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DSouza 2015 > Anatomy & Regional > Flashcards

Anatomy & Regional Flashcards

1
Q

Vasopressin and ACTH, TrH secreted from … nucleus

A

Paraventricular

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2
Q

Thermoregulation, Thirst, GnRH, and non REM regulated/secreted through … nucleus

A

Preoptic area

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3
Q

SA node and bronchial tree have predominantly PSNS or SNS tone?

A

PSNS

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4
Q

Innervation of sweat gland (short preganglionic neuron releases … and postganglionic sympathetic neuron release … and act on … receptors

A

Both ACh and act on muscurinic

All other postganglionic sympathetic releases NE with exception of adrenal medulla releases Epi and NE

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5
Q

Autonomic neurotransmitters

ACh

A

all preganglionic PSNS and SNS

all postganglionic PSNS

Postganglionic SYMPATHETIC sweat glands

Postganglionic sympathetic on skeletal blood vessels

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6
Q

Autonomic neurotransmitters

NE and Epi

Only Epi

A

NE and Epi -> Postganglionic adrenal medulla

All other POSTganglionic not to adrenal and not PSNS pulse the 2 postganglionic SNS to sweat glands and skeletal blood vessels (which both stimulated by ACh)

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7
Q

SNS nerve supply to the UE originated from … and synapses into … ganglion. Postganglionic fibers supply …. and their function …

A

T1 to T4/5 (sympathetic in general originates T1 - L2/3)

Synapses into sup, middle, and inf cervical ganglion

Postganglionic supply H&N, UE, heart and lung

Function; vasmotor, pilmotor, secretory, and pupillary dilatation.

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8
Q

PSNS originated from

A

Craniosacral

Cranial 3,7,9,10
S2-4

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9
Q

Causes of Atlanta-axial instability

A

RA
Achondroplasia
Down syndrome

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10
Q

Anesthetic consideration in ankylosing spondylitis

A

Airway( cervical immobility and instability, TMJ stiffness)

Systemic; restrictive lung, aortic insufficiency, uveitis, vasculitis

Neuroaxial; osseous ligments, reduces intervertebral space

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11
Q

Nerve supply to tongue

A

Ant 2/3 Trigeminal (sensory) Facial (Taste)

Post 1/3 sensory and taste by IX

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12
Q

Nerve supply to epiglottis

A

IX -> sup surface

Sup laryngeal N -> inf surface

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13
Q

Sensory innervation of larynx

A

Above vocal -> sup laryngeal N

Below vocals -> recurrent laryngeal

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14
Q

Motor innervation of larynx

A

Recurrent laryngeal supplies all except cricothyroid which supplied by sup laryngeal N (function is tensor of vocal cord)

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15
Q

To block sup laryngeal N, inject into

A

Post Cornu of hyoid bone

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16
Q

To block Recurrent laryngeal N, inject into

A

Transtracheal

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17
Q

To block IX N, inject into

A

Tonillar fossa

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18
Q

Recurrent laryngeal N injury causes

A

Hoarseness if unilateral

Airway obstruction if b/l

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19
Q

Sup laryngeal N injury causes

A

Change in voice (cricothyroid which is a tensor of vocal cord loses its function)

