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Repro anatomy > Anaesthesia and surgical incisions > Flashcards

Anaesthesia and surgical incisions Flashcards

1
Q

Nerve supply of the reproductive organs can be decided in relation to which muscle?

A

Levator Ani.
Above = pelvic cavity
Below = perineum

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2
Q

Modalities that innervate
A) pelvic cavity
B) Perineum

A

A) S, PS, visceral afferent

B) somatic motor and somatic sensory

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3
Q

fallopian tubes, uterus and ovaries are ABOVE/BELOW the pelvic pain line?

A

ABOVE as they are touching the peritoneum, the eritoneum s like a blanket over them

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4
Q

Which parts of the female PELVIC CAVITY are below the pelvic pain line?

A

Cervix, and superior vagina

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5
Q

inferior vagina, perineal muscles, glands and skin are said to be within?

A

The perineum.

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6
Q

Which nerve fibres sense PAIN
A) Above pelvic pain line
B) below pelvic pain line in pelvic cavity
C) Perineum

A

A) Visceral afferents T11-L2
B) Visceral afferents S2-S4
C)PUDENDAL NERVE S2,3,4

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7
Q

Sympathetic fivres run alongside which visceral afferents?

A

T11-L2

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8
Q

Parasympathetics run which which nerves?

A

S2-S4 visceral afferents.

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9
Q

Which modalities are carried in the pudendal nerve?

A

Somatic sensory and somatic motor

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10
Q

Which modalities are responsible for:
A) Uterine cramping or contractions
B) Pelvic floor contractions when sneezing
??

A

A) S/PS that run alongside visceral afferents

B) Somatic motor from pudendal nerve

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11
Q

Name for that nevres that carry sacral parasympathetic outflow (that runs alongside S2-4 visceral afferents from inferior pelvic cavity) ?

A

PELVIC splanchnic nerves.

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12
Q

What do lumbar and SACRAL splancnic nerves carry?

A

SYMPATHETIC from T11-L2.
Pelvic - Parasympathetic
Sacral - Sympathetic

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13
Q

NAme of the prevertebral plexus that sits between L5 and the bifurcation of the aorta and contains sympathetics ?

A

Superior hypogastric

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14
Q

Preganglionic PS slpnacnhic nevres (S2-4) pass into?

A

Inferior hypogastric plexus

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15
Q

what are the posterior ligaments of the spine that will need to be pierced through in spinal/epidural anaesthesia?

A

Supraspinatous
Ifnraspinatous
Ligamenum flavum

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16
Q

Spinal anaesthesia is injected
A) at which vertebral level
B) into which space?

A

A) L3/4

B) subarrachnoid space surrounding cauda equina

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17
Q

Which bony landmark can be used to orentiate yourself beefore giving spinal?

A

Iliac crests - L4/5

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18
Q

Epidural space contains?

A

fat and veins

19
Q

Which technique will anaesthatise:
A) from waist down
B) Below the pelvic pain line
C) Perineum

A

A) spinal via lp
B) caudal epidural block
Pudendal nerve block

20
Q

Where does the posterior longitudinal ligament lie in relation to the spinal cord?

A

ANTERIOR.

21
Q

Why is the needle for spinal NOT inserted nto spinal cord?

A

Spinal nerve roots of cauda equina are less easily damaged than the conus

22
Q

Why can a women still contract with an epidural but not a spinal?

A

Anaesthesia entering the epidural space wil lhave a much more diluted affect as it will have to get through so many tissues, it will not cause complete block but significantly reduce pain.

23
Q

Spinal anaesthesia can cause a motor block up to?

A

T4

24
Q

Why does spinal anaesthesia cause hypotension?

A

Sympathetic pass into all spinal nerves. Sympathetics vasoconstrict ALL arterioles. Blockage of a spinal nerve –> blockage of sympathetic tone => hypotension.

25
Q 
Pudendal nerve
A) Exits pelvic cavity via
B) Enters pelvic cavity via
C) Travels through \_\_\_ to structures of the perineum
??
A

A) greater sciatic foramen
B) Lesser sciatic foramen
C) Pudendal Canal

26
Q

Pudendal canal is formed from fascia of which lateral rotator muscle of the hip?

A

Obturator internus

27
Q

Upon exiting the pudendal canal pudendal nerve splits into ___ and ____ to supply the perinium?

A

Perineal and anal branch

28
Q

Indications for pudendal nerve block in childbirth?

A

Epiostomy incision
Forceps use
Perianal stitching post delivery

29
Q

Where is the fundus of the uterus at
A) 12 weeks
B) 20
C) full term

A

A) pubic symphisis
B) Umbillicus
C) Costal margins

30
Q

What is the linea alba?

A

Midline blending of two abdo aponeurosis. Rusn from xiphoid process to pubic symphisis.

31
Q

Which part of the abdominal wall allows for improved mechanical efficiency (flexion of trunk) ?

A

Tendinous intersections of the rectus abdominus

32
Q

Incision site for
A) Lower Segement CS or hysterectomy
B) LAparotomy or some emergancy C sections

A

A) “bikini line” incision

B) Vertical midline incision

33
Q

Are the rectus muscles cut in a LSCS?

A

NO only the anterior rectus sheath, then they are moved apart.

34
Q

Why might a verticla c section not heal as quick as a LSCs?

A

Incision through linea alba is relatively bloodless (good for surgery) which means healing isnt too great.

35
Q

Why is it important to suture and close the anterior rectus sheath on closing abdo wall?

A

Increases strength of the wound and reduces risk of wound complications (i.e. incisional hernia)

36
Q

Neurovascular layer of the abdomen lies between which layers?

A

Internal oblique and transverse abdominus

37
Q

4 sets of nerves that supply of anterolateral wall?

A

throacoabdominal (7th -111th)
Subcostal (T12)
Iliohypogastric (L1)
Ilioinguinal (L1)

38
Q

Whic arteries supplying ANTERIOR abdo wall are
A) a continuation of internal throcic A?
B) Branch of external iliac?

A

A) Superior epigastric As

B_ inferior epigastric As

39
Q

Blood supply to lateral abdo wall comes from?

A

Intercostal and subcostal As (which continue from posterior intercostals)

40
Q

Which artery must be avoided in insertion of a lateral port?

A

Inferior epigastric

41
Q

during a hysterectomy it is important to differentiate between which two structures?

A

Uterine artery and ureter. (water under bridge)

42
Q

Oavrian, uterine, vaginal arteries are branches off…?

A

Internal iliac

43
Q

Perineum blood supply?

A

Pudendal.

Repro anatomy (3 decks)

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