Regional- Spinal (subarachnoid) Neural Blockade

Question 1

The principle site of action for neuraxial blockade, spinal or epidural is where?

Answer 1

the nerve root

Question 2

what ligament binds the epidural space posteriorly

Answer 2

ligamentum Flavum

Question 3

where is the spinal cord the widest

Answer 3

L2

Question 4

Where is the spinal cord the narrowest

Answer 4

C5

Question 5

what are the layers of the spinal meninges form outer to inner?

Answer 5

Dura matter
Arachnoid matter
Pia Matter

Question 6

what is the specific gravity of CSF

Answer 6

1.004 - 1.009

think of james bond 007 (and your in the middle)

Question 7

if the sympathetic outflow from T1- T4 is blocked by LA, unapposed vagus stimulation will produce what? and what is this reflex termed?

Answer 7

bradycardia

Bainbridge reflex

Question 8

Anterior dermatome: name landmark

C4

Answer 8

Clavicle

Question 9

Anterior dermatome: name landmark

T4-T5

Answer 9

Nipples

Question 10

Anterior dermatome: name landmark

T6

Answer 10

Xiphoid

Question 11

Anterior dermatome: name landmark

T8

Answer 11

lower border of rib cage

Question 12

Anterior dermatome: name landmark

T10

Answer 12

umbilicus

Question 13

Anterior dermatome: name landmark

L1

Answer 13

inguinal ligament

Question 14

Anterior dermatome: name landmark

L2-L3

Answer 14

Knee and below

Question 15

Anterior dermatome: name landmark

S2-S3

Answer 15

Perineal

Question 16

Posterior dermatome: name landmark

C7

Answer 16

Most prominent cervical spinous process

Question 17

Posterior dermatome: name landmark​

T7

Answer 17

inferior boarder of scapula (lower tip)

Question 18

Posterior dermatome: name landmark​

L4

Answer 18

iliac creast (superior) 
tuftier's line or intercristal line

Question 19

Posterior dermatome: name landmark​

S2

Answer 19

Posterior superior iliac spine

Question 20

name all the structures the needle passes through for a Subarachnoid block (midline) from posterior to interior

Answer 20

​Skin
subcutaneous tissue
SupraSpinous Ligament
Intraspinous ligament
Ligamentum Flavum
(epidural space)- not a real space
Dura matter
arachnoid matter

Question 21

the lateral approach for a SA block will not pass through what 2 structures just listed for the midline approach?

Answer 21

Supraspinous ligament

intraspinous ligament

Question 22

memory master

Answer 22

IA3; IIIH1-2