Exercises Lesson

INSTRUCTIONS: Answer the following exercises by marking the lettered response that best answers the question, by completing the incomplete statement, or by writing the answer in the space provided at the end of the exercise.

After you have completed all of these exercises, turn to "Solutions to Exercises" at the end of the lesson and check your answers. For each exercise answered incorrectly, reread the material referenced with the solution.

1. Which of the following statements best defines the term local infiltration?

a. A type of anesthesia achieved by applying the anesthetic agent to the surface of mucous membranes to block nerve transmissions.

b. A type of anesthesia achieved when the nerve endings in the skin and subcutaneous tissues are blocked by direct contact with a local anesthetic that is injected into the tissue.

c. A type of anesthesia accomplished by injecting a nerve that leads to the operative site.

d. A type of anesthesia accomplished by injecting a local anesthetic into the peridural space.

2. Which of the following statements best describes the mechanism of action of local anesthetics?

a. Local anesthetics destroy the nerve tissue so that electrical impulses cannot be carried.

b. Local anesthetics greatly increase the number of electrical impulses being transmitted so that pain cannot be felt in that particular area.

c. Local anesthetics block depolarization of the nerve membrane so that the conduction of the nerve impulse is impossible.

d. Local anesthetics remove both potassium and sodium ions from the nerve tissue so that polarity in the nerve cannot be accomplished; therefore, the impulses are not allowed to move past a certain point in the tissue.

3. Why is hyaluronidase (Wydase®) used in conjunction with local anesthetics?

a. Hyaluronidase concentrates the local anesthetic in a particular area in order that its effects might be prolonged.

b. Hyaluronidase neutralizes the local anesthetic so that undesired adverse effects are greatly reduced.

c. Hyaluronidase is an enzyme that acts to tenderize the tissue and make the nerves more sensitive to the effects of the local anesthetic.

d. Hyaluronidase increases the movement of the local anesthetic through the tissue.

4. Select the caution(s) and warning(s) associated with the use of local anesthetics.

a. When a local anesthetic is to be injected, the plunger should be aspirated in several planes to ensure the drug is not being injected into a vein.

b. Discolored solutions of local anesthetic should be thrown away.

c. A previously used vial of local anesthetic solution should never be reautoclaved.

d. All the above.

5. Select the toxicity(ies) associated with the use of local anesthetics.

a. Large amounts of systemically absorbed local anesthetics can cause depression of the cardiovascular system.

b. Local anesthetics, even when given in small amounts, cause tremors, shivering, and convulsions.

c. Local anesthetics cause respiratory depression.

d. Local anesthetics tend to produce hypersensitive reactions in most people.

INSTRUCTIONS: In Exercises 6-9, match the trade and generic names of the local anesthetics.

6. Tetracaine_ a. Americaine®

8. Dichlorotetrafluorethane_ c. Pontocaine®

9. Benzocaine_ d. Carbocaine®

10. Select the clinical use of ethyl chloride.

a. Used to produce anesthesia when applied to the eye.

b. Used for topical anesthesia of the skin.

c. Used for infiltration and caudal anesthesia.

d. Used to produce anesthesia in mucous membranes procedures.

11. What is the clinical use of proparacaine?

a. Used to produce topical anesthesia on the skin.

b. Used to produce both anesthesia and vasoconstriction when applied to certain tissues.

c. Used in nerve block, spinal, and caudal anesthesia.

d. Used to produce anesthesia in the eye.

12. What is the clinical use of bupivacaine (Marcaine®)?

a. Used to produce anesthesia when applied to the eye.

b. Used to produce infiltration, nerve block, and epidural anesthesia.

c. Used to produce anesthesia when applied to the skin or mucous membranes.

d. Used to produce anesthesia in a localized area when applied topically (that is, bronchoscopy).

13. Select the caution and warning associated with the use of procaine (Novocaine®).

a. The drug should not be applied topically.

b. The drug should not be used for infiltration anesthesia.

c. The drug should not be used to produce spinal anesthesia.

d. The drug should not be used to produce nerve block anesthesia.

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