tract infection.
D Both the statement and the reason are correct and related. There MUST never be an injection through an area with an abscess, cellulitis, or osteomyelitis so as to prevent the spread of dental infection; this is considered a needle tract infection.
E Both the statement and the reason are correct and related. There MUST never be an injection through an area with an abscess, cellulitis, or osteomyelitis so as to prevent the spread of dental infection; this is considered a needle tract infection.

 

 

DIF:    Comprehension                                  REF:    p. 210              OBJ:    6

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

 

  1. Less variation exists in the anatomy of the maxillae and palatine bones and associated nerves with respect to local anesthetic landmarks as compared with similar mandibular structures, making the maxillary injections less routine and usually with the need for any troubleshooting of failure cases.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but NOT related.
c. The statement is correct, but the reason is NOT.
d. The statement is NOT correct, but the reason is correct.
e. NEITHER the statement NOR the reason is correct.

 

 

ANS:   C

 

  Feedback
A The statement is NOT correct, but the reason is correct. Less variation exists in the anatomy of the maxillae and palatine bones and associated nerves with respect to local anesthetic landmarks as compared with similar mandibular structures, making the maxillary injections MORE routine and usually without the need for troubleshooting of failure cases.
B The statement is NOT correct, but the reason is correct. Less variation exists in the anatomy of the maxillae and palatine bones and associated nerves with respect to local anesthetic landmarks as compared with similar mandibular structures, making the maxillary injections MORE routine and usually without the need for troubleshooting of failure cases.
C The statement is NOT correct, but the reason is correct. Less variation exists in the anatomy of the maxillae and palatine bones and associated nerves with respect to local anesthetic landmarks as compared with similar mandibular structures, making the maxillary injections MORE routine and usually without the need for troubleshooting of failure cases.
D The statement is NOT correct, but the reason is correct. Less variation exists in the anatomy of the maxillae and palatine bones and associated nerves with respect to local anesthetic landmarks as compared with similar mandibular structures, making the maxillary injections MORE routine and usually without the need for troubleshooting of failure cases.
E The statement is NOT correct, but the reason is correct. Less variation exists in the anatomy of the maxillae and palatine bones and associated nerves with respect to local anesthetic landmarks as compared with similar mandibular structures, making the maxillary injections MORE routine and usually without the need for troubleshooting of failure cases.

 

 

DIF:    Comprehension                                  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, 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

 

  1. Palatal anesthesia usually involves anesthesia of the soft and hard tissue of the periodontium of the palatal area such as the gingival tissue, periodontal ligament, and alveolar process. Palatal anesthesia usually does NOT provide any pulpal anesthesia to the maxillary teeth or associated facial or buccal gingival tissue.
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 Both statements are true. Palatal anesthesia usually involves anesthesia of the soft and hard tissue of the periodontium of the palatal area such as the gingival tissue, periodontal ligament, and alveolar process. Palatal anesthesia usually does NOT provide any pulpal anesthesia to the maxillary teeth or associated facial or buccal gingival tissue.
B Both statements are true. Palatal anesthesia usually involves anesthesia of the soft and hard tissue of the periodontium of the palatal area such as the gingival tissue, periodontal ligament, and alveolar process. Palatal anesthesia usually does NOT provide any pulpal anesthesia to the maxillary teeth or associated facial or buccal gingival tissue.
C Both statements are true. Palatal anesthesia usually involves anesthesia of the soft and hard tissue of the periodontium of the palatal area such as the gingival tissue, periodontal ligament, and alveolar process. Palatal anesthesia usually does NOT provide any pulpal anesthesia to the maxillary teeth or associated facial or buccal gingival tissue.
D Both statements are true. Palatal anesthesia usually involves anesthesia of the soft and hard tissue of the periodontium of the palatal area such as the gingival tissue, periodontal ligament, and alveolar process. Palatal anesthesia usually does NOT provide any pulpal anesthesia to the maxillary teeth or associated facial or buccal gingival tissue.

