Interventional Pain

Question 1

borders of safe triangle

Answer 1

lateral border = lateral edge of vertebral body
superior border = parallel to inferior pedicle
hypotenuse = spinal nerve root

Question 2

angle of C-arm for lumbar MBB vs cervical MBB

Answer 2

lumbar = obliquely
cervical = caudally

Question 3

where is the injection target for a sympathetic block

Answer 3

chassaignac tubercle of C6 vertebral body

Question 4

celiac plexus blocks are often indicated for controlling pain arising from where?

Answer 4

epigastric viscera

Question 5

1 symptom that patient experiences for anesthetic toxicity

Answer 5

metallic taste

Question 6

slightly soluble steroids

Answer 6

methylprednisolone

Question 7

presynaptic sympathetic fibers arise from where?

Answer 7

intermediolateral cell column of the spinal level T1-L2

Question 8

soluble steroids

Answer 8

dexamethasone

Question 9

innervation of SI joints

Answer 9

anterior SI joint = L2-S2 ventral rami

posterior SI joint = L4-S3 dorsal rami

Question 10

Benefit of using epinephrine with anesthetics

Answer 10

prolongs duration of action

Question 11

the stellate ganglion is composed of

Answer 11

lower cervical sympathetic and upper thoracic ganglia

Question 12

where do you want the needle in a TFESI

Answer 12

6 o’clock position inferior to pedicle in the upper third the neuroforamen

Question 13

is lidocaine an amide or ester?

Answer 13

amide. All amides have “i” before “-caine”

Question 14

relatively insoluble steroids

Answer 14

triamcinolone

Question 15

when doing discography, normal opening disc pressure is how many psi?

Answer 15

5 to 25 psi

Question 16

relationship between radiation exposure and distance from source

Answer 16

radiation exposure is inversely proportional to square of distance from source.
Increase distance, decrease radiation.

Question 17

where is hypogastric plexus located

Answer 17

lower 1/3 of L5 vertebral body

Question 18

celiac plexus receives sympathetic and parasympathetic fibers from where?

Answer 18

sympathetic - greater, lesser and least splanchnic nerves

parasympathetic - vagus nerve

Question 19

particulate steroids

Answer 19

1. betamethasone sodium phosphate and acetate
2. methylprednisolone
3. triamcinolone

Question 20

most potent steroids

Answer 20

betamethasone and dexamethasone

Question 21

advantage of amides over esters

Answer 21

amides have less allergic/adverse reactions

Question 22

longest acting steroids, in order

Answer 22

1. dexamethasone
2. methylprednisolone
3. betamethasone
4. triamcinolone

Question 23

where is stellate ganglion located

Answer 23

anterolateral to C7

Question 24

in a caudal approach, the needle should not advance higher than what level

Answer 24

S3, because dural sac ends at around S2 level

Question 25

non-particulate steroids

Answer 25

dexamethasone

Question 26

positive response after a diagnostic MBB is when there is how much pain relief?

Answer 26

> 80%