Anatomy of Anaesthesia for labour Flashcards
What transmits pain for the pelvic organs and what transmits pain from the perineum?
visceral affertens from the pelvic organs
pudendal nerve from the pernieum
Where does the viseral afferent nerve supply come from for the suprior aspect of the pelvic organs?
T11-L2
Where does the visceral afferent supply for the inferior aspect of the pelvic organs come from?
S2,3,4
what nerve roots supply the pudendal nerve?
S2,3,4
How does the pain travel at the (a) superior aspect of a pelvic organ and (b) the inferior aspect?
Superior aspect
visceral afferent follows sympathetics to T11 - L2
Inferior aspect
visceral afferent follows parasymapthic to S2,S3,S4
what are the 3 types of injectible asathesia in pregancny?
Spinal anaesthetic
Epidural anaesthetic
Pudendal nerve block
What does the spinal cord become the cauda equina?
2 people can fit on a horse
L2
Where does the subarchnoid space end?
Two people can ride a spider
L2
Where do you put in an epidural anaesthetic?
L3-L4
What layers does a spinal anaesthetic pass through?
Supraspinous ligament
Interspinous ligament
Ligamentum flavum
Epidural space
Dura mater
Arachnoid mater
CSF
What will happen to the legs after a spinal anaesthetic?
loss of symapthic vessle tone = vasodilation
Reduced sweating
Hypotension risk
What does the pudendal nerve come from?
Branch of the sacral plexus
s2,s3,s4
Where does the pudendal nerve travel?
greater sciatic foramen
posterior to sacrospinous ligament
pudendal canal (obturator fascia)
Where does the pudendal nerve pass in relation to the sacrospinous ligament?
nerve crosses the lateral aspect of the sacrospinous ligament
What nerve dmg can happen during a prolonged difficult vaginal labour?
pudendal nerve can be stretched
week pelvic floor and inconinece
What way do you do an episiotomy?
