Positioning Flashcards
The most common 3 causes of legal settlement against CRNAs due to missed documentation?
- mal-Patient Position.
- Not using protective padding.
- Preexisting patient conditions.
NOT CHARTING IS THE PROBLEM!!!
What is the most common nerve injury?
Ulnar nerve
About 28%
What increases the risk of nerve injury?
Inadequate/inappropriate positioning. Preexisting patient conditions. General anesthesia (can't move/talk). Extremes of size (large or small). Procedures lasting >4hrs
What are the four types of nerve injury?
Transection.
Compression.
Stretch.
Kinking.
The brachial nerves begin from what area of the spinal cord?
C5-T1
but can be C4-T2
How many roots are there?
5
How many cords are there?
3
How many divisions are there?
6
(3 anterior
3 posterior)
How many trunks are there?
3
List the brachial plexus deviations in order
Roots Trunks Divisions Cords Branches (Randy Travis Drinks Cold Beer)
What are the 5 peripheral nerves (branches)
- Musculo-cutaneous.
- Axillary.
- Radial.
- Median.
- Ulnar.
The naming/labeling of the nerves within the brachial plexus is in relation to what anatomic structure?
The Brachial Artery
Only three of the branches make it to the hand- what are they?
Radial.
Median.
Ulnar.
What does the musculo-cutaneous nerve innervate?
Bicep and skin of forearm.
What does the axillary nerve innervate?
Mostly deltoid and shoulder
What does the ulnar nerve innervate?
Ring ringer split in half and pinky
What does the radial nerve innervate?
Thumb and mostly back of hand side.
From what level of the spinal column does the ulnar nerve originate?
C8
What does the median nerve innervate?
Middle of hand, mostly palm side of hand. and nail beds of middle fingers.
Where in the spinal column do the cardiac nerves originate?
T1-T4
Where in the spinal column do the respiratory nerves originate?
C3-C4-C5 (keep the man alive)
As a spinal anesthetic “moves up”, what is the first sign in the hand that this is happening?
Ulnar nerve will be effected. May have pinky numbness.
Originates from C8.
The main etiology behind nerve injury is due to what?
Ischemia
Where are the most common points of nerve injury in the arm?
Points of joints and bony prominences
Where does the lumbar plexus extend from?
L1-L5
What is the only branch from femoral that makes it all the way to the foot/ankle?
Saphenous
What is the most important nerve running through the groin that can be damaged?
Femoral nerve
Where does the Sacral plexus extend from?
L4-coxis
What is the major nerve from the sacral plexus that can be injured?
Sciatic nerve
Which two nerves make up the sciatic nerve?
Tibial and common peroneal
At what spinal level is the nipple line involved?
T4
At what spinal level is the xyphoid process involved?
T6/T7
At what spinal level is the belly button involved?
T10 (Butt-ten)
What does the axillary roll prevent?
Compression of brachial nerves and artery
What injury is possible with fracture table?
Groin area compression.
Which nerve can be injured with tourniquet use and BP cuffs?
Radial nerve
Which nerve is most commonly damaged from stirrup use?
Common peroneal nerve
Three anesthetic techniques/factors are involved in risk of nerve injury- what are they?
General anesthesia.
Hypotensive.
Neuromuscular blockade
Does risk of nerve injury increase or decrease as length of surgery increase?
Risk of injury will increase as length of procedure increases
What is the most common metabolic cause of spontaneous neuropathy?
Diabetes
West Zone 1 pressures
Alveolar>Arterial>venous
West Zone 3 pressures
Arterial>Venous>Alveolar
West Zone 2 Pressures
Arterial>Alveolar>Venous
