Anaesthesia for Labour Flashcards
Which muscle is the border between the pelvis and perineum?
Levator ani
Pain from the superior aspect of pelvic organs is perceived where?
Suprapubic
Pain from the inferior aspect of pelvic organs is perceived where?
S2/3/4 dermatome
Why is pelvic organ pain perceived differently depending on it being superior or inferior?
Superior - runs alongside sympathetics
Inferior - runs alongside parasympathetics
Pain from structures above the levator ani that cross between pelvis and perineum is mediated by sympathetics/parasympathetics
Parasympathetics
Pain from structures below the levator ani that cross between the pelvis and perineum is mediated by which nerve?
Pudendal nerve
What are the two important spinal cord levels for pain from the female reproductive system?
T11-L2
S2-S4
At which level is epidural anaesthetic injected?
L3-4
Name the structures the needle passes through in an epidural anaesthetic
Supraspinous ligament
Interspinous ligament
Ligamentum flavum
Epidural space
Give some signs that spinal anaesthetic is working
Lower limb skin flushed
Warm lower limbs
Reduced sweating
What nerve supplies somatic motor/sensory innervation to the perineum?
Pudendal nerve
What are the nerve roots of the pudendal nerve?
S2-4
The pudendal nerve exits the pelvis via which foramen?
Greater sciatic
The pudendal nerve re-enters the pelvis/perineum via which foramen?
Lesser sciatic
The pudendal nerve travels within the pudendal canal located within which fascia?
Obturator fascia
