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My APA Anesthesia 1 > Midterm > Flashcards

Midterm Flashcards

1
Q

second leading cause of OR law suits?

A

Nerve injuries (22%)

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2
Q

3 largest reasons of inadequate documentation

A
  • Positioning
  • Padding
  • Preexisting nerve injuries
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3
Q

most common nerve injuries (and %) (4)

A
  • Ulnar (28%)
  • Brachial Plexus (20%)
  • Lumbosacral (?)
  • Spinal cord (16%)
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4
Q

Risk factors of nerve injuries (5)

A
  • Positioning
  • Preexisting conditions (DM, tobacco, hypotension, hypothermia, liver disease, anemia, alcoholism)
  • General anesthesia
  • Extremes of weight (obese/thin)
  • OR >4hrs
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5
Q

Pathophys of nerve injury (4)

A
  • Transection
  • compression
  • stretch
  • kink

(all equals ischemia)

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6
Q

5 nerves of the Brachial Plexus

A
  • Radial
  • Ulnar
  • Median
  • axillary
  • musculocutaneous
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7
Q

Order of nerves in arms (medial to distal) and what saying to remember them?

A
  • Roots
  • Trunks
  • Divisions
  • cords
  • branches

Randy Travis Drinks Cold Beer

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8
Q

What spinal processes innervate the Brachial plexus

A
  • C5-8

- T1

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9
Q

which 3 nerves reach hand?

A
  • Ulnar
  • Radial
  • Median
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10
Q

which nerve is responsible for carpel tunnel?

A
  • Median
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11
Q

innervates bottom of hand and nailbeds

A
  • Median

cant grasp if damaged

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12
Q

innervates back of hand

A
  • Radial

cant bend fingers back if damaged

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13
Q

innervates shoulder joint and covers deltoid

A
  • axillary
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14
Q

innervates bicep and skin over bicep and forearm

A
  • musculocutaneous
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15
Q

spinal processes for lumbar plexus

A

L1-L5

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16
Q

spinal processes for sacral plexus

A
  • L4-L5
  • S1-S5
  • C0
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17
Q

T4 located at the ?

A

Nipple line

18
Q

T6-T7 located at the ?

A

Xiphoid process

19
Q

T10 located at the ?

A

Belly Button

20
Q

Axillary Roll risk of ?

A

Brachial plexus compression

21
Q

tight table strap can damage?

A

spinal processes for lumbar plexus

22
Q

Stirrups can damage? (2)

A

Lateral - Common Peroneal Nerve

Medial - saphenous nerve

23
Q

Armboard or shoulder braces can damage?

A

Brachial Plexus

24
Q

Tourniquets, BP cuffs, firm surface can damage?

A

Radial Nerve

25
Q

longer length cases risk of damage what nerve?

A

Ocular Nerve

26
Q

Perioperative factors related to nerve damage?

A
  • Longer cases
  • General anesthesia
  • Hypotensive technique
  • Neuromuscular blockade
27
Q

Respiratory considerations for supine position?

A
  • Decreased FRC and total lung capacity
28
Q

pressure change in trend position

A

2 mmHg for every 2.5 cm above/below heart

29
Q

what receptors compensate for extra volume near heart?

A

Baroreceptors

30
Q

neuro considerations for trendelenburg position

A
  • Increased ICP
  • Decreased CBF (from cerebral venous congestion)
  • Increased Intraocular pressure in glaucoma
31
Q

lithotomy considerations? (2)

A
  • raise and lower both legs together

- lower legs slowly and together

32
Q

where to place pulse ox in Lateral position?

A

dependent side (side of positioning - left lateral = left side)

33
Q

high risk position for vision loss?

A

prone

34
Q

what to maintain for decreased eye nerve damage?

A

MAP within 20% baseline

35
Q

positions where air emboli greatest risk

A

-sitting
-prone
-lateral
(when operative site above level of heart)

36
Q

positions with risk of compartment syndrome (2)

and at what case length?

A
  • Lateral
  • Lithotomy

> 5 hours

37
Q

what does common peroneal nerve damage manifest as? Also, how common?

A

Foot drop

most common lower extremity nerve damage

38
Q

radial nerve injury manifests as?

A

wrist drop

39
Q

ulnar nerve damage manifests as?

A

sensory loss fifth digit and claw hand

40
Q

what to do if air emboli suspected?

A

spill saline on field and turn pt left lateral

My APA Anesthesia 1 (8 decks)

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