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Anesthesia Concepts > epidural/spinal > Flashcards

epidural/spinal Flashcards

1
Q

ligamentum flavum

A

foramen magnum to sacral hiatus
thickest in midline 3-5mm at L3
epidural space right after

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2
Q

dura

A

thickest meninge, foramen mag to S2

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3
Q

arachnoid

A

physiologic barrier for drugs, betwn it and pia is subarachnoid: CSF

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4
Q

pia

A

attached to SC, foramen mag to L1

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5
Q

dermatomes

A 
skin area innervated by a spinal nerve and its segment
T4 nipple
T6 xiphoid
T8 last rib
T10 unbliicus
E/S can climb 2 dermatomes
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6
Q

CSF

A

150ml in subara
replace 3-4x a day
produced in choroid plexus
s.g 1.004-1.008

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7
Q

ANS effects

A 
venous dilation
SVR decrease
CO decrease
HR decrease
MAP decrease
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8
Q

tissue layers tranersed

A 
skin
subq
supraspinous
intraspinous
ligamentum flavum
*epidural
dural
arachnoid
*subarachnoid (intrathecal)
pia
SC
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9
Q

widest epidural space

A

L2=5mm

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10
Q

epidural placement

A

LOR, air filled glass syringe, space right after log Flavum, has fat and blood vessels
touphy needle
advance catheter 2-3cm more.
4cm to lig flav

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11
Q

spinal

A

advance until CSF. remove style to check
when have CSF must Rotate all 4 QUADRANTS!
remove needle when done

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12
Q

specific gravity

A

density of solution to density water

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13
Q

baricity

A

density of solution to another solution

ex: LA:CSF

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14
Q

hyperbaric

A

SG >1.11
heavier sinks
mixed with dextrose

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15
Q

hypobaric

A

SG <1.005
lighter, rises
mixed with sterile water

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16
Q

isobaric

A

SG <1.006
same as CSF, does rise or sink
mixed with CSF

17
Q

factors of spread of LA

A

basicity of LA, pt position, drug concentration/volume

18
Q

spinal pt DC

A

PACU to floor, ater 4 dermatome regression or <T10

to home ambulate without orthostatic changes, and void

19
Q

epidural dose

A

1.25-1.6ml of LA per segment

20
Q

Caudal landmarks

A

Sacral cornu
post sup iliac spines
sacral hiatus

Anesthesia Concepts (5 decks)

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