 

 

DIF:    Recall              REF:    p. 211              OBJ:    5

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

 

  1. The dental professional MUST know the location of certain adjacent soft tissue structures, such as major blood vessels and glandular tissueRemember, as to make sure to allow for injecting these structures.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but NOT related.
c. The statement is correct, but the reason is NOT.
d. The statement is NOT correct, but the reason is correct.
e. NEITHER the statement NOR the reason is correct.

 

 

ANS:   C

 

  Feedback
A The statement is correct, but the reason is NOT. The dental professional MUST know the location of certain adjacent soft tissue structures, such as major blood vessels and glandular tissueRemember, as to make sure to avoid inadvertently injecting these structures and causing complications.
B The statement is correct, but the reason is NOT. The dental professional MUST know the location of certain adjacent soft tissue structures, such as major blood vessels and glandular tissueRemember, as to make sure to avoid inadvertently injecting these structures and causing complications.
C The statement is correct, but the reason is NOT. The dental professional MUST know the location of certain adjacent soft tissue structures, such as major blood vessels and glandular tissueRemember, as to make sure to avoid inadvertently injecting these structures and causing complications.
D The statement is correct, but the reason is NOT. The dental professional MUST know the location of certain adjacent soft tissue structures, such as major blood vessels and glandular tissueRemember, as to make sure to avoid inadvertently injecting these structures and causing complications.
E The statement is correct, but the reason is NOT. The dental professional MUST know the location of certain adjacent soft tissue structures, such as major blood vessels and glandular tissueRemember, as to make sure to avoid inadvertently injecting these structures and causing complications.

 

 

DIF:    Comprehension                                  REF:    p. 204              OBJ:    5

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

 

  1. There is ONLY one type of local anesthetic injection used commonly in dentistry, the nerve block. The type of injection used for a given dental procedure is determined by the type and length of the procedure.
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:   D

 

  Feedback
A The first statement is false; the second is true. There are two types of local anesthetic injections used commonly in dentistry: supraperiosteal injection and nerve block. The type of injection used for a given dental procedure is determined by the type and length of the procedure.
B The first statement is false; the second is true. There are two types of local anesthetic injections used commonly in dentistry: supraperiosteal injection and nerve block. The type of injection used for a given dental procedure is determined by the type and length of the procedure.
C The first statement is false; the second is true. There are two types of local anesthetic injections used commonly in dentistry: supraperiosteal injection and nerve block. The type of injection used for a given dental procedure is determined by the type and length of the procedure.
D The first statement is false; the second is true. There are two types of local anesthetic injections used commonly in dentistry: supraperiosteal injection and nerve block. The type of injection used for a given dental procedure is determined by the type and length of the procedure.

 

 

DIF:    Comprehension                                  REF:    p. 204              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

 

  1. Which of the following statements can be CORRECTLY used when discussing the “lingual shock” some patients may experience when administering an inferior alveolar local anesthetic block?
a. Occurs when the needle passes by the mylohyoid nerve
b. Patient may make involuntary movements
c. Reactions only include a slight opening of the eyes
d. Reactions made by the patient continue until anesthesia wears off

 

 

ANS:   B

 

  Feedback
A The “lingual shock” occurs when the needle passes by the lingual nerve and NOT the mylohyoid nerve during administration of the inferior alveolar block.
B The “lingual shock” occurs when the needle passes by the lingual nerve during administration of the inferior alveolar block. The patient may make an involuntary movement, varying from a slight opening of the eyes to jumping in the chair. This reaction is only momentary, and anesthesia will quickly occur.
C The patient may make an involuntary movement, such as a slight opening of the eyes, but also may involve jumping in the chair. However, this reaction is only momentary and will NOT continue, and anesthesia will quickly occur.
D The patient may make an involuntary movement, such as a slight opening of the eyes, but also may involve jumping in the chair. However, this reaction is only momentary and will NOT continue, and anesthesia will quickly occur.

