Anatomy of Anaesthesia in Labour

Question 1

What nerves supply the pelvis generally?

Answer 1

sympathetic, parasympathetic and visceral afferent

Question 2

What nerves supply structures in the perineum generally?

Answer 2

somatic motor and somatic sensory

Question 3

What nerves supply organs touching the peritoneum, and what nerves do these run along with?

Answer 3

visceral afferents running alongside sympathetics

Question 4

What nerves supply organs not touching the peritoneum and what nerves do these run along with?

Answer 4

visceral afferents running alongside parasympathetics

Question 5

What spinal levels do visceral afferents from structures touching the peritoneum?

Answer 5

T11-L2

Question 6

What spinal levels do visceral afferents not touching the peritoneum enter at?

Answer 6

S2-4

Question 7

What structures does the pudendal nerve take sensory info from?

Answer 7

inferior vagina; perineal muscles; glands and skin

Question 8

Where does the spinal cord become the cauda equina?

Answer 8

L2

Question 9

What level does the subarachnoid space end?

Answer 9

S2

Question 10

Where is anaesthetic in spinals and epidurals injected?

Answer 10

L3/4

Question 11

What ligaments does the needle for a spinal enter through?

Answer 11

supraspinous; interspinous and ligamentum flavum

Question 12

What is the function of hte supraspinous?

Answer 12

runs over the spinous processes

Question 13

What is the function of interspinous?

Answer 13

runs inbetween spinous processes

Question 14

What is the function of ligamentum flavum?

Answer 14

connects the lamina of adjacent bodies

Question 15

Where do sympathetic nerves exit the spinal cord?

Answer 15

T1-L2

Question 16

How do sympathetic ganglia recieve fibres below L2?

Answer 16

via the sympathetic chain and distribute via lumbar; sacral and coccygeal spinal nerves

Question 17

What vessels do sympathetic fibres supply?

Answer 17

all arterioles

Question 18

What does bloackade of sympethic tone cause in vessels?

Answer 18

vasodilation

Question 19

What are the results ofvasodilation due to sympathetic blockade?

Answer 19

skin lookds flushed; warmer and reduced sweating; hypotension

Question 20

What is the pudendal canal?

Answer 20

passageway within obturator fascia

Question 21

What travels with the pudendal nerve in the pudendal canal?

Answer 21

internal pudendal a. and v. and nerve to obturator internus

Question 22

How does pudendal nerve travel ?

Answer 22

exits pelvis via greater sciatic foramen; passes posterior to sacrospinous ligament- lateral to ischial spine; re-enters pelvis/perineum via lesser sciatic foraen

Question 23

What is an episiotomy?

Answer 23

made from the posterior aspect of the vaginal opening; posterolateral incision into relatively safe fat-filled ischioanal fossa to avoid incision extending into rectum