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N928 - Basic Principles > Perioperative Positioning > Flashcards

Perioperative Positioning Flashcards

1
Q

AANA Standards for Nurse Anesthesia Practice:

Standard 8

A

Patient positioning collaborate with the surgical or procedure team to position, assess, and monitor proper body alignment. Use protective measures to maintain perfusion and protect pressure points and nerve plexus.

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2
Q

What are the two most commonly injured nervous strucutres?

A
  • Ulnar nerve

- Brachial plexus

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3
Q

What are 7 goals for positioning?

A
  1. patient safety
  2. optimize surgical exposure
  3. preserve patient dignity
  4. maintain hemodynamic stability
  5. maintain cardiorespiratory function
  6. no ischemia, injury or compression
  7. 2015 Joint Comission Patient Safety Goal #14 “prevent healthcare associated pressure ulcers”
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4
Q

What are the 3 physiological systems associated with positioning injuries?

A
  1. Cardiopulmonary
  2. Nervous system
  3. Integumentary
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5
Q

What are 3 major cardiovascular concerns related to patient positioning and implicated medications?

A
  1. ↓CO & BP - Volatile anesthetics
  2. ↓muscle tone & venous return - NMBDs
  3. ↓HR (CO&BP) - Opioids
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6
Q

What are 3 major respiratory concerns related to patient positioning?

A
  1. barriers to thoracic excursion
  2. positive pressure ventilation
  3. gravity related effects
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7
Q

What positions may affect thoracic excursion?

A

Prone = reduced capacity for chest expansion

Supine/Lateral/Prone = Cephalad displacement

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8
Q

What are 3 gravity related effects on the pulmonary system related to positioning?

A
  1. Ventilation - nondependent (dead space; ventilation no perfusion)
  2. Perfusion - dependent (shunt; perfused, no ventilation)
  3. Loss of hypoxic pulmonary vasoconstriction (HPV) r/t _______
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9
Q

What are the mechanisms associated to nerve injury?

A
  • compression
  • transection
  • stretch
  • traction
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10
Q

Nerve sheath ischemia can be a result of _____ or ____ forces.

A

direct

indirect

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11
Q

What are some risk factors for pressure injury development?

A
  • Age; elderly
  • diabetes
  • peripheral vascular disease
  • surgical time
  • chronic hypotension
  • increased body temperature
  • body habitus
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12
Q

When does patient positioning and injury prevention begin?

A

during the pre-operative interview

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13
Q

4 considerations for all surgical patients & positioning:

A
  1. perioperative nerve injury & comorbidities
  2. Identify those at risk
  3. mobility limitations?
  4. always take precautionary measures
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14
Q

5 “standard” (my words) surgical positions:

A
  1. supine
  2. prone
  3. lithotomy
  4. lateral
  5. sitting (beach chair)
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15
Q

Variations in surgical positions:

A 
Trendelenburg
Reverse Trendelenburg
High Lithotomy
Low Lithotomy
Jack-knife
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16
Q

What are the pressure points when in supine position?

9

A
  1. toes
  2. calcaneae (heel)
  3. calves / thighs
  4. coccyx / sacrum
  5. thoracic vertebrae
  6. olecranon (elbow)
  7. humerous
  8. scapulae
  9. occiput
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17
Q

3 Arm considerations when supine:

A
  1. Lateral or abducted?
    - <90 degrees
    - supinated forearm / palms parallel to
    thighs/trunk
    - avoid stretch → brachial plexus injury
  2. arm boards, padding
  3. secured, arm straps
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18
Q

Pronation of forearm can lead to:

A

ulnar nerve compression at the cubital tunnel (elbow)

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19
Q

3 considerations/position of the legs when supine:

A
  1. legs flat, uncrossed
  2. heel padding
  3. consider small lumbar support
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20
Q

When arms are tucked, ensure you add ___

A

padding elbow (ulnar nerve)

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21
Q

How might monitoring/equipment effect positioning?

A

ensure patient is not in contact with tubing/lines/wires

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22
Q

How does flexion & extension of neck effect ETT position?

A

Flexion → ETT tip down up to 1.9cm

Extension → ETT tip up, up to 1.9cm

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23
Q

How does head turning effect ETT position?

A

can raise ETT tip up to 0.7cm

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24
Q

What are 2 cardiovascular implications of supine positioning?

