Neuraxial Blocks Flashcards
3 names for spinal?
spinal, subarachnoid block, SAB
4 names for epidural?
epidural, extradural, caudal, central neuroaxial blockade
How many cervical, thoracic, lumbar, sacral, and coccygeal vertebrae are there and are they anterior or posterior?
cervical: 7 and anterior; thoracic: 12 and posterior; lumbar: 5 and anterior; sacral: 5 and posterior; coccygeal: 4
Which parts of the spine are fused in adults?
sacral and coccygeal
Landmark for T7?
line drawn on the lower borders of the scapula
Landmark for L4 is also known as?
Tuffier’s line
Landmark for S2?
line between posterior superior iliac spines (distal extend of dural sac)
Spinal cord stops at the level of? And what emerges from there?
L1; cauda equina
6 characteristics all vertebrae have?
vertebra body, 2 pedicles (notched for nerve roots), 2 transverse processes (notched for muscle attachment), 2 laminae (one left and one right), 1 spinous process (allows us to tell what level we’re at), 4 articular processes (2 project upward and 2 downward)
What part of the vertebra serves as synovial joints and allow us to bend, twist, and move spinal column?
articular processes
What part of vertebra do we palpate from the outside?
spinous process
These 2 kinds of vertebrae in the spine are more horizontal?
lumbar and cervical
From cephalad to caudad what happens to the vertebral laminae?
they become more vertical
Lumbar spinous processes have what shape characteristic?
they’re shorter and broader
The spinous process angle of cervical, thoracic, and lumbar?
cervical: more horizontal but small; thoracic: angular; lumbar: almost horizontal and bone is very thick
A way to get the sacral region anesthetized?
Have pt lie on side and flat, place small pillow under knees and flatten out lumbar curve which promotes more even distribution of hyperbaric LA in spine
Hyperbaric solution has a viscosity that compares how to the CSF?
hyperbaric solution has > varicity than CSF
What holds together the anterior vertebral bodies?
anterior longitudinal ligament
This ligament is on the far side of the dura and holds together the posterior part of the vertebral bodies?
posterior longitudinal ligament
This ligament joins the vertebral spines?
supraspinous
Where does the supraspinous ligament extend from?
occipital protuberance to coccyx
This ligament runs between the spinous processes?
interspinous
Where does this ligament extend to?
foramen magnum to sacral hiatus
Where does the epidural space extend to?
base of skull to sacrococcygeal membrane