 

 

DIF:    Comprehension                                  REF:    p. 230              OBJ:    6

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

 

MULTIPLE RESPONSE

 

  1. From the following list, select those that are anatomic factors involved in providing MORE clinically effective maxillary arch anesthesia than mandibular arch anesthesia. (Select all that apply.)
a. Thinner facial cortical plate over teeth
b. Less variation exists in anatomy
c. More variation exists in anatomy
d. Thicker facial cortical plate over teeth

 

 

ANS:   A, B

 

  Feedback
Correct MORE clinically effective maxillary arch anesthesia involves thinner facial cortical plate over teeth, and less variation exists in anatomy making it MORE clinically effective than mandibular arch anesthesia.
Incorrect MORE clinically effective maxillary arch anesthesia involves thinner facial cortical plate over teeth, and less variation exists in anatomy making it MORE clinically effective than mandibular arch anesthesia.

 

 

DIF:    Comprehension                                  REF:    pp. 210-211     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

 

  1. From the following list of complications involving the eyelid, nose, and upper lip, select the MOST common ones associated with the infraorbital nerve block. (Select all that apply.)
a. Hematoma
b. Stimulation of the gag reflex
c. Tingling
d. Numbness

 

 

ANS:   C, D

 

  Feedback
Correct The most common complications noted with the infraorbital block are tingling and numbness of the eyelid, nose, and upper lip; there is rarely hematoma of the eyelid, nose, and upper lip.
Incorrect The most common complications noted with the infraorbital block are tingling and numbness of the eyelid, nose, and upper lip; there is rarely hematoma of the eyelid, nose, and upper lip.

 

 

DIF:    Comprehension                                  REF:    p. 218              OBJ:    6

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

 

  1. From the following list, select those statements that can be used CORRECTLY when discussing paresthesia from the administration of local anesthesia and its progression over time. (Select all that apply.)
a. Possibly abnormal area sensation
b. Possible burning or prickling
c. Usually occurs with infections
d. Usually occurs with nonsurgical procedures

 

 

ANS:   A, B, C

 

  Feedback
Correct The following can be used to describe paresthesia and its progression: possible abnormal area sensation, burning or prickling; it usually occurs with infections as well as oral surgical procedures.
Incorrect Paresthesia does NOT usually occur with nonsurgical oral procedures such as periodontal scaling but with oral surgical procedures such as the removal of impacted mandibular third molars.

 

 

DIF:    Recall              REF:    p. 230              OBJ:    6

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

 

  1. From the following list of oral cavity landmarks, select those that need to be noted before administering a clinically effective inferior alveolar nerve block. (Select all that apply.)
a. Occlusal plane
b. Maxillary tuberosity
c. Pterygomandibular fold
d. Coronoid notch
e. Mandibular notch

 

 

ANS:   A, C, D

 

  Feedback
Correct The occlusal plane, pterygomandibular fold, and coronoid notch are ALL landmarks for the administration of the inferior alveolar nerve block.
Incorrect The maxillary tuberosity is a landmark for the administration of the posterior superior alveolar nerve block and NOT the inferior alveolar nerve block. The mandibular notch is NOT a landmark for the administration of the inferior alveolar nerve block.

 

 

DIF:    Recall              REF:    p. 225              OBJ:    3

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

 

  1. From the following list of oral cavity landmarks, select those that need to be noted before administering a clinically effective posterior superior alveolar nerve block. (Select all that apply.)
a. Mucobuccal fold
b. Coronoid notch
c. Maxillary first molar
d. Maxillary tuberosity

 

 

ANS:   A, D

 

  Feedback
Correct The height of the mucobuccal fold and the maxillary tuberosity are landmarks for the administration of the posterior superior alveolar nerve block.
Incorrect The coronoid notch is a landmark for the administration of the inferior alveolar nerve block. The maxillary first molar is usually NOT a landmark for any maxillary nerve anesthesia, but the maxillary second molar is a landmark for the administration of the posterior superior alveolar nerve block.