A
  1. BP instability

2. Compensatory mechanisms (ANS) ______

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25
Q

What are 3 respiratory implications of supine positioning?

A
  1. Reduced TLC & FRC
  2. Diaphragm shifts cephalad
  3. general anesthesia & NMBDs enhance effects
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26
Q

What are some special considerations of ventral decubitus positioning?

A
  1. patient often ventilated
  2. induction & intubation occurs on stretcher, before moving to OR table
  3. maintain neutral head/neck
  4. movement from stretcher to OR table will be on ANESTHESIA’s count
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27
Q

What are 4 special considerations of ventral decubitus positioning?

A
  1. patient often ventilated
  2. induction & intubation occurs on stretcher, before moving to OR table
  3. maintain neutral head/neck
  4. movement from stretcher to OR table will be on ANESTHESIA’s count
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28
Q

What kinds of surgical positions use the prone position?

A
  1. supine
  2. buttocks
  3. rectum or peri-rectal
  4. ankle
  5. intracranial
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29
Q

What 5 kinds of surgical positions use the prone position?

A
  1. supine
  2. buttocks
  3. rectum or peri-rectal
  4. ankle
  5. intracranial
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30
Q

What are respiratory considerations for potential complications when in prone position?

A
  1. decreased compliance if chest not freely hanging

2. increased FRC (improved posterior lung ventilation may increase oxygenation)

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31
Q

During prone positioning, take special care with which anatomical parts?

A
  1. eyes
  2. face
  3. nose
  4. breasts
  5. genitalia (penis)
  6. lower legs
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32
Q

During prone positioning, take special care with which anatomical parts (6)?

A
  1. eyes
  2. face
  3. nose
  4. breasts
  5. genitalia (penis)
  6. lower legs
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33
Q

Postoperative vision loss (POVL) is caused by: (3)

A
  1. central retinal artery occlusion (CRAO)
  2. central retinal vein occlusion (CRVO)
  3. ischemic optic neuropathy (ION - 89% of POVL)
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34
Q

POVL is associated with which type of surgery:

A

prolonged surgical time, supine surgeries

patient is positioned prone

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35
Q

What are steps to prevent POVL?

4

A
  1. surgical duration <6 hours
  2. 10-15 degrees head up [will reduce orbital edema]
  3. BP 20% of preoperative baseline????? (MAP >70mmHg)
  4. maintain Hct >25%
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36
Q

Ischemic optic neuropathy (ION) is a type of POVL and associated with what two factors?

A
  1. extended surgical time

2. extensive blood loss

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37
Q

Ischemic optic neuropathy (ION) is NOT associated with which factor?

A
  • globe pressure
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38
Q

What are patient specific factors that increase risk of Ischemic optic neuropathy (ION)?

A
  • obesity

- male gender

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39
Q

What is the ocular perfusion pressure equation?

A

OPP = MAP - IOP

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40
Q

Central retinal artery occlusion (CRAO) “nickname”:

A

eye stroke

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41
Q

Central retinal vein occlusion (CRVO) “nickname”

A

eye DVT

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42
Q

What is the clinical presentation of central retinal artery occlusion (CRAO)?

A

sudden, profound vision loss.
painless
monocular

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43
Q

What is the etiology of central retinal artery occlusion (CRAO)?

A
  1. embolism
  2. vasculitis
  3. vasospasm
  4. sickle cell
  5. trauma
  6. glaucoma
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44
Q

What are 6 possible etiologies of central retinal artery occlusion (CRAO)?

A
  1. embolism
  2. vasculitis
  3. vasospasm
  4. sickle cell
  5. trauma
  6. glaucoma
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45
Q

What are the 3 signs to diagnose central retinal artery occlusion (CRAO)?

A
  1. Retinal pallor
  2. Macular cherry red spot
  3. +/- Afferent pupillary defect
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46
Q

What is the treatment of central retinal artery occlusion (CRAO)?

A
  1. consult ophtho + neurology

Some case reports indicate intra-arterial TPA.
Limited evidence for other treatments, including digital massage & lowering IOP.

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47
Q

What is the clinical presentation of central retinal vein occlusion (CRVO)?

A

Variable presentation.

  1. spectrum from blurred vision to sudden vision loss
  2. painless
  3. monocular
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48
Q

What are risk factors of central retinal vein occlusion (CRVO)?

