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A1 > Positioning/ Nerve injury > Flashcards

Positioning/ Nerve injury Flashcards

1
Q

Ulnar nerve senation

A

whole pinky finger, half of ring ringer to bottom of hand

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2
Q

Radial nerve sensation

A

Starts under deltoid, middle of arm, down to thumb(only digit full finger, others no tip), and first half of 2,3, only half of 4th digit

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3
Q

Musculocutaneous sensation

A

brachialis
Has radial above and below it

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4
Q

Median Antebrachial cutaneous

A

Opposite of musculocutaneous
When arm abducted and palm up, starts just before wrist, and goes up to mid bicep

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5
Q

Axillary sensation

A

Lower deltoid

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6
Q

Intercostobrachial sensation

A

armpit area

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7
Q

Brachial plexus branches

A

Axillary
Radial
Medium
Ulnar

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8
Q

RTDCB

A

Randy travis drinks cold beer
Root
Trunks
Division
Cords
Branch

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9
Q

Two most common injuries to brachial plexus

A

Stretch and compression

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10
Q

Testing integrity of brachial plexus

A

Push er-radial- pinch web between 1&2, wrist drop
Pullem- musculocutaneous- pinch lateral forearm
Pinch me-median-pinch tip of index finger
Pinch U-ulnar-pinch pinky finger- claw hand

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11
Q

Most frequent reported nerve injury after surgery and anesthesia?

A

Ulnar

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12
Q

Increased risk ulnar damage

A

Male
Pre existing damage
Prolonged hospital stay
Extreme habitus

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13
Q

When will ulnar neuropathy present?

A

> 24h after surgery

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14
Q

When is claw hand present?

A

Ulnar injury

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15
Q

Is sensory or motor nerve injury more serious? How long for recovery?

A

Motor is more serious and less common
4-6 weeks, may need PT
Consult nuerology

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16
Q

When to consult nuerology for nerve sensory damage

A

5 days

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17
Q

2 ways to injure median nerve

A

IV in AC
Hyperextension of elbow

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18
Q

Presentation of median injury? what if its high median? what if chronic?

A

Unable to oppose thumb
Reduction in sensation of plamar side of thumb, index, middle, and ring finger
If high- hand of benediction “make a clenched fist”
If chronic- ape hand

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19
Q

When will ape hand appear

A

Median injury (chronic)

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20
Q

Presentation of radial injury

A

Wrist drop
inability to extend hand at wrist

21
Q

How to injure radial

A

Compression w iv pole
Excessive NIBP cuff
Tourniquet
Sheets too tight when arms are tucked

22
Q

Long thoracic nerve innervates ___, presentation of injury

A

serratus anterior muscle
Scapular winging
Dorsal protrusion of scapula

23
Q

How to injure long thoracic nerve

A

Lateral position
Trauma

24
Q

Suprascapular nerve innervates ___ and presentation of injury

A

suprascapular and infrascapular muscles, dull shoulder pain

25
Q

How to prevent suprascapular nerve injury

A

Roll distall to axilla

26
Q

Location obturator

A

Medial knee

27
Q

Location femoral nerve

A

anterior and medial thigh

28
Q

Posterior cutaneous nerve location

A

posterior thigh to back of knee

29
Q

Lateral femoral cutaneous location

A

Lateral upper thigh

30
Q

Saphenous location

A

medial calf

31
Q

Peroneal location (3 branches)

A

common- lateral knee
superficial- lateral calf to top of foot- big toe, 2,3, and half of 4th toe
deep- space inbetween 1 and 2 toe

32
Q

Sural location

A

lateral side of foot, 5th toe, half of 4th toe (shared with deep peroneal nerve)

33
Q

Tibial nerve location (3x)

A

medial calcaneal- heel
lateral plantar- bottom of lateral foot
medial plantar- palm of foot to palm of 1,2,3,4 toes

34
Q

Presentation of obturator injury, causes

A

Inability to adduct leg
excessive flexion of thigh toward groin

35
Q

Femoral nerve presentation

A

impaired knee extension and hip flexion

36
Q

Saphenous presentation, prevention

A

Reduced sensation over anteromedial aspect of leg
Padding between leg and stirrup

36
Q

What is the #1 lower extremity injury

A

common peroneal

37
Q

Presentation of common peroneal

A

Foot drop
cant evert foot
Cant extend toes

38
Q

Etiology of sciatic injury, presentation, prevention

A

lithotomy- extreme hip flexion or external rotation of legs
sitting- straight legs
-
foot drop
-
pad under butt

39
Q

Pudendal injury etiology, presentation, prevention

A

Perineal post compression
Loss of perineal sensation
Padd between perineal post and patient

40
Q

If legs crossed-

A

Top- sural injury
bottom- superficial peroneal injury

41
Q

What position is lower extremity compartment syndrome most likely seen in? What will it progress to?

A

lithotomy
ischemia, edema, rhabdo, reperfusion injury

42
Q

LECS risk factors

A

high bmi
surgery time 2-3h
hypotension

43
Q

What position is most likely to cause air embolism?

A

sitting

44
Q

SS air embolism

A

air on TEE***
decreased etco2
increased PAP
hypotension
Dysrhytmias
Hypoxia

45
Q

Air embolism treatment

A

100 fio2
flood field w NS
Stop insufflation
left side durant manuever
aspirate from cvc
hemodynamic support

46
Q

How to prevent backache?

A

small pad under spine- if pad too big will cause paraplegia dt extreme hyperextension
Risk factors: max retroflexion, kidney rest highest position, large rolls under spine

47
Q

What causes midcervical tetraplegia

A

Hyperflexion of neck
sitting- make sure 2 fingers between chin and chest
tracheal resection pts

48
Q

POSTOP vision loss

A

A1 (122 decks)

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