Neuraxial APEX

Question 1

Most important determinant of intrathecal spread when isuing hypo or isobaric solutions

Answer 1

Dose

Question 2

Most important factor in intrathecal spread when using a hyperbaric solution

Answer 2

Baricity

Question 3

Differential blockade order

Answer 3

Autonomic fibers
Sensory
Motor

Question 4

Spinal anesthesia sensory vs motor block (dermatomes)

Answer 4

sensory is 2 dermatomes above motor
Autonomic is 2-6 above sensory

Question 5

Epidural anesthesia autonomic vs sensory vs motor block (dermatomes)

Answer 5

Sensory and autonomic is 2-4 above motor

Question 6

How to monitor a sensory block

Answer 6

1st- wont feel a cold alcohol pad
2nd- wont feel pinprick
3rd- wont feel touch or pressure

Question 7

How to monitor a motor block

Answer 7

Modified bromage scale (only for lumbosacral, nothing higher)
0- no block
1- pt cant raise an extended leg, but can move FEET AND KNEES
2- pt cant raise and extended leg, but can move the FEET
3- complete block, can move legs, knees, or feet

Question 8

Primary determinant of epidural block height and density

Answer 8

H- volume
D- concentration

Question 8

Important factors for LA spread in spinals

Answer 8

Position
LA dose
Baricity

Question 9

What causes apnea ?

Answer 9

Brainstem hypoperfusion
NOT PHRENIC NERVE PARALYSIS

Question 10

Bezold jarish reflex

Answer 10

Heart slows to allow adequate time to fill
Can cause asystole