Nerve Injuries

Question 1

What is the most common post-op peripheral neuropathy?

Answer 1

Ulnar nerve

Question 2

Injury of ulnar nerve causes…

Answer 2

Inability to abduct or oppose the 5th finger
Decreased sensation over both surfaces of the ring and pinky fingers
“Claw hand” deformity

Question 3

What is the second most common post-op neurologic injury?

Answer 3

Brachial plexus injury

Question 4

Injury to radial nerve causes…

Answer 4

Wrist drop
Inability to extend the metacarpophalangeal joints
Weakness in abduction of the thumb
Decreased sensation over dorsal surfaces of the lateral 3.5 fingers

Question 5

Injury to median nerve causes…

Answer 5

Inability to oppose the first and fifth digits
Decreased sensation on the palmar surface of the lateral 3.5 fingers
“Ape hand” deformity

Question 6

Injury to musculocutaneous nerve causes…

Answer 6

Inability to flex arm

Decreased sensation over the ventral surface of the forearm

Question 7

Injury to the sciatic nerve causes…

Answer 7

Foot drop
Weak muscles below the knee
Decreased sensation over the lateral half of the leg and almost all the foot

Question 8

What is the most frequently damaged nerve in the LE?

Answer 8

Common peroneal nerve

*Lithotomy and lateral position

Question 9

Injury of the common peroneal nerve causes…

Answer 9

Foot drop
Loss of dorsal extension of toes
Inability to evert the foot

Question 10

Injury of the femoral nerve causes…

Answer 10

Decreased or absent knee jerk reflex
Loss of flexion of hip
Loss of extension of knee
Decreased sensation over the superior, medial, and anteromedial aspect of the leg

Question 11

Suspect ______ in patients who develop a femoral neuropathy.

Answer 11

Diabetes

Question 12

Injury of the obturator nerve causes…

Answer 12

Inability to adduct the leg

Decreased sensation over the medial aspect of the thigh

Question 13

What 3 nerve injuries can cause foot drop?

Answer 13

1. Sciatic nerve injury
2. Common peroneal nerve injury
3. Anterior tibial nerve injury

Question 14

What nerves may be damaged during face mask ventilation?

Answer 14

Buccal branch of the Facial nerve (CN 7)

Supraorbital branch of the Trigeminal nerve (CN 5)

Question 15

The lawn chair position prevents injury to what nerve?

Answer 15

Sciatic nerve

Question 16

For a patient in steep T-burg, what is the most likely nerve injury?

Answer 16

Brachial plexus

Question 17

Injury to bilateral hypoglossal nerves causes…

Answer 17

Difficulty with speech and swallowing

Question 18

The patient’s foot has been placed in plantar flexion for an extended period of time. What nerve is commonly injured in this scenario?

Answer 18

Tibial

Question 19

Steep T-burg

Answer 19

Decrease
Pulmonary compliance 
TLC
VC
FRC 
CO

Increase 
Zone 3 or 4 
VR 
CVP
Pulmonary BF 
ICP

Question 20

What position most decreases FRC and pulmonary compliance?

Answer 20

T-burg

Question 21

Why is pulmonary edema a complication in the patient placed in the steep T-burg position?

Answer 21

The most common cause of pulmonary edema is an elevated LA pressure, which is transmitted back to the pulmonary capillaries

Question 22

What happens to FRC when awake healthy patients shift from the supine to the prone position?

Answer 22

FRC increases

Question 23

Position change: Upright to supine

What happens to: TLC, RV, TV, FRC, ERV, IRV, CV

Answer 23

RV, TV, TLC, CC, CV - do NOT change significantly

FRC, ERV - decreases

IRV - increase

Question 24

The least amount of physiological compromise occurs in what position?

Answer 24

Supine

Question 25

How many fingerbreadths of space should be between the chin and sternum?

Answer 25

2

*Excessive flexion obstructs venous and lymphatic outflow

Question 26

Elevation of the kidney rest compresses which structure and leads to what response?

Answer 26

IVC

Decreased VR and BP

Question 27

Placement of the head and neck at the limits of motion may produce anatomic changes that compress the…

Answer 27

Vertebral arteries