Anatomy Flashcards
In the adult patient, the superior border of the thyroid cartilage overlies:
C4 In the adult, the larynx extends from the superior border of the thyroid cartilage at the C4 level to the inferior border of the cricoid ring at the C6 level. The hyoid bone, which provides the chief support for the larynx, overlies C3.
Branches of the left coronary artery include: (Select 3)
cicumflex, diagonal, left anterior descending
Regarding a block of the celiac plexus:
it is frequently utilized to mitigate visceral pain The celiac plexus block is utilized for various types of intra-abdominal visceral pain syndromes, most frequently for relief of pain associated with intra-abdominal cancer. It is generally performed with the patient in the prone position with a pillow placed under the abdomen to decrease lumbar lordosis. It is performed at the level of T12-L1. Potential complications of celiac plexus block include inadvertent aortic puncture or spinal or epidural anesthesia.
Branches of the facial nerve (CN VII) include the:
zygomatic nerve, buccal nerve, mandibular nerve Branches of the facial nerve (CN VII) include the temporal, zygomatic, buccal, mandibular, and cervical nerves.
A patient presents for a stellate ganglion block for the treatment of CRPS Type I of the right upper extremity. After completion of the block, sympathetic blockade of the right upper extremity can be best assessed by observing:
a temperature change in the right arm
Stellate ganglion block is most commonly performed for patients with upper extremity pain (CRPS I or II). Horner’s syndrome, a side effect of stellate ganglion block, is heralded by symptoms of SNS denervation such as miosis, ptosis, and enophthalmos of the globe on the ipsilateral side of the block. Although practitioners look for the development of Horner’s syndrome as a metric for efficacy of the block, its presence does not necessarily equate to sympathetic denervation of the upper extremity.
pg. 1233
Cousins, MJ, Carr DB, Horlocker, TT et al. Neural Blockade in Clinical Anesthesia and Pain Medicine. Philadelphia: Lippincott Williams & Wilkins, 2009.
A superior laryngeal nerve block: provides block to where?
provides a sensory block to the epiglottis and the airway mucosa to the level of the vocal cords
The superior laryngeal nerve is comprised of two branches: the external branch which provides motor innervation to the cricothyroid muscle, and the internal branch which provides sensory innervation to the laryngeal mucosa above the level of the vocal cords. SLN block is performed between the lateral aspect of the hyoid bone and the thyroid cartilage at the thyrohyoid membrane.
pg. 1318
Barash, PG, Cullen, BF, Stoelting, RK, Calahan, MK and Stock, MC. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2009.
Fibers found in the spinothalamic tract of the spinal cord are involved in the transmission of: (Select 3)
simple touch, pain, temperature
“U.S. National Library of Medicine..”
URL: http://www.ncbi.nlm.nih.gov/books/NBK10967/
In the adrenal gland, glucocorticoids are chiefly secreted in the:
zona fasciculata
Endogenous glucocorticoids are secreted by the zona fasciculata of the adrenal gland. The zona glomerulosa secretes mineralocorticoids (aldosterone) and the zona reticularis secretes androgens. The adrenal medulla secretes epinephrine (80%) and norepinephrine (20%).
pg. 823
Nagelhout, JJ, and Zaglaniczny, KL. Nurse Anesthesia. St. Louis: Elsevier, 2010.
What is the only cartilage of the larynx that forms a complete ring?
The cricoid cartilage: is the only cartilage of the larynx that forms a complete ring
The larynx consists of 9 cartilages: the thyroid, epiglottis and cricoid cartilages (singular) and the arytenoids, corniculates, and cuneiforms (paired). Of the laryngeal cartilages, the cricoid is the only one to form a complete ring.
pp. 423, 452
Nagelhout, JJ, and Zaglaniczny, KL. Nurse Anesthesia. St. Louis: Elsevier, 2010.
A list of laryngeal muscle functions is shown (Click here to display definitions). By dragging & reordering the selections in yellow, match the term with the associated muscle.
1) Opens (abducts) vocal cords
2) Closes (adducts) vocal cords, closes glottis
3) Tenses and elongates vocal cords
4) Shortens and relaxes vocal cords
1) Opens (abducts) vocal cords
2) Closes (adducts) vocal cords, closes glottis
3) Tenses and elongates vocal cords
4) Shortens and relaxes vocal cords
- post cryicoarytenoid
- lat cyricoarytenoid
- cricothyroid
- thyroarytenoid
Cranial nerves possessing only motor function include:
Cranial Nerve Innervation Cranial Nerve Innervation I Sensory VII Both II Sensory VIII Sensory III Motor IX Both IV Motor X Both V Both XI Motor VI Motor XII Motor
The primary complication associated with the sitting position is:
venous air embolization
Although hypoperfusion of the cerebral vasculature, pooling of blood in the lower extremities and a decrease in FRC may all occur in the sitting position, VAE is the principal hazard. Air may be entrained into the vasculature as a result of a negative pressure gradient created when the operative site is above the level of the heart. The incidence of venous air embolism in the sitting position ranges from 1-76%.
pp. 428-429
Nagelhout, JJ, and Zaglaniczny, KL. Nurse Anesthesia. St. Louis: Elsevier, 2010.
