Anaesthesia and surgical incisions Flashcards
Nerve supply of the reproductive organs can be decided in relation to which muscle?
Levator Ani.
Above = pelvic cavity
Below = perineum
Modalities that innervate
A) pelvic cavity
B) Perineum
A) S, PS, visceral afferent
B) somatic motor and somatic sensory
fallopian tubes, uterus and ovaries are ABOVE/BELOW the pelvic pain line?
ABOVE as they are touching the peritoneum, the eritoneum s like a blanket over them
Which parts of the female PELVIC CAVITY are below the pelvic pain line?
Cervix, and superior vagina
inferior vagina, perineal muscles, glands and skin are said to be within?
The perineum.
Which nerve fibres sense PAIN
A) Above pelvic pain line
B) below pelvic pain line in pelvic cavity
C) Perineum
A) Visceral afferents T11-L2
B) Visceral afferents S2-S4
C)PUDENDAL NERVE S2,3,4
Sympathetic fivres run alongside which visceral afferents?
T11-L2
Parasympathetics run which which nerves?
S2-S4 visceral afferents.
Which modalities are carried in the pudendal nerve?
Somatic sensory and somatic motor
Which modalities are responsible for:
A) Uterine cramping or contractions
B) Pelvic floor contractions when sneezing
??
A) S/PS that run alongside visceral afferents
B) Somatic motor from pudendal nerve
Name for that nevres that carry sacral parasympathetic outflow (that runs alongside S2-4 visceral afferents from inferior pelvic cavity) ?
PELVIC splanchnic nerves.
What do lumbar and SACRAL splancnic nerves carry?
SYMPATHETIC from T11-L2.
Pelvic - Parasympathetic
Sacral - Sympathetic
NAme of the prevertebral plexus that sits between L5 and the bifurcation of the aorta and contains sympathetics ?
Superior hypogastric
Preganglionic PS slpnacnhic nevres (S2-4) pass into?
Inferior hypogastric plexus
what are the posterior ligaments of the spine that will need to be pierced through in spinal/epidural anaesthesia?
Supraspinatous
Ifnraspinatous
Ligamenum flavum
Spinal anaesthesia is injected
A) at which vertebral level
B) into which space?
A) L3/4
B) subarrachnoid space surrounding cauda equina
Which bony landmark can be used to orentiate yourself beefore giving spinal?
Iliac crests - L4/5
Epidural space contains?
fat and veins
Which technique will anaesthatise:
A) from waist down
B) Below the pelvic pain line
C) Perineum
A) spinal via lp
B) caudal epidural block
Pudendal nerve block
Where does the posterior longitudinal ligament lie in relation to the spinal cord?
ANTERIOR.
Why is the needle for spinal NOT inserted nto spinal cord?
Spinal nerve roots of cauda equina are less easily damaged than the conus
Why can a women still contract with an epidural but not a spinal?
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.
Spinal anaesthesia can cause a motor block up to?
T4
Why does spinal anaesthesia cause hypotension?
Sympathetic pass into all spinal nerves. Sympathetics vasoconstrict ALL arterioles. Blockage of a spinal nerve –> blockage of sympathetic tone => hypotension.
