Anatomy of Anaesthesia Flashcards

1
Q

what is the area called above and below levator ani?

A

above - pelvis

below - perineum

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2
Q

where is pain from the pelvic organs touching peritoneum felt?

A

suprapubic

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3
Q

what do visceral afferents from the pelvic organs touching peritoneum run alongside? where do they enter the spinal cord?

A

sympathetic fibres

T11-L2

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4
Q

what level do visceral afferents organs not touching the peritoneum enter the spinal cord?

A

S2, S3, S4

parasymp

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5
Q

what do visceral afferents from pelvic organs not touching the peritoneum run alongside?

A

parasympathetic fibres

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6
Q

where is pain percieved from pelvic organs not touching the peritoenum?

A

S2, S3, S4 dermatome (perineum)

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7
Q

what named nerve supplies the perineum?

A

pudendal (S2, 3, 4 keeps shit off the floor)

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8
Q

what 3 types of anaesthesia can be given during labour?

A

spinal anaesthesia

epidural anaesthesia

pudendal nerve block

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9
Q

what level does the spinal cord become cauda equina?

A

L2 vertebra

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10
Q

what level does the subarachnoid space end?

A

S2

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11
Q

what spinous process is in line with the most superior point of the iliac crests?

A

L4

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12
Q

for an spinal/epidural, what level is anaesthetic injected into?

A

L3-L4 (L5) region

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13
Q

in spinal anaesthetic, what does the needle pass through?

A

supraspinous ligament

interspinous ligament

ligamentum flavum

epidural space

dura mater

arachnoid mater

subarachnoid space

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14
Q

in an epidural, what does the needle pass through?

A

supraspinous ligament

interspinous ligament

ligamentum flavum

epidural space

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15
Q

what level do sympathetic nerves leave the spinal cord?

A

T1 - L2

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16
Q

how do levels below L2 recieve sympathetic innervation?

A

sympathetic ganglia recieve via sympathetic chains

17
Q

what are arterioles supplied by?

A

sympathetic fibres

18
Q

what does spinal anaesthesia cause?

A

vasodilation

flushed skin

warm limb

reduced sweating

hypotension

19
Q

what is a pudendal nerve block useful for?

A

episotomy

forceps

perineal stitching post delivery

20
Q

route of pudendal nerve?

A

exits via greater sciatic foramen

passes posterior to sacrospinous ligament

travels in pudendal canal

branches to supply perineum

21
Q

what aspect of the sacrospinous ligament does the pudendal nerve cross?

A

lateral

22
Q

what useful anatomical landmark can be used in a pudendal nerve block?

A

ischial spines (4 and 8 o clock)

23
Q

fibres supplying what muscles could be damaged during labour?

A

levator ani

anal sphincter

24
Q

in an episiotomy, where is the incision made?

A

ischioanal fossa

25
Q

what direction is the incision made, so to avoid tearing?

A

medially