Local Anaesthesia — ORE Part 1 MCQ

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EasyPharmacology & TherapeuticsLocal AnaesthesiaORE Part 1

A fit and healthy 30-year-old man requires extraction of a lower wisdom tooth. He is anxious but cooperative. You plan to administer an inferior alveolar nerve block (IANB). Which nerve is also routinely blocked during an IANB injection?

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Correct answer: B — Lingual nerve

Explanation lettering: B = shown as A · A = shown as B · D = shown as C · E = shown as D · C = shown as E

The lingual nerve runs through the pterygomandibular space alongside the inferior alveolar nerve and is routinely blocked during IANB administration due to diffusion of local anaesthetic through their shared anatomical compartment. This is an expected and concurrent blockade, not a separate injection. The mental nerve (B) is a distal branch of the inferior alveolar nerve that supplies the lower lip and chin; it requires a separate mental nerve block. The buccal nerve (C) supplies buccal soft tissues and is blocked by separate buccal infiltration or a dedicated buccal block. Mylohyoid (D) and auriculotemporal (E) nerves are located away from the pterygomandibular space and are not affected by IANB.

Reference: Anatomical Study of the Lingual Nerve and Inferior Alveolar Nerve in the Pterygomandibular Space: Complications of the Inferior Alveolar Nerve Block. NCBI PMC, 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175254/