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20
Q

To prevent gag reflex, block … N and for cough, block …. N

A

IX for gag

Sup and recurrent laryngeal N for cough

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21
Q

Location of recurrent laryngeal N in neck

A

Btw trachea and esophagus, medial to carotid sheath

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22
Q

Location of vagus nerve in neck

A

Within crayons sheath, btw internal jugular and carotid A

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23
Q

Relation of sympathetic chain to carotid sheath

A

Posterior to the sheath

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24
Q

Relation of phrenic to carotid sheath

A

Lateral to the sheath

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25
PXT higher risk with left or right internal jugular venous cannulation ?
Left Because the diaphragm higher on left side and also the thoracic duct more likely to be injured with the left
26
The most complication with interscalene block ...
Ipsilateral diaphragmatic paralysis
27
When trapezius twitch elicited during interscalene block, direct the needle to
Anteriorly
28
With axillary block, least likely brachial nerve to be blocked ?
C5 Musculocutaneous (which supplies lateral forearm) to supplement with this Nerve block, inject within the body of coracobrachialis It will block for sure the C8-T1 (ulnar and medial)
29
With interscalene block, least likely to block nerve?
C8-T1 It will for sure block C5-C6 (all radial, medial, axillary and musculocutaneous except Ulnar)
30
During brachial blockade is it motor or sensory that is blocked first?
Motor
31
Interscalene block will be more successful when ... twitch is elicited
Biceps (musocutaneous N)
32
Intercostobrachial N supplies the ... and it is or not part of brachial pluxes
Medial aspect of the arm It is not (it is form from T2 which is not in brachial pluxes)
33
The onset of brachial plexus block is fastest with ... approach
Supraclavicular
34
Axillary block will miss ... nerve, which supplies the ...
Musculocutaneous sensory of Lateral forearm
35
To supplement axillary block with Musculocutaneous nerve block, inject the local at ...
The body of coracobrachialis muscle
36
The base of middle finger supplied by ...
Median N
37
Sciatic nerve block landmark
Greater trochanter and posterior superior iliac spine
38
Landmark for meralgia parasthetica ...
Anterior superior iliac spine
39
Landmark of stellate ganglion block
Tubercle of chassaiganc (tubercle of transverse process of C6)
40
Landmark of superficial cervical plexus block
Posterior border of SCM
41
Landmark of Deep cervical plexus block
Mastoid process and tubercle of chassaiganc
42
Landmark of deep cervical plexus block
At the transverse process of C2-C4
43
The correct position for CVP tip catheter
At 2nd costochondral junction on right side At level of 4th vertebra RA/SVC junction
44
Celiac plexus is formed by ... and ...
Greater splanchnic nerve and lesser splanchnic nerve (T5-L1)
45
Where is the celiac pluxes located in relation to spine
L1
46
Celiac plexus has preganglionic... and celiac ganglion is a .... the postganglionic provides ...
Preganglionic has sympathetic and parasympathetic The ganglion is symptomatic and postganglionic provides sympathetic and sensory
47
Distribution of celiac plexus
Mid stomach to mid transverse colon (visceral pain only)
48
The 2 most common SE of celiac plexus block
Orthostatic hypotension due to splanchnic vasodilation And diarrhea The 3rd MCC is paraplegic due to injury to the artery of adamkewicz
49
Neuroaxial blockade time interval and anticoagulant Tidopidine Therapeutic LMWH Ppx LMWH
14 days 24 hours 12 hours
50
Potential Advers effect of spinal microcatheters ?
Increases incidence of transient neurological sx and cauda equina syndrome (LBP, sensory abnormality in saddle area, bowel and bladder dysfunction and weakness of LL)
51
Midline spinal needle passes through... Paramedian approach passes 2 ligaments .... and encounter .... muscle instated.
Skin -> SC tissue -> supraspinous ligament -> interspinous -> ligmantum flavum -> dura -> arachnoid (Dose not encounter anterior spinous ligament). Paramedian approach passes supraspinous and interspinous; instead encounters paraspinous muscle).
52
The bony landmark of the end of dura sac is ....
Posterior superior iliac spine
53
Level where spinal cord ends in adults ... and neonates ....
L1 L3
54
The level where dura ends in adults at ... and neonates ...
S2 S3
55
Factors affecting the spread after subarachnoid blockade are
Total dose Baricity Position during and immediately following injection of hyperbaric solution (Height has minimal effect).
56
Subdural block can be differentiated from subarachnoid blockade by ...
Slower onset Extensive sensory block with minimal motor block Hypotension less than spinal, but more than epidural
57
What’s the indicator of complete resolution of spinal blockade
Ability to urinate
58
Ilioinginal vs iliohypogastric Origin Supplies Site of block
Both originates from L1 Peins, sctoutm/labia, upper medial thigh (where iliohypogastric just inguinal region) Both at 2 cm above medial to the anterior superior iliac spine
59
What’s the sole block option for femoral muscle biopsy?
Femoral block
60
Femoral triangle bouderies, content and floor?
Sup: inguinal ligament Medial: adductor longus Lateral: sartorius Contain LN -> V -> A -> N (medial to lateral) vein closer to peins The floor made of adductor longus, pectinius -> iliospoas (medial to lateral)

DSouza 2015 (21 decks)

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