Anatomy Flashcards
What view is this and what nerves? where on brachial plexus?
what is seen?
L4-5 Disc herniation
What kind of block for carotid endarterectomy? how is it done?
what is the c6 transverse process called?
chassaignac tubercle
Motor stimulation with …..? is associated with intraneural injection.
Motor stimulation with < 0.2 mA is associated with intraneural injection.
Explain the acetylcholine receptor?
The acetylcholine (ACh) receptor is a ligand-gated channel that opens when ACh binds to the α subunits. Upon opening, the sodium current exceeds the potassium current.
The acetylcholine (ACh) receptor is a ligand-gated channel that opens when ACh binds to the α subunits. Upon opening, the sodium current exceeds the potassium current.
ACh must bind to both alpha units to open. Na influx exceeds K eflux
What is a celiac plexus block? why used? where is it located? side effects?
Local injection and neurolysis of the celiac plexus.
Relieves pain for stomach, pancreas, diaphragm, liver, spleen, small colon, large colon up to transvese colon, adrenal glands, and kidney.
The celiac plexus is typically comprised of 2-3 splanchnic nerves that lie over the anterolateral surface of the aorta and close to the celiac artery trunk, and spans the T12-L1 vertebral levels.
The two most commonly utilized neurolytic agents for celiac plexus neurolysis include ethyl alcohol and phenol. Typically 10-15 mL of injectate is required on each side.
Notable side effects after a celiac plexus block include orthostatic hypotension and diarrhea due to unopposed parasympathetic activity of the alimentary tract. Other potential complications include hematuria, intravascular injection, retroperitoneal hemorrhage, and pneumothorax. Depending on the neurolytic agent used, complications from intravascular injection may vary. If alcohol is injected intravascularly, the blood ethanol level will be well above the legal intoxication limit. If phenol is injected intravascularly, it will mimic effects of local anesthetic toxicity including central nervous system excitation, seizures, and cardiovascular collapse. Notably, a serious complication is paraplegia due to spread of the neurolytic agent to the subarachnoid space or to posterior border of the aorta, surrounding the artery of Adamkiewicz and other spinal segmental arteries and causing potential damage (anterior cord infarction).
Between which two bony landmarks is the sciatic nerve located when performing a sciatic nerve block with an ultrasound-guided subgluteal approach?
Bonus question: what is the sciatic nerve comprised of?
what is the 3in1 block?
covers femoral, lateral femoral cutaneous and obturator
What happens if you are doing a femoral nerve block with nerve stimulator and you get hip flexion and abduction?
Stimulation of the sartorius muscle will elicit hip flexion and abduction; this indicates stimulation of the anterior branch of the femoral nerve which is inadequate for blockage. Redirecting the needle laterally and deeper will target the posterior branch of the femoral nerve and stimulation will cause quadriceps contraction.
what is the femoral nerve composed of?
posterior devisions of L2-4
When performing a caudal epidural, which of the following structures should a needle traverse just prior to the epidural space?
what does the transversus abdominis plane block actually block? like nerves?
anterior rami of T7-L1
Coronary blood flow to ventricular wall? also what gives supply to SA node? AV node?
also what gives blood supply to SA node? AV node?
what is the only muscle of the larynx not innervated by reccurent laryngeal nerve? what is it innervated by ?
cricothyroid muscle is the exception, being innervated by the superior laryngeal nerve (external branch). It primarily functions as a tensor, thereby elongating the cords and raising the pitch of the sound produced.
What are the abnormal valve sounds? where are they located? characteristics?
Benefits of retrobulbar block?
Disadvantages of retrobulbar block?
compared to peribulbar block?
what nerves does a retrobulbar block?
Retrobulbar blocks provide exquisite analgesia and akinesia to the eye and require less local anesthetic solution than a peribulbar block to ensure ocular akinesis. When compared to peribulbar blocks, however, they carry a higher risk of intravascular and intradural injection, retrobulbar hematoma and hemorrhage, and penetration of the globe itself.
retrobulbar blocks ciliary nerves and ganglion, as well as cranial nerves III, IV, and V
peribulbars require more local and take longer to set up
how to tell C7 vertebral process?
what nerve fibers make up lateral femoral cutaneous nerve?
where is the lateral femoral cutaneous nerve located?
L2-3 nerve roots
where is the artery of adamkiewicz located?
injury will cause what to spinal cord?
The arteria radicularis magna, or artery of Adamkiewicz, is a large aortic radicular artery that supplies the anterior two-thirds of the lower spinal cord. It almost always lies on the left side and most commonly arises at T9-12, but may also be found at T5-T9 or L1-2.
Compromise of the artery of Adamkiewicz can result in anterior cord syndrome due to ischemia. This is manifested by a loss of motor function and pinprick sensation below the level of the lesion, but the preservation of vibration and proprioception via the dorsal cord
33-year-old construction worker with suspected lumbar facet syndrome presents for intra-articular facet injections. The patient is placed prone on the procedural bed, and anterior-posterior imaging is first obtained to identify the appropriate vertebral level. The fluoroscopy machine is then rotated outward in the sagittal-coronal oblique plane to obtain the following image….
Which of the labels on the image above BEST indicates the posterior margin of the space that is to be injected?
Answer is D
In reference to the anatomy of the dog that is overlaid on the image, the ear (A) represents the superior articular facet, while the front leg (D) represents the inferior articular facet. The pedicle (B) is represented by the radiolucency where the dog’s eye should be. The transverse process of the vertebra is represented by the nose of the dog. The neck of the dog (C) represents the pars interarticularis. The defects in the pars that occur in spondylolysis can be clearly visualized in this view and present as a dark line across this structure, referred to as a ‘collar’ on the neck of the dog.
tell me about the lumbar plexus block?
what is it used for?
where is it located?
The lumbar plexus block, often known as the psoas compartment block, is commonly performed to provide analgesia for various lower extremity surgeries and is
particularly utilized for femoral shaft and neck fractures. If the provider obtains a hamstring twitch after nerve stimulation, then the needle is inappropriately too caudal and is stimulating the sacral plexus region which gives rise to the sciatic nerve. The needle would have to be withdrawn and re-directed more cranially to target the lumbar plexus.
what is crps of the lower extremity? how do you treat it?
Complex regional pain syndrome
