Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Advanced Principles > Neuraxial > Flashcards

Neuraxial Flashcards

1
Q

of vertebrae and nerves

A
  • 33 vertebrae
    • 7 cervical (neck)
    • 12 thoracic
    • 5 lumbar
    • 5 sacral (fused)
    • 4 coccygeal (fused)
  • 31 spinal nerves
    • 8 cervical
    • 12 thoracic
    • 5 lumbar
    • 5 sacral
    • 1 coccygeal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

supraspinous ligament

A
  • runs from C5 to sacrum
  • resids on top of each spinous process, continuous, runs all the way down
  • joins the tip of the spinous processes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Interspinous Ligament

A
  • in between each spinous process
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ligamentum flavum

A
  • yellow, tough, thick ligament
  • thickest in the midline at a L3
  • wedge shaped, composed of elastin
  • extends from FORAMEN MAGUM to SACRAL HIATUS
  • as your pt gets older, the flavum can get weaker and feel less like a landmark
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

posterior longitudinal ligament

A
  • posterior surface of vertebral bodies, C2-SACRUM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

anterior longitudinal ligament

A
  • anterior surface of vertebral bodies C1-SACRUM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

vertebral curves

A
  • HIGH (when supine)
    • L3, C5
  • LOW (when supine)
    • S2, T5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

dermatomes:

A
  • C6 - tumb
  • C7 - index and middle finger
  • C8 - 4th and 5th finger
  • T1 - elbow
  • T4 - nipple line
  • T6 - xiphoid
  • T8 - last rib
  • T10 - umbilicus
  • T12 - pubic symphysis
  • L4 - anterior knee
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CSF volumes

A

CSF volume

  • 150 mL in the subarachnoid space
  • CSF replaced 3-4x per day
  • made by choroid plexus, rate of 21 mL/hr
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CSF SG:

A
  • nicole: 1.004 - 1.008
  • Apex:
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Anterior Spinal Artery

A
  • arises from joining of vertebral arties
  • perfuses the anterior 2/3 of the superior (Short) segment of spinal cord
  • runs entire length of spinal cord
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Posterior Spinal Arteries

A
  • two!
  • run the entire length of the spine
  • arise from a branch of either the vertebral arteries or hte psoterior inferior cerebral artery
  • supply posterior 1/3 of spinal cord,
  • only supplies the short, superior segment

Posterior spinal cord has better continuity of blood supply!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Remained of spinal cord relies on blood supply from

A
  • anterior spinal artery - anterior 2/3 spinal cord, superior, short segment
  • 2 posterior spinal arteries, posterior 1/3 of spinal cord, short, superior segment

Remained of spinal cord relies on BRANCHES from cervical, deep cervical, vertebral, posetrior intercostal and lumbar arteries, enter the vertebral column through intervertebral foramina. +Artery of Adamkiewics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Artery of Adamkiewics

A
  • also known as great anterior segmantal medullary artery
  • provids circulation to the inferior two thirds of the anterior spinal cord
  • generally arises from T9 - T12 on the left side of the aorta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

differential blockade in spinals

A

IN SPINALS

  • autonomic blockade is 2-6 dermatomes higher than sensory blockade
  • sensory blockade is 2 dermatomes higher than motor block
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

differential blockade in epidurals

A

IN EPIDURALS

  • No autonomic differential bloackde with epidural anesthesia
  • sensory blockade is 2-4 dermatomes HIGHER than motor blockade
17
Q

CV changes with neuraxial

A
  • decrease in SVR of 15-20%
  • decrease in preload of 10-15%
  • venous dilation > arterial dilation
  • sympathectomy

fluid bolus rec: 15 mL/kg

+ vasopressors

+ anti-cholinergics if necessary

18
Q

GI/Renal effects with neuraxial

A
  • 20% N/V
  • Hyper-peristalsis from sympathectomy and unopposed parasympathetics
  • maintenance of MAP guards against untoward effects to liver
  • Renal blood flow is autoregulated therefore minimal effects
  • urinary retention!
19
Q

low CBF with neuraxial is manifested by

A
  1. N/V
  2. if sufficently dereased -> apnea and hypoxia
20
Q

pencil point needle names

A
  1. sprotte
  2. whitacre
  3. pencan
21
Q

cutting needle names

A
  1. quincke
  2. pitkin
22
Q

hyperbaric solution SG

A
  • >1.11
  • CSF SG: 1.004 - 1.008
23
Q

Isobaric SG

A

~ 1.006

CSF SG: 1.004 - 1.008

24
Q

Hypobaric SG

A

<1.005

CSF SG: 1.004 - 1.008

25
Q

epidural space is widest at

A

L2

(5 mm)

  • ligamentum flavum widest at L3
26
Q

caudal anesthesia carries high risk of

A

injection into venous plexus

27
Q

+ rxn to test dose for epidural

A
  • increase of HR/BP by 15-20% within 1 minute - + for intravascular
  • numbness of legs/motor blockade within 1 minute -> intrathecal
28
Q

Sacral hiatus

A
  • corresponds with S5
  • covered by the sacrococcygeal ligament
  • provdes entry point to epidural space (in children)
29
Q

apnea is usually the result of

A

cerebral hypoperfusion and ischemia to respiratory drive center

30
Q
A

Advanced Principles (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions