LOCAL ANESTHESIA OSCE EXAM QUESTIONS AND ANSWERS
2025 #12
1. Where does the mandibular nerve pass through the skull?: Foramen Ovale
2. What is the length of the long needle?: 32 mm
3. What is the length of the short needle?: 20 mm
4. Which anesthetic has the highest occurrence of allergic reactions?: Ester local anesthetics are
associated with higher incidence of allergic reactions due to one of their metabolites para-
amino benzoic acid (PABA)
5. What color is the 25 gauge needle?: red
6. What color is the 27 gauge needle?: yellow
7. What color is the 30 gauge needle?: blue
8. Where does the nasopalatine nerve pass through the skull?: Incisive Fora- men
9. Is the maxillary division of the trigeminal nerve sensor, motor, or both?: -
Sensory
10.Is the mandibular division of the trigeminal nerve sensor, motor, or both?-
: Both sensory and motor
11.Which nerve is NOT associated with the mandibular nerve branch?: infra- orbital
12.What does the PSA innervate?: 1st, 2nd, and 3rd maxillary molars
13.What is most likely not going to be innervated by PSA?: Mesiobuccal root of the maxillary 1 st
molar
14.What injection needed to anesthetize the lingual of maxillary anteriors?: -
Nasopalatine
15.What injections needed to anesthetize the entire palate on one side?: -
Greater palatine and nasopalatine
16.How far do you insert the needle on an IANB?: 20-25mm or 3/4 the length of the needle
17.What happens during depolarization?: sodium flows in potassium
flows out
18.When do you aspirate?: You should aspirate right before the anesthetic is to be deposited.
19.Why aspirate ?: To ensure that the local anesthetic is not deposited into a blood vessel.
20.What should you do if you aspirate blood?: Remove needle without deposit- ing the
anesthetic. Deposited anesthetic and
Needle into appropriate area....and Try again.
21.Which local anesthetic is metabolized by pseudocholinesterase in the plasma?: esters
22.Topical anesthetics are least effective on what type of tissues?: keratinized tissues
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, 23.True/False
Topical anesthetics cause no systemic problems.: TRUE
24.Which anesthetic has the highest occurrence of allergic reactions?: Esters (Benzocaine)
25.What anesthetic is the safest to use in children?: Lidocaine
26.Which local anesthetic has one ester chain?: articaine (metabolized in both liver and blood
plasma)
27.What is the significance of giving an amide anesthetic to a patient with cirrhosis (scarring of the
liver)?: Amide anesthetics are metabolized in the liver
28.What is the landmark for the IANB injection?: Coronoid notch and pterygo- mandibular raphe
29.What is psychogenic pain: physical cause for pain cannot be identified
30.What is the maximum epinephrine dose for a cardiac patient?: 0.04 mg for cardiac patient
31.In a 1:50,000 solution how many cartridges can you give an ASA I/II patient?: 5
cartridges
32.In a 1:50,000 solution how many cartridges can you give an ASA III/IV patient?: 1 cartridge
33.In a 1:100,000 solution how many cartridges can you give an ASA I/II patient?: 11
cartridges **** on test
34.In a 1:100,000 solution how many cartridges can you give an ASA III/IV patient?: 2 cartridges
35.In a 1:200,000 solution how many cartridges can you give an ASA I/II patient?: 22
cartridges
36.In a 1:200,000 solution how many cartridges can you give an ASA III/IV patient?: 4 cartridges
37.What is the maximum epinephrine dose for a normal, healthy patient?: 0.2 healthy patient
38.What is trismus ?: Trismus (Lockjaw) is limited/restricted of the range of motion within the
jaws.
39.How do you manage trismus?: This condition can best be managed is to massage and
exercise the jaw muscles
With the application of heat to the areas. You can take muscle relaxants, pain reliever, or anti-
inflammatory medications.
40.How should you manage a hematoma immediately after it occurs?: Apply cold compress and
pressure to the bleeding site.
