Maxillary Local Anesthesia Injections Guide - Adults

Question 1

In a PSA injection, what are the structures anesthetized?

Answer 1

pulps and buccal periosteum of molars; NOT always MB root of first molar

Question 2

In a PSA injection, what is the injection site/anatomical landmark (AL)?

Answer 2

near muccobuccal fold of the DB root of the second molar

AL: posterior superior alveolar foramen

Question 3

In a PSA injection, what is the path of the needle?

Answer 3

45 degrees: upward (superiorly), inward (mesially), and backward (distal) OR syringe is down and out at 45 degrees

Question 4

In a PSA injection, what is the depth of insertion of the needle? Do you contact bone?

Answer 4

16 mm or 3/4 of the needle

DO NOT contact bone

Question 5

In a PSA injection, what amount is deposited?

Answer 5

1/2 to 1 cartridge

Question 6

In a PSA injection, what length needle do you use?

Answer 6

Short

Question 7

In a MSA injection, what are the structures anesthetized?

Answer 7

pulps and buccal periosteum of premolars and MB root of first molar

Question 8

In a MSA injection, what is the injection site/anatomical landmark?

Answer 8

near muccobuccal fold of the 2nd PM

AL: none

Question 9

In a MSA injection, what is the path of the needle?

Answer 9

parallel to the long axis of the tooth

Question 10

In a MSA injection, what is the depth of insertion? Do you contact bone?

Answer 10

just beyond the apex about 5 mm

DO NOT contact bone

Question 11

In a MSA injection, what amount is deposited?

Answer 11

1/2 to 2/3 of a cartridge

Question 12

In a MSA injection, what length needle is used?

Answer 12

short

Question 13

In an ASA injection, what structures are anesthetized?

Answer 13

pulp and buccal periosteum of the incisors and canine; lip

Question 14

In an ASA injection, what is the injection site and anatomic landmark?

Answer 14

near muccobuccal fold of the canine

AL: canine eminence

Question 15

In an ASA injection, what is the path of the needle?

Answer 15

parallel to the long axis of the tooth (canine)

Question 16

In an ASA injection, what is the depth of insertion? Do you contact bone?

Answer 16

just beyond the apex about 5-6 mm

DO NOT contact bone

Question 17

In an ASA injection, what amount is deposited?

Answer 17

1/2 to 2/3 of a cartridge

Question 18

In an ASA injection, what length needle is used?

Answer 18

short

Question 19

In an IO injection, what structures are anesthetized?

Answer 19

pulp and buccal periosteum of anteriors and premolars; sometimes (28%) tissues of MB root of 1st molar; lower eyelid; lips; side of nose

Question 20

In an IO injection, what is the injection site/anatomical landmark?

Answer 20

3mm from muccobuccal fold of the 1st premolar (in buccal mucosa)

Question 21

In an IO injection, what is the path of the needle?

Answer 21

toward the infraorbital foramen (line up with middle of the pupil)

Question 22

In an IO injection, what is the depth of insertion? Do you contact bone?

Answer 22

about 16 mm (1/2 of a long needle OR 3/4 short needle)

YES contact bone

Question 23

What is something significant to remember about an IO injection?

Answer 23

After injection, apply pressure to the infraorbital foramen for 2 min

Question 24

In an IO injection, what amount is dispensed?

Answer 24

1/2 to 2/3 of a cartridge

Question 25

In an IO injection, what length needle is used?

Answer 25

long or short

Question 26

In a GP injection, what structures are anesthetized?

Answer 26

lingual periodontium from the posterior portion of the hard palate and medially to the median palatine suture - includes molars and premolars; DOES NOT numb the pulps

Question 27

In a GP injection, what is the injection site/anatomical landmark?

Answer 27

1-2 mm slightly anterior to the greater palatine foramen and the junction of the alveolar process and the hard palate

AL: greater palatine foramen

Question 28

In a GP injection, what is the path of the needle?

Answer 28

approach from the opposite side at a 90 degree angle

Question 29

In a GP injection, what is the depth of insertion? Do you contact bone?

Answer 29

4-6 mm

YES contact bone

Question 30

In a GP injection, what is something significant to remember?

Answer 30

Apply pressure for 30 seconds before inserting when giving solution

Question 31

In a GP injection, what amount is dispensed?

Answer 31

1/4 to 2/3 cartridge

Question 32

In a GP injection, what length needle is used?

Answer 32

short or ultrashort

Question 33

In an NP injection, what structures are anesthetized?

Answer 33

bilateral lingual periodontium of anterior portion of hard palate and anterior teeth - DOES NOT numb pulp

Question 34

In an NP injection, what is the injection site/anatomical landmark?

Answer 34

palatal tissue just lateral to incisive papilla (at middle or widest part of papilla - DO NOT inject into papilla)

AL: incisive foramen

Question 35

In an NP injection, what is the path of the needle?

Answer 35

45 degree angle to the midsagittal plane

Question 36

In an NP injection, what is the depth of insertion? Do you contact bone?

Answer 36

about 4-5 mm

YES do contact bone

Question 37

In an NP injection, what is something significant to remember?

Answer 37

apply pressure for 30 seconds before inserting and when giving solution

Question 38

In an NP injection, what amount is dispensed?

Answer 38

about 1/4 of a cartridge

Question 39

In an NP injection, what length needle is used?

Answer 39

short or ultrashort