Positioning

Question 1

The most common 3 causes of legal settlement against CRNAs due to missed documentation?

Answer 1

1. mal-Patient Position.
2. Not using protective padding.
3. Preexisting patient conditions.

NOT CHARTING IS THE PROBLEM!!!

Question 2

What is the most common nerve injury?

Answer 2

Ulnar nerve

About 28%

Question 3

What increases the risk of nerve injury?

Answer 3

Inadequate/inappropriate positioning.
Preexisting patient conditions.
General anesthesia (can't move/talk).
Extremes of size (large or small).
Procedures lasting >4hrs

Question 4

What are the four types of nerve injury?

Answer 4

Transection.
Compression.
Stretch.
Kinking.

Question 5

The brachial nerves begin from what area of the spinal cord?

Answer 5

C5-T1

but can be C4-T2

Question 6

How many roots are there?

Answer 6

5

Question 7

How many cords are there?

Answer 7

3

Question 8

How many divisions are there?

Answer 8

6
(3 anterior
3 posterior)

Question 9

How many trunks are there?

Answer 9

3

Question 10

List the brachial plexus deviations in order

Answer 10

Roots
Trunks
Divisions
Cords
Branches
(Randy Travis Drinks Cold Beer)

Question 11

What are the 5 peripheral nerves (branches)

Answer 11

1. Musculo-cutaneous.
2. Axillary.
3. Radial.
4. Median.
5. Ulnar.

Question 12

The naming/labeling of the nerves within the brachial plexus is in relation to what anatomic structure?

Answer 12

The Brachial Artery

Question 13

Only three of the branches make it to the hand- what are they?

Answer 13

Radial.
Median.
Ulnar.

Question 14

What does the musculo-cutaneous nerve innervate?

Answer 14

Bicep and skin of forearm.

Question 15

What does the axillary nerve innervate?

Answer 15

Mostly deltoid and shoulder

Question 16

What does the ulnar nerve innervate?

Answer 16

Ring ringer split in half and pinky

Question 17

What does the radial nerve innervate?

Answer 17

Thumb and mostly back of hand side.

Question 18

From what level of the spinal column does the ulnar nerve originate?

Answer 18

C8

Question 19

What does the median nerve innervate?

Answer 19

Middle of hand, mostly palm side of hand. and nail beds of middle fingers.

Question 20

Where in the spinal column do the cardiac nerves originate?

Answer 20

T1-T4

Question 21

Where in the spinal column do the respiratory nerves originate?

Answer 21

C3-C4-C5 (keep the man alive)

Question 22

As a spinal anesthetic “moves up”, what is the first sign in the hand that this is happening?

Answer 22

Ulnar nerve will be effected. May have pinky numbness.

Originates from C8.

Question 23

The main etiology behind nerve injury is due to what?

Answer 23

Ischemia

Question 24

Where are the most common points of nerve injury in the arm?

Answer 24

Points of joints and bony prominences

Question 25

Where does the lumbar plexus extend from?

Answer 25

L1-L5

Question 26

What is the only branch from femoral that makes it all the way to the foot/ankle?

Answer 26

Saphenous

Question 27

What is the most important nerve running through the groin that can be damaged?

Answer 27

Femoral nerve

Question 28

Where does the Sacral plexus extend from?

Answer 28

L4-coxis

Question 29

What is the major nerve from the sacral plexus that can be injured?

Answer 29

Sciatic nerve

Question 30

Which two nerves make up the sciatic nerve?

Answer 30

Tibial and common peroneal

Question 31

At what spinal level is the nipple line involved?

Answer 31

T4

Question 32

At what spinal level is the xyphoid process involved?

Answer 32

T6/T7

Question 33

At what spinal level is the belly button involved?

Answer 33

T10 (Butt-ten)

Question 34

What does the axillary roll prevent?

Answer 34

Compression of brachial nerves and artery

Question 35

What injury is possible with fracture table?

Answer 35

Groin area compression.

Question 36

Which nerve can be injured with tourniquet use and BP cuffs?

Answer 36

Radial nerve

Question 37

Which nerve is most commonly damaged from stirrup use?

Answer 37

Common peroneal nerve

Question 38

Three anesthetic techniques/factors are involved in risk of nerve injury- what are they?

Answer 38

General anesthesia. Hypotensive. Neuromuscular blockade

Question 39

Does risk of nerve injury increase or decrease as length of surgery increase?

Answer 39

Risk of injury will increase as length of procedure increases

Question 40

What is the most common metabolic cause of spontaneous neuropathy?

Answer 40

Diabetes

Question 41

West Zone 1 pressures

Answer 41

Alveolar>Arterial>venous

Question 42

West Zone 3 pressures

Answer 42

Arterial>Venous>Alveolar

Question 43

West Zone 2 Pressures

Answer 43

Arterial>Alveolar>Venous