 

 

DIF:    Recall              REF:    p. 212              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

 

  1. Which of the following local anesthesia nerve blocks would benefit from using a topical anesthetic-laced long cotton tip applicator to palpate the injection site as if it were the needle and syringe? (Select all that apply.)
a. Posterior superior alveolar block
b. Inferior superior alveolar block
c. Greater palatine block
d. Nasopalatine block

 

 

ANS:   A, B, C, D

The sometimes-complex orientation for ALL local anesthetic nerve blocks can be practiced using a topical anesthetic-laced long cotton tip applicator to palpate the injection site as if it were the needle and syringe.

 

DIF:    Application     REF:    pp. 212, 223-224, 229                        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

 

  1. When troubleshooting incomplete anesthesia following an inferior alveolar local anesthetic nerve block on a patient, the clinician notes a doubled mandibular canal on an intraoral radiograph. What is present with this patient, and how can clinically effective anesthesia be achieved? (Select all that apply.)
a. More superiorly placed second mandibular foramen exists.
b. More inferiorly placed second mandibular foramen exists.
c. The local anesthetic agent needs to be deposited more inferiorly to the usual anatomic landmarks.
d. The local anesthetic agent needs to be deposited more superiorly to the usual anatomic landmarks.

 

 

ANS:   B, C

 

  Feedback
Correct Incomplete anesthesia following an inferior alveolar block may be due to a bifid inferior alveolar nerve, which can be detected by noting a doubled mandibular canal on an intraoral radiograph. In many such cases a second mandibular foramen, MORE inferiorly placed, exists. To correct this, the local anesthetic agent is deposited MORE inferiorly to the usual anatomic landmarks for the target area of the inferior alveolar block.
Incorrect Incomplete anesthesia following an inferior alveolar block may be due to a bifid inferior alveolar nerve, which can be detected by noting a doubled mandibular canal on an intraoral radiograph. In many such cases a second mandibular foramen, more inferiorly placed and NOT superiorly placed, exists. To correct this, the local anesthetic agent is deposited more inferiorly and NOT superiorly to the usual anatomic landmarks for the target area of the inferior alveolar block.

 

 

DIF:    Application     REF:    p. 230              OBJ:    6

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, 2.0 Obtaining and Interpreting Radiographs | 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

 

  1. Which of the following procedures may allow for LESS discomfort when anesthetizing the palate of a patient with the anterior middle superior alveolar block? (Select all that apply.)
a. Topical anesthetic
b. Pressure anesthesia
c. Computer-controlled local anesthetic delivery device
d. Bidirectional rotation needle insertion technique
e. Prepuncture technique with needle bevel

 

 

ANS:   A, B, C, D, E

To allow for less discomfort when anesthetizing the palate of a patient anterior middle superior alveolar block, topical anesthetic, pressure anesthesia, computer-controlled local anesthetic delivery device may be used. In addition, the techniques of bidirectional rotation needle insertion and prepuncture with the needle may be also used.

 

DIF:    Comprehension                                  REF:    pp. 223-224     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

 

  1. Which of the following are included in the linear relationship noted on the face that can assist with the CORRECT administration of the infraorbital block? (Select all that apply.)
a. Ipsilateral supraorbital notch
b. Pupil of the eye looking forward
c. Midpoint of the infraorbital notch
d. Posterior superior alveolar foramina
e. Philtrum near the upper lip

 

 

ANS:   A, B, C

 

  Feedback
Correct There is also a linear relationship noted on the face that can assist with the infraorbital block between the ipsilateral supraorbital notch, pupil of the eye looking forward, midpoint of the infraorbital rim with its zygomaticomaxillary suture, infraorbital foramen, and labial commissure.
Incorrect There is also a linear relationship noted on the face that can assist with the infraorbital block between the ipsilateral supraorbital notch, pupil of the eye looking forward, midpoint of the infraorbital rim with its zygomaticomaxillary suture and NOT midline median palatine suture, infraorbital foramen and NOT the posterior superior alveolar foramina, and labial commissure and NOT the midline philtrum near the upper lip.

 

 

DIF:    Recall              REF:    p. 217              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

 

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