'CRDTS Local Anesthesia Practice Test 2026 – All-in-One Guide to Mastering Your Certification!'

The important idea here is how you locate the injection so the anesthetic reaches the inferior alveolar nerve as it enters the mandibular foramen. For this block, two fixed surface landmarks are used: the coronoid notch and the pterygomandibular raphe.

The coronoid notch is the deepest inward notch on the anterior border of the mandibular ramus. It gives a reliable vertical reference to position the needle high enough on the ramus without going too close to the coronoid process or the joint. The pterygomandibular raphe is a palpable fibrous band running between structures of the cheek and the mandible, marking the medial border of the ramus. By using both landmarks together—placing the insertion point a short distance above the deepest part of the coronoid notch and just medial to the pterygomandibular raphe—you align with the mandibular foramen where the inferior alveolar nerve enters, ensuring anesthetic delivery to the nerve before it branches.

The other options point to landmarks for different facial nerves or regions of the maxilla (for example, mental foramen relates to the mental nerve block; infraorbital rim and maxillary tuberosity relate to maxillary nerve blocks; anterior nasal spine and palatal suture are midline maxillary/palatal landmarks). They do not reliably guide the inferior alveolar nerve block.