A
  • typical stroke risk factors
  • hypercoagulable state
  • glaucoma
  • compression of the vein from thyroid or orbital tumors
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49
Q

What are 2 indicators to diagnose central retinal vein occlusion (CRVO)?

A
  1. optic disk edema

2. diffuse retinal hemorrhages (blood-and-thunder)

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50
Q

What is the treatment of central retinal vein occlusion (CRVO)?

A
  1. consult ophtho & neurology
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51
Q

Lithotomy leg & finger positioning:

A
  • legs abducted & elevated
  • hip flexion
  • fingers free and over end of bed (by hips)
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52
Q

Nerves at risk of damage due to hip flexion in lithotomy & mechanism of injury: (2)

A
  1. Sciatic / Obturator (stretched with external rotation of leg or hyperflexion of the hip & knee extension)
  2. Femoral nerve (palsy)
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53
Q

Lithotomy position facilitates access to:

A
  • perineal structures
  • gynecological
  • urology
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54
Q

What are cardiovascular effects of the lithotomy position?

A
  1. 20% reduced FRC
  2. Reduced VC
  3. Hypoventilation when breathing spontaneously
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55
Q

What are respiratory effects of the lithotomy position?

A
  1. increased (shifted) central blood volume
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56
Q

How much volume of blood is shifted in the lithotomy position?

A

~200-300mL per leg when raised

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57
Q

What are possible variations of the lithotomy position? (4) - outside source

A
  1. low lithotomy
    - posterior thighs & bed make 40-60 degree angle; lower legs are parallel to bed
  2. high lithotomy
    - posterior thighs & bed make 110-120 degree angle; lower legs are flexed
  3. hemi-lithotomy
    - patient’s NON-operative leg is positioned in standard lithotomy; operative leg may be placed in traction
  4. exaggerated lithotomy
    - posterior thighs & bed make 130-150 degree angle; lower legs are almost vertical
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58
Q

What nerves are at risk of damage in lithotomy due to knee flexion?

A

peroneal nerve: pressure of head of fibula by bar or support structure

saphenous nerve: pressure on medial condyle of tibia

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59
Q

Lateral position head & face considerations:

A
  1. head neutral & supported

2. eyes/ears/face pressure free

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60
Q

In the lateral position ____ should be aligned.

A

shoulders, hips, head, legs

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61
Q

In the lateral position supporters or bean bags should be used in two locations:

A

hip & chest

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62
Q

In the lateral position, how should the dependent arm be positioned?

A
  1. nearly perpendicular to torso, <90 degrees

2. on padded arm board

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63
Q

Where should an axillary roll be placed when a patient is in the lateral position?

A

under the dependent side of the thorax, slightly caudad, not directly in axilla

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64
Q

During which surgical procedures is the lateral position used?

A
  • kidney
  • shoulder
  • orthopedic (THA; hip)
  • thorax
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65
Q

What are respiratory considerations of the lateral position?

A
  1. V/Q mismatch is possible
  2. FRC:
    - increased in non-dependent lung
    - decreased in dependent lung
  3. dependent lung will be lower than the left atrium → prone to atelectasis & fluid accumulation
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66
Q

The sitting surgical position is used for which procedures?

A
  • cervical spine surgery
  • shoulder surgery
  • posterior fossa
  • breast reconstruction
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67
Q

How is the head positioned in the sitting position?

A
  1. HOB 30-90 degrees above horizontal plane
    [OR table flexed & backrest elevated]
  2. head secured (2 fingerbreadths b/t neck and mandible?)
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68
Q

Consideration of vigorous surgical manipulation when patient is in the sitting position:

A

dislodgement of the head from the headrest

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69
Q

How are the lower extremities positioned when patient is in the sitting position?

A 
legs flexed (prevent sciatic stretch)
pad heels
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70
Q

How are the upper extremities positioned when patient is in the sitting position?

A

padded with arm boards or in patient’s lap with drawsheet

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71
Q

What are three major complications associated with the surgical sitting position?

A
  1. Venous air embolus (VAE)
  2. Pneumocephalus
  3. Quadriplegia
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72
Q

What are 3 major complications associated with the surgical sitting position?

A
  1. Venous air embolus (VAE)
  2. Pneumocephalus
  3. Quadriplegia
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73
Q

How does pneumocephalus occur in the sitting position?

A

air enters the open dura
CSF drainage
surgical decompression

*often benign

74
Q

What is the etiology of quadriplegia r/t surgical sitting position?

