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Y3 Reproductive > Anatomy Lecture 3 Anaesthesia > Flashcards

Anatomy Lecture 3 Anaesthesia Flashcards

1
Q

Pelvic floor muscles ____ during sneezing

A

contract

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2
Q

Structures in the pelvis are part of body _____, the nerve modalities that supply these structures are _______.

A

Structures in the pelvis are part of body CAVITY, the nerve modalities that supply these structures are SYMPATHETIC, PARASYMPATHETIC, VISCERAL AFFERENT.

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3
Q

Structures in the perineum are part of body _____, the nerve modalities that supply these structures are _______.

A

Structures in the perineum are part of body WALL, the nerve modalities that supply these structures are SOMATIC MOTOR AND SOMATIC SENSORY.

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4
Q

What type of nerve fibres are involved in uterine cramping and contractions? (during menstruation and labour)

A

Sympathetic and parasympathetic

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5
Q

What type of nerve fibres are involved in pelvic floor muscle contraction?

A

Somatic motor

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6
Q

What type of nerve fibres are involved in pain from the adnexae?

A

Visceral afferents

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7
Q

What type of nerve fibres are involved in pain from the uterus?

A

Visceral afferents

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8
Q

What type of nerve fibres are involved in pain from the vagina?

A

Superior part = visceral afferents

Inferior part = somatic sensory

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9
Q

What type of nerve fibres are involved in pain from the perineum?

A

Somatic sensory

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10
Q

The nerve supply to superior pelvic organs that are in contact with the ______ is from ______ that run alongside ______. These fibres enter the spinal cord at _____ level. The pain is then felt in the _____ area.

A

The nerve supply to superior pelvic organs that are in contact with the PERITONEUM is from VISCERAL AFFERENTS that run alongside SYMPATHETIC FIBRES. These fibres enter the spinal cord at T11-L2 level. The pain is then felt in the SUPRAPUBIC area.

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11
Q

The nerve supply to inferior pelvic organs that are not in contact with the ______ is from ______ that run alongside ______. These fibres enter the spinal cord at _____ level. The pain is then felt in the _____ area.

A

The nerve supply to inferior pelvic organs that are not in contact with the PERITONEUM is from VISCERAL AFFERENTS that run alongside PARASYMPATHETIC FIBRES. These fibres enter the spinal cord at S2, 3, 4 level. The pain is then felt in the S2, 3, 4 DERMATOMES area.

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12
Q

Below the levator ani sensory fibres are contained within _____ nerve. The fibre type is _____. These fibres enter the spinal cord at _____ level. The pain is then felt in the _____ area.

A

Below the levator ani sensory fibres are contained within PUDENDAL nerve. The fibre type is SOMATIC SENSORY. These fibres enter the spinal cord at S2, 3, 4 level. The pain is then felt in the PERINEUM area.

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13
Q

Give examples of the pelvic organs in contact with the peritoneum whose nerve supply is visceral afferents to T11-L2?

A

Uterine tubes, uterus, ovaries

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14
Q

The ______ separates organs touching and not touching the peritoneum and their respective different nerves supplies.

A

pelvic pain line

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15
Q

What level do the gonadal arteries exit the abdominal aorta?

A

L2

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16
Q

Which structures (not touching the peritoneum) are innervated by the visceral afferents travelling to S2-4?

A

Cervix and superior vagina

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17
Q

The inferior vagina, perineal muscles, glands and skin are within the _____.

A

Perineum

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18
Q

Name the 3 main types of gynae/repro anaesthesia?

A

Spinal anaesthetic
Epidural anaesthetic
Pudendal nerve block

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19
Q

In epidural anaesthesia can you feel contractions?

A

Yes

20
Q

In spinal anaesthesia can you feel contractions?

A

No

21
Q

What vertebral level does the spinal cord become the cauda equina?

A

L2

22
Q

What vertebral level does the subarachnoid space end?

A

S2

23
Q

Spinal and epidural anaesthetic anaesthetises the cauda equina. T or F

A

True

24
Q

What level is inject in spinal and epidural anaesthesia?

