Dental Hygiene Local Anesthesia Board Review
Exam Answers.
1. Describe the polarization of a nerve cell: - ANS at rest, inside of a cell is slightly
(-) charged and outside is lightly (+) charged. (70 mv) difference.
2. Describe the depolarization of a nerve cell: - ANS when there is an influx of Na+
ions and it causes the cell to become depolarized with a (+) charge.
3. Describe the repolarization of a nerve cell: - ANS begins immediately after
depolarization with potassium (+) ions leaving the cell in order to restore
equilibrium.
4. Militated nerves conduct impulses _________ with ________ energy. - ANS
faster; less
5. What do the nodes of Ranvier on militated nerves allow for? - ANS the passage
of local anesthesia into the nerve cell.
6. What is the primary action of local anesthetics? - ANS to block pain
perception/transmission by decreasing permeability of sodium ions.
7. Where does the biotransformation of esters occur? - ANS in the pseudo
cholinesterase of blood plasma and is then excreted by the kidneys.
8. Where does the biotransformation of amides occur? - ANS in the liver and is then
excreted by the kidneys.
9. Which local anesthetic type is less likely to admit an allergic reaction? - ANS
amides
10. ___________ are readily hydrolyzed in aqueous solutions, and _____________
are resistant to hydrolysis in aqueous solutions. - ANS esters; amides
11. What is the first sensation that is lost with local anesthetics? - ANS pain
12. What is the function of sodium chloride in local anesthetics? - ANS to maintain an
isotonic solution
13. What happens when there is infection in the area of an injection? - ANS because
of its low pH, local anesthetic is less effective.
14. What is the most commonly used local anesthesia without a vasoconstrictor? -
ANS carbocation 3%
, 15. What is the safe does of a vasoconstrictor in a healthy patient? - ANS .2 mg
16. What is the safe does of a vasoconstrictor for a cardiac compromised patient? -
ANS .04 mg
17. What is the advantage of using a vasoconstrictor in local anesthetic? - ANS they
significantly delay absorption and removal of the local anesthetic solution thus
they provide a much longer time for the completion of a procedure.
18. What is used as a preservative for epinephrine in local anesthetics? - ANS
sodium bisulfite
19. How much epinephrine does a carpooled of 1/100,000 contain? With this
information, what is the cardiac patient limit based on how much epinephrine is in
each carpooled? - ANS .018 mg; two carpels of 1/100,000 because 2 x .018
= .036 mg
20. Adrenalin (epinephrine) is naturally found in the body. Where is it produced? -
ANS the adrenal glands
21. When should epinephrine not be used? - ANS in a cocaine addict
22. Where are topical local anesthetics not effective? - ANS on keratinized tissue
23. How far does topical anesthetic penetrate mucous membrane? - ANS 2-3 mm
24. What should we limit the placement of a 20% lidocaine patch to? - ANS 15
minutes
25. What are some examples of amide agents? - ANS topical lidocaine, bupivacaine,
mepivocaine (carbocation)
26. What are some examples of ester agents? - ANS topical benzocaine, topical
tetracainehypochloride, procaine, and procaine.
27. What are the only ester injectable local anesthetics? - ANS procaine and
lidocaine
28. Example of a safe topical anesthetic: - ANS benzocaine (ester)
29. How long should you apply topical anesthetic to non-keratinized tissue? - ANS at
least 30 seconds
30. What should be avoided when sanitizing the injection site as well as contact with
local anesthetic cartridges? - ANS alcohol
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