A stimulus is an electrical message from one part of the body to another, and an impulse is an environmental change in an excitable tissue.
Both statements are false
Which fibers are the principle fibers in the transmission of sharp, bright dental pain?
A δ(delta) Fibers
Local anesthetics work by:
Penetrating the nerve to inhibit Na+ influx
Local anesthetics have their effect of myelinated nerves in which way?
Mostly at the Node of Ranvier
The minimal threshold stimulus required to excite a "C" fiber will also be sufficient to stimulate an "A" fiber.
When energy for conduction is derived from the nerve cell membrane itself and is no longer dependent of the stimulus for continuance the conduction is considered to be...?
The absolute refractory period occurs during the fraction of a millisecond when a nerve fiber can be excited by a much stronger stimulus than the initial stimulus.
Saltatory conduction refers to what?
Rapid transmission of nerve impulses along a myelinated nerve fiber
What is the type of glial cell located in the peripheral nervous system?
Myelin (lipoprotein sheath) is composed of what?
Approximately 75% lipid, 20% protein, and 5% carbohydrate
The sympathetic division is involved with the "rest or digest" response. The parasympathetic division is the "fight or flight" response.
Both statements are false.
The afferent division consist of all incoming information traveling along sensory or afferent pathways. The efferent division consist of all outgoing information traveling along motor or efferent pathways.
Both statements are true
The outer layer of the myelin sheath that wraps the entire nerve is called what?
The axon hillock:
Is where neurotransmitter chemicals are released for possible reception by a nearby neuron.
In a resting neuron, what positive ion is most abundant outside the plasma membrane?
In a resting neuron, what is the most abundant positive ion inside the plasma membrane?
The electrical potential of nerve axoplasm in the resting state is approximately what?
Mantle bundles will be anesthetized first by a local anesthetic compared to core bundles.
Chemical synapses use chemical mediators called what?
The "all or none principle" occurs:
Once a nerve is excited by the minimal threshold level.
Infection and Inflammation cause the following effects when administering a local anesthetic:
Increases tissue vascularity, which can inactivate the local anesthetic more rapidly.
Which of the following are desirable properties of local anesthetics?
All of the above (Rapid onset, Reversible, Stability in solution, Potent)
Which characteristic enhances the onset and effectiveness of local anesthetics?
High lipid solubility
Where is the action site of local anesthetics?
The protein receptors
Which part of the chemical structure of a local anesthetic determines if it classified as an amide or an ester?
Local anesthetics have their effect on the myelinated nerves mostly in which way?
Mostly at the nodes of Ranvier
The quaternary form of local anesthetic:
Is the ionized form in the cartridge and is responsible for binding to the receptor site.
Ester type local anesthetics are no longer manufactured in injectable form for dentistry because why?
Of there high degree of hypersensitivity
During manufacturing of local anesthetics are something as which of the following to render them water soluble?
Which of following anesthetics will provide the most rapid onset based on it's pKa?
Which of following local anesthetics is the most lipid soluble?
The mantle bundles of the inferior alveolar nerve innervate which teeth?
The molar area
When the local anesthetic is administered the solution reaches the core bundle first.
What is tachyphylaxis?
Increased tolerance to a drug that is administered repeatedly.
Recovery of local anesthetics following the inferior alveolar block begins in the posterior teeth.
Which of the following are true for local anesthetics:
1. Are potent vasodialtors
2. Exhibit antimicrobial properties
3. Cause hemostasis
4. Cause hypotension
5. Have a pH of 7.5
1, 2, 4
Which of the following is responsible for the allergic reaction in ester anesthetics?
Para-amino benzoic acid
Most amide local anesthetics are biotransformed in the what?
Local anesthetic, overdose has an effect on system?
Central nervous system
Topical anesthetics are available in both esters and amides.
The most important advantage of amide over ester LA is:
Which LA is the longest acting?
Bupivacaine with epi
Which LA has the least vasodilatory effect when used without epi?
Which LA has the greatest vasodilatory effect
when used without epi?
One cartridge of anesthetic contains how much
Factors in selection of LA for a patient include
all of the following except:
Which of the following is false:
Topical Benzocaine is an amide
Which of the following LA is metabolized in the
plasma and liver?