A
  • Spinal cord stretch when the head is flexed & loss of autoregulation with GA
  • ensure 2 fingerbreadths between the neck and mandible → will limit the strain placed on C5 vertebra
75
Q

What are cardiovascular considerations of the sitting position?

A
  1. reduced SV and CO
  2. decreased MAP and CVP
  3. venous pooling in the lower extremities
  4. decreased cerebral perfusion (CPP = MAP-ICP)
76
Q

What is the conversion factor of rise above heart & change in MAP?

A

1cm rise above heart = 0.75mmHg drop in MAP

77
Q

A rise of 20cm above the heart will lead to a decrease of ____ in MAP?

A

15mmHg

ie. MAP @ heart 65 = MAP @ brain 50mmHg

78
Q

What are respiratory considerations of the sitting position?

A
  1. increased FRC

2. increased compliance

79
Q

Basics of trendelenburg position:

A

Head down;

severity of considerations depends on the degree of trendelenburg

80
Q

In trendelenburg positioning, what three measurements increase?

A

ICP
IOP
CVP

81
Q

What injuries can occur due to shoulder braces when in the trendelenburg position?

A
  1. plexus stretch

2. plexus compression

82
Q

Basics of reverse trendelenburg:

A

bed flat; head up

83
Q

Reverse trendelenburg leads to an increase in ____ & ____.

A

pulmonary compliance

FRC

84
Q

Reverse trendelenburg will result in an increase in these 4 physiological measurements:

A
  1. ICP
  2. IOP
  3. CP
  4. BP
85
Q

What is the CRNA’s role in patient positioning?

A
  1. call turns/repositioning
  2. ensuring patient stability
  3. Everyone’s responsibility
    - surgeon
    - nursing
    - anesthesia provider
86
Q

Avoid excessive in 2 specific areas when positioning a patient:

A
  1. peripheral nerves

2. bony prominences

87
Q

When positioning a patient ensure these 5 things:

A
  1. adequate circulation
  2. head & neck support
  3. airway protection
  4. anatomical alignment
  5. access
88
Q

Effects of lithotomy on lung compliance & ventilation

A

↓compliance

↓ventilation

89
Q

4 types of nerve injuries

A
  1. transection
  2. compression
  3. stretching
  4. kinking
90
Q

What is transection of a nerve?

A

Nerve cut due to surgical maneuver or trauma

91
Q

What is a compression nerve injury?

A

Nerve forced against a hard surface or bony prominence

92
Q

What are the 2 types of nerve injuries most at risk for?

A

Compression & stretching

93
Q

Femoral nerve damage in high lithotomy

A

Femoral nerve kinked under inguinal ligament when hips are flexed during high lithotomy position

94
Q

What is a stretching nerve injury?

A

excessive elongation or stretching

95
Q

What is a kinking nerve injury?

A

nerve pinched between two immovable structures

96
Q

Positioning device injury to lateral femoral cutaneous nerve is from…

A

tight thigh table strap or leg holding device used for knee arthroscopy

97
Q

Positioning device injury to common peroneal nerve

A

candy cane stirrups

98
Q

Positioning device injury to brachial plexus

A

armboard falling off OR table or shoulder braces with steep trendelenburg position

99
Q

Shoulder braces should be positioned, where?

A

Outer side of the clavicle

100
Q

positioning device injury to radial nerve

A

compression injury d/t tourniquets (TQ) or BP cuffs

101
Q

improper positioning of an axillary roll may cause

A

compartment syndrome

102
Q

procedures >4 hours are ↑ concern for..

A 
- post-op vision loss
nerve injuries
compartment syndrome
rhabdomyolysis
acute renal failure
103
Q

muscle relaxation increases risk of which positioning injury?

A

stretch injury d/t increased mobility of joints

104
Q

hypotension increases the risk of which positioning injury?

A

low perfusion pressure → ischemia

105
Q

Peripheral nerve blocks increase the risk of which positioning injuries?

A

block technique, hematoma formation → compartment syndrome & needle trauma

106
Q

Ulnar nerve injury & gender

A

3:1 male/female predominence

107
Q

what are the ulnar nerve anatomical differences between women & men?

