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Reproduction SOH > Anaesthesia for labour > Flashcards

Anaesthesia for labour Flashcards

1
Q

If the structure is in the pelvis which types of nerves supply it?

A

Sympathetic
Parasympathetic
Visceral afferent

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2
Q

If the structure is in the perineum, which types of nerves supply it?

A

Somatic sensory

Somatic motor

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3
Q

What separates the pelvis from the perineum ?

A

Levator ani

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4
Q

Anything above the elevator ani is pelvis/perineum?

A

Pelvis

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5
Q

Anything below the elevator ani is pelvis/perineum?

A

Perineum

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6
Q

Uterine cramping is controlled by nerves/hormones ?

A

Hormones

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7
Q

Uterine contraction is controlled by nerves/hormones?

A

Hormones

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8
Q

Pelvic floor muscle contraction (e.g. when sneezing) is controlled by nerves/hormones?

A

Nerves

- somatic motor nerve

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9
Q

Pain from the ovaries, fallopian tubes and uterus is controlled by which group of nerves?

A

Visceral afferents

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10
Q

Pain from the vagina is controlled by which group of nerves?

A

Pelvic part - visceral afferent

Perineum part - somatic sensory

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11
Q

Pain from the perineum is controlled by which group of nerves?

A

Somatic sensory

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12
Q

When thinking about pain from the female reproductive system, what are the 2 important SC levels?

A

T11-L2

S2-S4

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13
Q

Superior aspect of pelvic organs which touch the peritoneum - pain enters SC at which levels

A

T11-L2

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14
Q

Superior aspect of pelvic organs which touch the peritoneum - where is pain perceived by the patient?

A

Suprapubic

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15
Q

Give 3 examples of pelvic organs which touch the peritoneum

A

Uterine tubes
Uterus
Ovaries

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16
Q

Inferior aspect of pelvic organs which touch the peritoneum - - pain enters SC at which levels

A

S2,S3,S4

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17
Q

Inferior aspect of pelvic organs which touch the peritoneum - where is pain perceived by the patient?

A

S2,3,4 dermatome

  • S2 = posterior leg pain
  • S3,4 = bullseye around the anus
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18
Q

Give 2 examples of pelvic organs which are inferior to the peritoneum?

A

Cervix

Superior vagina

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19
Q

Name 3 types of anaesthesia used in obs and gynae

A

Spinal anaesthesia
Epidural anaesthesia
Pudendal nerve block

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20
Q

Spinal anaesthesia can be carried out in an emergency situation as it does not require planning. True or false?

A

False

- needs to be planned

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21
Q

Will uterine contractions be affected by spinal anaesthesia ?

A

No

  • they will still occur as they are hormonal
  • uterine sensations will be blocked
22
Q

Where is spinal anaesthesia administered ?

A

L3-L4 region

23
Q

Spinal anaesthesia - what does the needle pass through

A 
Supraspinous ligament 
Interspinous ligament 
Ligamentum flavum 
Epidural space 
Dura mater
Arachnoid mater 
Reach the subarachnoid space
24
Q

Spinal anaesthesia - if the patient is lying flat how can this be a problem?

A

Anasthesia fluid can move up the spine and patient will get headaches

25
Q

Spinal anaesthesia causes blockage to ______ tone and results in ______ in the lower limbs

A

Blockage to sympathetic tone and therefore results in vasodilation

26
Q

Epidural anaesthesia - definition

A

Numbs everything below the pelvic pain line

27
Q

Epidural anaesthesia - will you be able to feel contractions?

A

Yes, they are hormonal

28
Q

Epidural anaesthesia - where is it administered?

A

L3-L4 region

29
Q

Epidural anaesthesia - what does the needle pass through

A

Supraspinous ligament
Interspinous ligament
Ligamentum glavum
Epidural space

30
Q

Epidural anaesthesia passes through the dura. True or false?

A

False

31
Q

What is more safe - epidural anaesthesia or spinal anaesthesia and why?

A

Epidural is more safe

- no need to directly involve the SC

32
Q

Epidural anaesthesia can be used during normal vaginal labour. True or false?

A

True

33
Q

What is the downside of administering epidural during normal vaginal labour?

A

May inhibit progress during stage 2 of labour as the patient won’t want to actively push the baby out

34
Q

Complications of epidural?

A 
Hypotension
Dural puncture 
Headache 
High block 
Atonic bladder
35
Q

Pudendal nerve block definition

A

Anaesthetises the area innervated by the pudendal nerve

36
Q

What area is innervated by the pudendal nerve?

A

Majority of the perineum

37
Q

Give examples of when a pudendal nerve block is used?

A

Episiotomy incision
Repairing tears
Painful vaginal delivery
Forceps use

38
Q

Where is the pudendal nerve located - exits the pelvis via which foramen?

A

Greater sciatic foramen

39
Q

What does the pudendal nerve wrap round?

A

Ischial spine

40
Q

Where is the ischial spine located?

A

At 4 and 8 o’clock positions

41
Q

What is used as a landmark to administer pudendal nerve block?

A

Ischial spine

42
Q

If the pudendal nerve exits the pelvis via the greater sciatic foramen, where does it re-enter the pelvis?

A

Lesser sciatic foramen

43
Q

What does the pudendal nerve travel in to keep it contained?

A

Pudendal canal

44
Q

What does the pudendal nerve supply?

A

Majority of the perineum

45
Q

Function of pudendal nerve

A

Role in motor control of external anal and urethral sphincters

46
Q

How can the pudendal nerve be damaged during labour?

A

Can be stretched

47
Q

If there is pudendal nerve damage, what may result?

A

Weakened pelvic floor

Faecal incontinence

48
Q

Episiotomy - why is it done

A

To prevent a nasty tear during labour

49
Q

Episiotomy - which kind of incision should be made?

A

Mediolateral incision from the posterior fortieth to the fat filled ischia anal fossa

50
Q

Episiotomy - What does it reduce the risk of

A

Faecal incontinence

Reproduction SOH (50 decks)

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