41.Hematoma can occur if a needle penetrates the of veins during
which injection?: pterygoid plexus during PSA injection
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7
2025 #12
1. Where does the mandibular nerve pass through the skull?: Foramen Ovale
2. What is the length of the long needle?: 32 mm
3. What is the length of the short needle?: 20 mm
4. Which anesthetic has the highest occurrence of allergic reactions?: Ester local anesthetics are
associated with higher incidence of allergic reactions due to one of their metabolites para-
amino benzoic acid (PABA)
5. What color is the 25 gauge needle?: red
6. What color is the 27 gauge needle?: yellow
7. What color is the 30 gauge needle?: blue
8. Where does the nasopalatine nerve pass through the skull?: Incisive Fora- men
9. Is the maxillary division of the trigeminal nerve sensor, motor, or both?: -
Sensory
10.Is the mandibular division of the trigeminal nerve sensor, motor, or both?-
: Both sensory and motor
11.Which nerve is NOT associated with the mandibular nerve branch?: infra- orbital
12.What does the PSA innervate?: 1st, 2nd, and 3rd maxillary molars
13.What is most likely not going to be innervated by PSA?: Mesiobuccal root of the maxillary 1 st
molar
14.What injection needed to anesthetize the lingual of maxillary anteriors?: -
Nasopalatine
15.What injections needed to anesthetize the entire palate on one side?: -
Greater palatine and nasopalatine
16.How far do you insert the needle on an IANB?: 20-25mm or 3/4 the length of the needle
17.What happens during depolarization?: sodium flows in potassium
flows out
18.When do you aspirate?: You should aspirate right before the anesthetic is to be deposited.
19.Why aspirate ?: To ensure that the local anesthetic is not deposited into a blood vessel.
20.What should you do if you aspirate blood?: Remove needle without deposit- ing the
anesthetic. Deposited anesthetic and
Needle into appropriate area....and Try again.
21.Which local anesthetic is metabolized by pseudocholinesterase in the plasma?: esters
22.Topical anesthetics are least effective on what type of tissues?: keratinized tissues
1/
7
, 23.True/False
Topical anesthetics cause no systemic problems.: TRUE
24.Which anesthetic has the highest occurrence of allergic reactions?: Esters (Benzocaine)
25.What anesthetic is the safest to use in children?: Lidocaine
26.Which local anesthetic has one ester chain?: articaine (metabolized in both liver and blood
plasma)
27.What is the significance of giving an amide anesthetic to a patient with cirrhosis (scarring of the
liver)?: Amide anesthetics are metabolized in the liver
28.What is the landmark for the IANB injection?: Coronoid notch and pterygo- mandibular raphe
29.What is psychogenic pain: physical cause for pain cannot be identified
30.What is the maximum epinephrine dose for a cardiac patient?: 0.04 mg for cardiac patient
31.In a 1:50,000 solution how many cartridges can you give an ASA I/II patient?: 5
cartridges
32.In a 1:50,000 solution how many cartridges can you give an ASA III/IV patient?: 1 cartridge
33.In a 1:100,000 solution how many cartridges can you give an ASA I/II patient?: 11
cartridges **** on test
34.In a 1:100,000 solution how many cartridges can you give an ASA III/IV patient?: 2 cartridges
35.In a 1:200,000 solution how many cartridges can you give an ASA I/II patient?: 22
cartridges
36.In a 1:200,000 solution how many cartridges can you give an ASA III/IV patient?: 4 cartridges
37.What is the maximum epinephrine dose for a normal, healthy patient?: 0.2 healthy patient
38.What is trismus ?: Trismus (Lockjaw) is limited/restricted of the range of motion within the
jaws.
39.How do you manage trismus?: This condition can best be managed is to massage and
exercise the jaw muscles
With the application of heat to the areas. You can take muscle relaxants, pain reliever, or anti-
inflammatory medications.
40.How should you manage a hematoma immediately after it occurs?: Apply cold compress and
pressure to the bleeding site.
41.Hematoma can occur if a needle penetrates the of veins during
which injection?: pterygoid plexus during PSA injection
2/
7