Which of the following is an advantage of having a LA metabolized in the plasma and liver?
Shorter half-life of drug
Which of the following LA is metabolized in the
lungs and liver?
Methylparaben is a:
Bacterial static agent that is no longer added to dental cartridges due to high incidence of allergic reaction
How is 3% mepivacaine formulated?
Which of the following is a concern when
Which of the following LA is the best option for
readministration of anesthetic to provide a lessened likelihood of blood concentration buildup?
The lower the pKa of a drug, the more cations
are present, which decreases the onset of action?
Which of the following is not a factor in the
duration of a LA?
Which of the following LA used without a
vasoconstrictor provides intermediate duration of action when administering a
Which of the following is the best reason for
choosing a LA that provides a long duration?
Need for postoperative pain control
When is lidocaine 1:50,000 epi most effective?
When hemostasis is needed
Where is procaine metabolized?
What best describes a localized complication?
A complication that occurs in a region of injection and is attributed to the needle or the administered anesthetic
What best describes a secondary complication?
A complication that is experienced by the patient after the injection
If needle breakage occurs and the clinician can
easily retrieve the needle, what is the next step?
Keep hand in patient's mouth and ask him or her to open widely
Anaphylaxis is considered to be what type of
Systemic and severe
When a blood vessel is punctured or lacerated by the anesthetic needle, an asymmetrical swelling and discoloration may occur. This is possibly a sign of:
What is the first step in managing a hematoma?
Soreness in the muscles caused by muscles spasms is called what?
Edema can be caused by which of the following?
All of the above (trauma during injection, infection, contaminated solutions, allergic rxn)
Paresthesia occurs most commonly during which intraoral injection?
How can the dental hygienist decrease the risk
of infection during injection?
All of the above (use sterile needles, store cartridges in original containers, use topical anesthetic, carefully sheath and unsheathe the needle before and after injections)
Why should topical anesthetics only be applied
for 1-2 minutes?
To prevent tissue sloughing
Systemic complications usually occur more
frequently than local complications and are usually caused by high plasma concentrations of the LA drug.
First statement is False, second is True.
All of the following can increase the risk of LA
What are signs of central nervous system overdose?
Convulsions, resp. distress, cardio depression,
and coma are all signs of what?
Local anesthetic overdose
Which of the following has the lowest concentration of epi?
Which of the following is the appropriate treatment for a mild cutaneous reaction?
All are signs of angina pectoris EXCEPT:
If the clinician strongly suspects the patient is having a MI, he or she should terminate the procedure and then:
If a patient starts to experience involuntary muscle contractions and altered breathing, what should the clinician suspect?
Before administering LA the dental hygienist should describe the risk and benefits to the patient. What type of terms should be used?
Term appropriate for the patient's education level
Practicing within the legal scope of practice means?
Practicing only within the limits set fourth by your license and state's rules and regulations
Which of the following statements is false regarding the administration of LA?
Never inform the patient of any unanticipated occurences during or after the administration of LA
In most stated the hygienist is not required to have malpractice insurance, bc the hygienist will be covered under the dentist’s insurance:
Both are False
Hygienists are accountable for their own actions and practice: however, the dentist is always liable for any legal actions taken against the hygienist:
First statement is true, second is false
Hygienist who hold a current anesthesia license are always able to administer LA without the physical presence of a dentist, but only if the dentist authorizes the procedure:
First statement is false, second is true
What is the appropriate amount of anesthetic to be administered during a procedure?
The amount necessary to complete the area that will be treated or finished in a single appt.
Which of the following diseases is contractible if a needlestick occurs to the hygienist?
All of the above (HBV, HCV, HIV)
Postexposure management protocol for occupational exposures should contain?
None of the above
Which statement is true regarding the handling of sharps?
It is acceptable to recap a needle only using the single handed scoop method.
If a needlestick injury occurs, is it not necessary to report the details of what happened, only that you were possibly exposed?
Both are false
Secondary prevention is when there is containment of an injury after it occurs. Tertiary prevention involved the return of the patient to a functional state and the prevention of further injuries:
Both are true
What does PPE stand for?
Personal protective equiptment
When it comes to occupational exposure risks, a QHCP should be experienced in which of the following?