Upon removal of the drapes after an extended surgery in the supine position, it is noted that the patient’s legs are crossed. After awakening, the patient complains of numbness on the lateral and posterior portion of the sole of his foot. The nerve most likely injured is the:
sural nerve
Conscious patients cross their legs to alleviate lumbosacral strain in the supine position. This may result in injury of the superficial peroneal nerve in the dependent leg and the sural nerve in the superior leg. Damage of the sural nerve may result in numbness of the posterior portion of the sole of the foot and heel the lateral foot, and the Achilles just above the ankle.
pp. 429-430, 1099
Nagelhout, JJ, and Zaglaniczny, KL. Nurse Anesthesia. St. Louis: Elsevier, 2010.
The protective mechanism which prevents over distention of the alveoli at high lung volumes is known as the:
Hering-Breuer reflex
Stimulation of stretch receptors in the lungs can elicit the Hering-Breuer inflation reflex. This reflex may help prevent over distention of the alveoli at high lung volumes by inhibiting large tidal volumes and may decrease the frequency of the inspiratory efforts by causing a transient apnea.
pg. 579
Nagelhout, JJ, and Zaglaniczny, KL. Nurse Anesthesia. St. Louis: Elsevier, 2010.
The component of the nephron that is involved in the concentration of urine via the countercurrent mechanism is the:
loop of Henle
The primary function of the Loop of Henle is the establishment of a hyperosmotic state within the medullary area of the kidney, a mechanism that is vital to the conservation of salt and water. Water conservation and the production of a concentrated urine involve a countercurrent exchange system or “multiplier” in which a concentration gradient causes fluid to be exchanged across parallel sides of the hairpin-shaped loop. The gradient increases as the loop moves from the renal cortex into the medulla.
pp. 699-700
Nagelhout, JJ, and Zaglaniczny, KL. Nurse Anesthesia. St. Louis: Elsevier, 2010.
The posterior cord of the brachial plexus gives rise to the: (Select 2)
axillary nerve, radial nerve
The brachial plexus arises from spinal nerve roots C8-T1. These roots divide into the superior, middle and inferior trunks. Trunks further subdivide into 3 anterior and 3 posterior divisions. Divisions then give rise to the lateral, posterior and medial cords. The posterior cord gives rise to the axillary and radial nerves, the lateral cord gives rise to the musculocutaneous and median nerves, and the medial cord gives rise to the median and ulnar nerves.
Plate 418
Netter, FH. Atlas of Human Anatomy, 5th Edition. Philadelphia: Saunders Elsevier, 2011.
The two cerebral hemispheres of the brain are connected by the:
corpus callosum
Plate 111
Netter, FH. Atlas of Human Anatomy, 5th Edition. Philadelphia: Saunders Elsevier, 2011.
The majority of blood supply to the lower and anterior two thirds of the spinal cord arises from the:
great ventral radicular artery
The great ventricular radicular artery (A.K.A. the artery of Adamkiewicz or arteria radicularis magna) enters the cord at approximately T7 and supplies the lumbosacral segment. It is the largest and most important radicular artery. Spinal cord segments that receive blood from one source are particularly prone to ischemic injury if flow is interrupted. Interruption of flow from this artery results in paraplegia.
pg. 659
Nagelhout, JJ, and Zaglaniczny, KL. Nurse Anesthesia. St. Louis: Elsevier, 2010.
A potential problem associated with cannulation of the dorsalis pedis artery for monitoring of blood pressure is:
the waveform may be distorted and result in overestimation of the pressure
The dorsalis pedis pulse reflects the highest systolic blood pressure in the body. As the arterial pulse leaves the heart, pulse pressure increases due to decreasing arterial lumen size and the reflection of the BP wave as it moves towards the periphery. This reflection causes an additive effect for systolic BP.
pg. 56
Karlet, M. Nurse Anesthesia Secrets. St. Louis: Mosby, 2005.
Attributes associated with the development of post-operative ulnar neuropathy include: (Select 4)
male sex, extreme obesity, prolonged bedrest, preexisting contralateral ulnar neuropathy
Anesthesia-related ulnar nerve injury is thought to be secondary to external nerve compression or stretch caused by intraoperative malpositioning. Occurrence is associated with the following factors: male sex (70-90% of cases), contralateral ulnar nerve dysfunction, high BMI (> 38) and prolonged postoperative bedrest.
pg. 800
Barash, PG, Cullen, BF, Stoelting, RK, Calahan, MK and Stock, MC. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2009.
