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Gross III > Part III. Clinical notes > Flashcards

Part III. Clinical notes Flashcards

1
Q

There are two general types of anesthesia for childbirth. What are they?

A

General anesthesia

Regional anesthesia

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2
Q

Why is general anesthesia not commonly used for childbirth except in emergency procedures?

A

Renders woman unconscious and unaware of labor and delivery so childbirth occurs passively under control of maternal hormones with out feedback from mother so she must be closely monitored.

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3
Q

Where is anesthetic agent introduced in a spinal block?

A

into subarachnoid space at L3/L4

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4
Q

What does the spinal block anesthetize?

A

Anesthetizes everything inferior to waist including perineum, pelvic floor, birth canal, uterine pain sensations, motor/sensory of lower limbs

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5
Q

What type of regional anesthesia requires electronic monitoring of contractions?

A

Spinal block, because everything from the waist down in numb

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6
Q

Can you readminister a spinal block if labor is long?

A

Difficult or impossible to re-administer anesthetic

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7
Q

What is a common side effect of spinal block after delivery?

A

After delivery, when lying flat, anesthetic circulates to cranial cavity commonly resulting in a severe headache

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8
Q

Where is anesthetic agent introduced in a caudal epidural block?

A

Via an in-dwelling catheter in sacral canal to nerve roots of S2-S4

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9
Q

What are the benefits of epidural block in childbirth?

A
  • can be administered in advance of labor
  • enables readministering of anesthesia
  • Woman is aware of uterine contractions but doesn’t experience most pain
  • no spinal headache
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10
Q

Why does the epidural block not result in a spinal headache?

A

because vertebral epidural space is not continuous with

cranial epidural space

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11
Q

What does the epidural block anesthetize?

A

Anesthetizes fibers in Pudendal N plus uterus and upper vagina - woman is aware of contractions and therefore they do not need to be monitored

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12
Q

Where is anesthetic administered in a pudendal nerve block?

A

injected near Pudendal N where it passes over ischial spine

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13
Q

What does the pudendal nerve block anesthetize?

A

S2-S4 dermatomes (majority of perineum and lower vagina)

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14
Q

Does pudendal nerve block anesthetize sensations of uterine contractions?

A

No

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15
Q

Does epidural block anesthetize sensations of uterine contractions?

A

No

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16
Q

Does spinal block anesthetize sensations of uterine contractions?

A

Yes

17
Q

Can anesthesia be readministered with a pudendal nerve block is labor is long?

A

Yes

18
Q

Can anesthesia be readministered with an epidural block if labor is long?

A

Yes

19
Q

What is a hysterectomy?

A

Excision of the uterus

20
Q

How can the hysterectomy be performed?

A

Through abdominal wall or through vagina

21
Q

What are some reasons for performing a hysterectomy?

A

Uterine cancer, cervical cancer, uterine prolapse

22
Q

What type of anesthesia is administered before doing an episiotomy?

A

Pudendal nerve block

23
Q

what does a total hysterectomy mean?

A

Cervix was also taken

24
Q

What other procedure is also commonly done with a hysterectomy?

A

Oopherectomy - removal of ovaries

25
Q

What structures can be palpated by digital rectal exam in both males and females?

A

Sacrum
Coccyx
Ischial spines
Ischial tuberosities

26
Q

What structures can be palpated by digital rectal exam in males?

A

Prostate

Seminal vesicles

27
Q

What structure can be palpated by digital rectal exam in females?

A

Cervix

28
Q

What are you palpating for on a digital rectal exam?

A

Pathology such as enlarged nodes, thickened ureters or abscesses

29
Q

What is a proctoscope used for?

A

Proctoscope may be used to visualize rectal lumen and remove lesions (hemorrhoids)

30
Q

Benign prostatic hypertrophy is associated with which lobe of the prostate?

A

Middle lobe

31
Q

What are the symptoms of BPH?

A

It obstructs prostatic urethra and impedes urine flow, causing nocturia, dysuria and urgency

32
Q

When palpating for BPH on a digital rectal exam, when is it best done?

A

with a full bladder which provides resistance to push against

33
Q

What is a transurethral procedure?

A

Procedure to widen urethra by removing some gland tissue

34
Q

Prostate cancer occurs most commonly in men over the age of ___.

A

55

35
Q

Prostate cancer is associated with which lobe of the prostate?

A

Posterior lobe

36
Q

How will a cancerous prostate feel on digital rectal exam?

A

firm and irregular

37
Q

Metastatic cells associated with prostate cancer will move to which lymph nodes?

A

internal iliac and sacral lymph nodes

38
Q

What is the treatment for prostate cancer?

A

often combines radiation and hormone therapy

Sometimes removal of prostate - Prostatectomy

39
Q

What are the risks of a prostatectomy?

A

damaging nerves involved in erection and urinary control

Gross III (20 decks)

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