A

tubercle of the coronoid process
- covered only by skin, subQ fat, very thin aponeurosis of the flexor carpi ulnaris

larger and the nerve & blood vessels passing by it are less protected by subQ fat in men than in women

108
Q

Underweight concerns in positioning

A

lack of adequate adipose tissue over bony prominences

may develop decubiti or nerve damage

109
Q

muscular physique concerns in positioning

A

↑ risk for compartment syndrome & ulnar nerve injury

110
Q

obesity concerns in positioning

A

large tissue masses place increased pressure on dependent body parts

111
Q

preexisting conditions that increase the risk of positioning injury

A 
HTN
DM
PVD
peripheral neuropathies
alcoholism
smoking
subclinical ulnar nerve entrapment
anemia
liver disease
limited joint mobility
112
Q

6 types/locations of position related injuries

A
  1. ulnar nerve
  2. brachial plexus
  3. spinal cord
  4. post-op visual loss
  5. compartment syndrome
  6. venous air embolism
113
Q

What is the ultimate goal of patient positioning?

A

allow optimal surgical access while minimizing potential risk to the patient

114
Q

What are 5 factors that affect physiological changes during surgical positioning?

A
  1. surgical position
  2. length of time
  3. padding & positioning devices used
  4. the type of anesthesia given
  5. operative procedure
115
Q

What 2 physiological effects do volatile anesthetics have on the cardiovascular system?

A
  1. depression of the CNS & myocardial depression

2. vasodilation

116
Q

What physiological effects do NMBs have on the cardiovascular system?

A

abolished normal muscle tone

117
Q

What physiological effects do opioids have on the cardiovascular system?

A

slow HR

118
Q

What physiological effects does supine position have on the cardiovascular system?

A

minimal changes

119
Q

What physiological effects does sitting/prone/lateral position have on the cardiovascular system?

A

↓BP

↓CO

120
Q

What physiological effects does lithotomy position have on the cardiovascular system?

A

BP will be ↑ or normal

121
Q

In sitting position, where should the arterial line transducer be placed?

A

at the level of the head

122
Q

What is a goal MAP for a patient >50y in the sitting position (cuff BP)

A

MAP 70 or higher

123
Q

Robert Taylor Drinks Cold Beer

A 
root
trunk
division
cord
branches
124
Q

Position that can cause a stretch injury brachial plexus

A

arm abducted, head turned opposite side

unsupported shoulder

125
Q

In sitting position, close to 90degrees, what is the effect on FRC

A

↓FRC b/c diaphragm pushes up

126
Q

In sitting position, close to 30degrees, what is the effect on the FRC?

A

FRC should be increased (compared to supine)

127
Q

what is the #1 concern with nerve injury?

A

ischemia

128
Q

Hyperflexion of the neck can cause:

A

spinal cord injury. & ischemia

spinal cord moves anterior toward the vertebral body & is stretched

129
Q

Maintain ___ space between sternum and chest in sitting position

A

2 finger breadths to prevent hyperflexion of the neck

130
Q

5 ways to attenuate hemodynamic changes when positioning

A
  1. slow or gradual changes in positioning
  2. modify anesthesia technique to maintain stable vitals
  3. gradual attainment of level of anesthesia
  4. intravascular volume loading prior to positioning
  5. trendelenburg
131
Q

prone & trendelenburg position effects on intracerebral venous pressure

A

increased

132
Q

lithotomy & trendelenburg position effects on blood distribution

A

↑myocardial work

hypo-perfusion of the lower extremities

133
Q

Occlusion of the ophthalmic artery will prevent blood flow to where?

A

the entire eye

134
Q

The supine position will decrease FRC by how much?

A

0.8-1L

135
Q

Induction will decrease FRC by how much?

A

0.5L

136
Q

Effects of supine position on lung compliance & ventilation

A

↓compliance
↓ventilation

(same as lithotomy)

137
Q

Effects of prone position on lung compliance & ventilation

A

improved oxygenation

improved compliance

*** if abdomen is “hanging”

138
Q

Effects of lateral position on dependent lung compliance & ventilation

A

Dependent lung:
↓compliance
↓ventilation

139
Q

Effects of lateral position on nondependent lung compliance & ventilation

A

↑compliance

↑ventilation

140
Q

2 tools to detect a VAE

A
  1. ETCO2

2. precordial doppler

141
Q

What will the ETCO2 do in the event of a VAE?

A

big, immediate drop

142
Q

Precordial doppler

A

Mill-Will?? murmur?