All of the above (conducting testing, providing antiretroviral therapy, being familiar with the unique nature of dental injuries)
Risk management occurs when:
You identify preventative measures to reduce or elimnate the risk of legal actions
Following exposure, if there is not enough time to get tested right away it is okay to use bleach to cleanse the exposure site. However, if you are able to get tested immediately then you should just use soap and water.
First is false, second is true
Communication, documentation, and risk reduction protocols are all necessary elements when administering a LA. This is because they help to reduce the chance of possible litigation.
Both are true
The QHCP must take into consideration which of the following factors when determining the need for follow-up of occupational exposures?
All of the above (infectious state of source, type and amount of tissue/fluid, type of exposure, susceptibility of exposed person)
When handling a contaminated needle it is only important to avoid being exposed to the end that penetrated the tissues or fluids. The cartridge-penetrating end of the needle is not a risk for contamination.
Both are false
It is the responsibility of the hygienist to report any illegal activities regarding the administration of LA to the proper authorities as well as to educate the dentist about current regulations regarding the hygienist’s scope of practice.
First true, second false
The activity of the sympathetic autonomic nervous system neurotransmitters are terminated mainly by:
Re-uptake by adrenergic nerves
Which of following is a sign of epi toxicity?
The maximum recommended dose of epi per appt for a patient with ischemic heart disease is:
Epi should be avoided in patients with:
Both A and D (untreated hyperthyroidism and MI or CVA within prior 6 months)
Epinephrine is used for what?
An effect of epi used in dentistry is to:
Increase vasoconstriction and decrease bleeding
Which of the following is a systemic effect of vasoconstrictors used with LA?
A and C (Increase diastolic BP and Increases systolic BP)
Vasoconstrictors are added to LA to:
All of the above
Which of the following is a preservative added to LA solutions containing epi to prevent oxidation?
There is no difference in pain control when using a 1:50,000 or 1:100,000 concentration of epi.
Epi causes direct stimulation of which of following adrenergic receptors resulting in cardiac stimulation?
Which of the following vasoconstrictor can be safely administered to a patient with uncontrolled hyperthyroidism?
The half-life of epi is approximately:
What is a 1:1000 concentration of epi for:
Levinordenfrin is added to what LA?
Vasoconstrictor drugs are also known as:
All of the above
Epinephrine and norepinephrine are endogenous hormones excreted by:
Which adrenergic receptor causes epi to have inhibitory actions that cause vasodilation and bronchodilation?
Which of following concentrations is the most diluted?
Signs and symptoms associated with vasoconstrictor overdose manifest itself as:
Which of following topical anesthetics is classified as an amide?
Benzocaine is available in which of the following preperations
All of the above (cream, gel, spray, and patch)
Which of the following statements is incorrect:
The more topical placed at the site of the needle penetration the better
Which of the following topical anesthetics has a FDA pregnancy category of B?
Which of the following would be an indication for use of a topical anesthetic?
To minamize a patient's gag reflux
Which of the following is true regarding Maximum recommended dosage for topical anesthetics?
Patches are a good way to monitor exact doses
Concentrations available in over-the-counter products can be as high as those administered professionally in a dental office.
Which of the following topical anesthetics do not require a prescription?
All of the following are considered to be ideal properties of a topical except:
It should be allergenic
Which method of delivery is recommended to decrease the risk of methemoglobinemia?
Unmetered spray with disposable knob
Topical anesthetics generally penetrate____ into the tissue.
Oraqix is composed of which of the following anesthetics:
A and B (Lidocaine and Prilocaine)
The concentrations of topical anesthetics are greater than those of their injectable counterparts and they do not contain vasoconstrictors
Both are True
Which of the following describes an advantage of single-unit dose applications?
All of the above
EMLA is approved for use on which of the following areas:
All of the above (intact skin, hard palate, and mucous membranes)
Pulpal anesthesia can be achieved using 2.5% lidocaine and 2.5% prilocaine gel mixture.
Which of the following topical anesthetic agents is considered a ketone?
If plasma concentration in the body become too high, the most prominent systemic effect will occur in which of following systems?
B and C (Cardiovascular and CNS)
Allergic reactions from topical anesthetics are rare. It is not necessary to review a patient's med history before applying it.
First true, second false
Which of the following is a possible localized adverse reaction associated with topical anesthesia?