How much volume of CSF is in the subarachnoid space?
Cerebrospinal fluid: occupies a volume of approximately 150 mL in the subarachnoid space
Cerebrospinal fluid supports and cushions the spinal cord and brain. It occupies a volume of approximately 150 mL in the subarachnoid space. It is produced by choroid plexuses in the brain’s ventricles at a rate of approximately 500 mL/day. It is largely reabsorbed by arachnoid granulations and by small CNS capillaries.
pg. 564
Hansen, JT and Lambert, DR. Netter’s Clinical Anatomy. Philadelphia: Elsevier, 2005.
The cricopharyngeus muscle receives sensory innervation primarily from the:
glossopharyngeal nerve
The cricopharyngeus muscle, an integral part of the upper esophageal sphincter, receives sensory innervation primarily from the glossopharyngeal nerve (CN IX). It receives motor innervation primarily from the vagus (CN X) and to a lesser extent from CN IX. It acts as a barrier to regurgitation in the conscious patient.
pg. 442
Nagelhout, JJ, and Zaglaniczny, KL. Nurse Anesthesia. St. Louis: Elsevier, 2010.
Aviv, J. “Voice and Swallowing Center.” 2011
URL: http://www.entandallergy.com/vas/services/swallowing_normal.php
Arterial blood supply to the larynx arises from the:
superior and inferior thyroid arteries
The superior thyroid artery, a branch of the external carotid, gives rise to the superior laryngeal artery. This artery supplies the supraglottic region of the larynx. The inferior laryngeal artery, a branch of the inferior thyroid artery, supplies the infraglottic region of the larynx.
pg. 563
Nagelhout, JJ, and Zaglaniczny, KL. Nurse Anesthesia. St. Louis: Elsevier, 2010.
Return to Selection Page Next Referenced Answer
A view of the larynx is shown (Click here to display graphic). By dragging & reordering the selections in yellow, match the name with the corresponding structure.
A view of the larynx is shown (Click here to display graphic). By dragging & reordering the selections in yellow, match the name with the corresponding structure.
The lower border of the scapula corresponds to spinal level:
T7
Important landmarks associated with dermatome levels include: C7 - vertebra promenens, T7 - inferior edge of scapula, T10 - umbilicus, L4 - highest points of iliac crests and S2 - level of posterior iliac spines.
pg. 1048
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2010.
Anatomic dead-space ends at the:
terminal bronchiole
The terminal bronchiole is the last airway component incapable of gas exchange. It has a diameter of < 1 mm, it is devoid of cartilaginous support, and it has the highest proportion of smooth muscle in its walls relative to the other airway components. The respiratory bronchiole, which follows the terminal bronchiole, is the first site in the tracheobronchial tree where gas exchange occurs.
pg. 235
Barash, PG, Cullen, BF, Stoelting, RK, Calahan, MK and Stock, MC. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2009.
The most serious complication of a supraclavicular block is:
pneumothorax
The most feared complication of supraclavicular block is pneumothorax. Its principal cause is a needle angle that “aims” toward the apex of the lung. Its incidence ranges from 0.5 - 5%. Although the incidence of phrenic nerve blockade is 30 - 50%, its effects are usually well-tolerated by the patient with normal pulmonary function.
pp. 51-52
Brown, DL. Atlas of Regional Anesthesia. Philadelphia: Elsevier, 2006.
Potential complications associated with an interscalene block include: (Select 4)
phrenic nerve block, injection of local anesthetic into the vertebral artery, total spinal & pneumothorax
Potential complications associated with the use of interscalene blocks include: subarachnoid injection leading to total spinal, epidural block, intravascular injection (especially in the vertebral artery), pneumothorax, and phrenic block.
pg. 42
Brown, DL. Atlas of Regional Anesthesia. Philadelphia: Elsevier, 2006.
The ansa cervicalis innervates the:
sternohyoid muscle
The ansa cervicalis, a component of the cervical plexus, provides motor innervation to the sternohyoid and the inferior belly of the omohyoid muscles.
Plate 128
Netter, FH. Atlas of Human Anatomy, 5th Edition. Philadelphia: Saunders Elsevier, 2011.
Chassaignac’s tubercle may be palpated at: t
the cricoid cartilage at C6
Chassaignac’s tubercle is an anatomic landmark for the placement of interscalene and cervical plexus blocks. It is the transverse process of the verterbal body at C6 and may be palpated lateral to the cricoid cartilage.
pg. 1088
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2010.