143
Q

Precordial stethoscope

A

diaphragm to stick on chest

144
Q

Concerned about a VAE? use these 2 things:

A

CVP to pull air out of the right atrium

left lateral decubitus

145
Q

3 patient factors that increase the risk of perioperative nerve injury

A
  1. T2DM
  2. tobacco use
  3. HTN
146
Q

What procedures use the supine position?

A

ENT, chest, head, abdomen, extremity

147
Q

Where are the arms in supine position?

A
  1. abducted and secured on arm boards

2. padded & secured next to body

148
Q

Where are the legs in supine position?

A

flat, uncrossed, heel padding, support under knees

149
Q

What is the nerve on the anterior side of the leg that is prone to injury in supine position?

A

sural nerve

150
Q

What is the nerve on the posterior side of the leg that is prone to injury in the supine position?

A

superficial peroneal nerve

151
Q

What/where is the cubital tunnel?

A

groove between the medial epicondyle of the humerus and the olecranon of the ulna

152
Q

Claw hand occurs with what nerve injury?

A

ulnar nerve injury

153
Q

Wrist drop occurs with what nerve injury?

A

radial nerve injury

154
Q

Is VR increased or decreased in supine position?

A

increased d/t gravity

155
Q

What happens to HR in supine position?

A

initially is elevated; increased CO & BP lead to ↓SNS = ↓HR & vasodilation *final result

156
Q

3 factors that will ↓FRC

A

supine (cephalad displacement of the diaphragm)

general anesthesia

neuromuscular blockade

157
Q

In lithotomy position, the legs should be flexed < ___ at the hip

A

90

158
Q

In extreme flexion of the knees, obstruction of the ____ _____ & ___ can occur

A

popliteal vasculature & nerves

159
Q

What nerves are at high risk with flexion of the hips/knees

A

Sciatic nerve > splits into the common peroneal nerve & the tibial nerve

160
Q

Moving the legs together prevents ___ of the ____ &/or ____

A

stretching of the lumbosacral plexus &/or sciatic nerve

161
Q

Moving the legs together avoids strain on the

A
  • pelvic ligaments
162
Q

Moving the legs together prevents ___ dislocation

A

hip

163
Q

Moving the legs together avoids injury of __ nerve

A

femoral

164
Q

Pressure on the lateral aspect of the leg can cause injury to which nerve?

A

peroneal nerve

165
Q

Compression on the medial aspect of the leg can cause injury to which nerve?

A

saphenous nerve

166
Q

A patient with PVD will have impaired tissue perfusion when?

A

after autotransfusion d/t lithotomy position

167
Q

Once legs are lowered from lithotomy position, what may present itself at that time?

A

hypovolemia

168
Q

What are some procedures that require the lateral position?

A 
intracranial
shoulders
thoracic
kidney
hips
other orthopedic surgeries
169
Q

An axillary roll is placed to decompress 3 anatomical structures

A
  1. shoulder
  2. axillary vasculature
  3. brachial plexus
170
Q

In lateral position, the dependent leg can be ___

A

flexed for stabilization

171
Q

What are the three most common sites of injury when in the lateral position?

A
  1. brachial plexus
  2. ulnar nerve
  3. peroneal nerve

[of the dependent side]

172
Q

What can cause direct caval compression leading to ↓VR & hypotension?

A

kidney-rest

173
Q

What can lead to post-op blindness?

A
  • ↑IOP

- retinal artery occlusion

174
Q

During surgery, high intra-abdominal pressure may lead to

A

↓VR & ↓CO

epidural vein engorgement

175
Q

What might lead to increased venous blood loss during spine surgery?

A

engorgement off the epidural vein d/t increased intra-abdominal pressure (prone position)

176
Q

In the sitting position, it is important to flex the knees to prevent injury to what nerve?

A

Sciatic nerve

177
Q

Keeping 2 fingerbreadths between the neck and mandible will prevent strain on what?

A

C5

178
Q

Shoulder braces, when used in trendelenburg can lead to damage of what?

A

the brachial plexus

179
Q

If a patient’s legs are NOT uncrossed during surgery, the top leg can experience damage to which nerve?

A

sural nerve

180
Q

If a patient’s legs are NOT uncrossed during surgery, the bottom leg can experience damage to which nerve?

A

superficial peroneal nerve

181
Q

In reverse trendelenburg what positioning structure is used?

A

foot board

N928 - Basic Principles (22 decks)

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