A

L3-L4 region

25
Q

What landmark of surface anatomy aids in spinal and epidural anaesthesia?

A

Superior iliac crests are at L4 level

26
Q

These are the structures that spinal and epidural anaesthetic passes through. Put them in order from superficial to deep:

  • Dura mater
  • Ligamentum flavum
  • Superficial fascia
  • Subarachnoid space
  • Supraspinous ligament
  • Epidural space (fat and veins)
  • Interspinous ligament
  • Skin
  • Arachnoid mater
A
  • Skin
  • Superficial fascia
  • Supraspinous ligament
  • Interspinous ligament
  • Ligamentum flavum
  • Epidural space (fat and veins)
  • Dura mater
  • Arachnoid mater
  • Subarachnoid space
27
Q

Sympathetic outflow originates from _______.

A

autonomic centres in the brain

28
Q

Sympathetic nerves exit the spinal cord with ______.

A

T1-L2 spinal nerves

29
Q

After exiting the spinal cord, sympathetic fibres travel to ______ running the length of the vertebral column, and then pass into the _______.

A

After exiting the spinal cord, sympathetic fibres travel to SYMPATHETIC CHAINS running the length of the vertebral column, and then pass into the ANTERIOR AND POSTERIOR RAMI OF ALL SPINAL NERVES.

30
Q

There are sympathetic fibres contained with the femoral, sciatic, obturator and pudendal nerves. T or F

A

True

31
Q

All spinal nerves and their named nerves contain sympathetic fibres. T or F

A

True

32
Q

Sympathetic fibres supply _____ to maintain sympathetic tone.

A

all arterioles

33
Q

Blocking sympathetic tone to all arterioles in lower limb would cause ______

A

vasodilation

34
Q

What are the signs of vasodilation of the lower limb arterioles?

A

Flushed skin
Warm
Reduced sweating

35
Q

Spinal anaesthetic can cause hypertension. T or F

A

False, can cause hypotension

36
Q

The pudendal nerve has a role in the ______ sphincter and _____ sphincter

A

The pudendal nerve has a role in the EXTERNAL URETHRAL sphincter and EXTERNAL ANAL sphincter

37
Q

What nerve roots does the pudendal nerve emerge from?

A

S2, 3, 4

38
Q

What fibre types are contained within the pudendal nerve?

A

Somatic motor
Somatic sensory
Sympathetic

39
Q

The pudendal nerve exits the pelvis via the _______. It then passes _____ to the _____ ligament. It then re-enters the pelvis via the ______. It then travels within the ______. And finally ______ to supply structures of the ______.

A

The pudendal nerve exits the pelvis via the GREATER SCIATIC FORAMEN. It then passes POSTERIOR to the SACROSPINOUS ligament. It then re-enters the pelvis via the LESSER SCIATIC FORAMEN. It then travels within the PUDENDAL CANAL. And finally BRANCHES to supply structures of the PERINEUM.

40
Q

The pudendal canal is a passageway within _______

A

obturator fascia

41
Q

What structures are contained within the pudendal canal?

A

Pudendal nerve
Internal pudendal artery and vein
(Nerve to obturator internus)

42
Q

What part of the bony nerve is used as a landmark when administering pudendal nerve block?

A

Ischial spines

43
Q

Pudendal nerve block anaesthetises most of the perineum? What nerve is also response for sensory innervation to this area and hence it is required to also be anaesthetised?

A

Ilioinguinal nerve

44
Q

What are the potential consequences of pudendal nerve or sphincter damage from labour?

A

Fecal incontinence

Weak pelvic floor muscles

45
Q

What direction is an incision made in an episiotomy?

A

Posterolateral

46
Q

What structure is affected in a posterolateral episiotomy? What structure are you trying to avoid cutting in an episiotomy?

A

Cut into fat filled ischioanal fossa

Avoid external anal sphincter / rectum

Y3 Reproductive (28 decks)

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