Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SRNA3AnesthesiaMgt > Spinal Anesthesia > Flashcards

Spinal Anesthesia Flashcards

1
Q

Cephalad

A

continuous with brainstem through the foramen magnum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Spinal cord terminates as the

A

conus medullaris are the level of the lower border of the first lumbar vertebral body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Conus medullaris attached by means of

A

Filum terminale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Filum terminale surrounded by the nerves of the lower lumbar and sacral roots known as

A

Cauda Equina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hyperbaric

A

Heavier than CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pregnancy

A 
Decrease Dose (Cm is decrease) 
Specific gravity is lower
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

3 membranes

A

Pia mater
Arachnoid
Dura
‘Know diagram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pia mater

A

Very vascular and close to SC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Arachnoid mater

A

Delicate, non vascular , adherent to the third and outermost layer, the dura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Dura Mater

A

Close to the subarachnoid space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Spinal aka

A

Subarachonoid Block (SAB)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Subarachnoid space located

A

between pia mater and arachnoid mater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Components of Subarachnoid

A 
CSF
Spinal nerves
A trabecular network between 2 membranes
Blood vessels that supply SC
Later extensions of the pia mater - the dentate ligaments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Inability to drain CSF

A

Hydrocephalus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Multiple puncture

A

Post Dural puncture headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Overproduction of CSF leads to (compensatory mechanism)

A

vasodilation –> Headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Blood patach

A

Tuohy
sit patient up
Access epidural space
20 cc of blood( obtained from venous) injected to the epidural space until pt feel pressure (forms clot)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Blood supply of SC

A

One anterior

2 posterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Sharp needles

A

Unable to feel layers and structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Type of needle use is

A

Pencil point needle (NOT a cutting needle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

is thought to be the widest part of the epidural space, measuring 5 to 6 mm at this level

A

L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The spinal cord begins at the______and ends where?

A

level of the foramen magnum and ends at the conus medullaris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Apply lidocaine

A

Go all the way in then inject while removing the needle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When you arrive to ligamentum FLAVUM

A

Lose resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When you are in ligmentum Flavum

A

You are in the epidural SPACE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

When you perform an SAB (Sub-Arachnoid Block, or Spinal), at L-3-4, 4-5, or L5/S-1, you are injecting into

A

the Cauda Equina and not into the actual spinal cord,

so there is no risk of damage to the spinal cord!

27
Q

CSF total volume between the brain and the spinal cord is about

A

150ml.

28
Q

CSF volume itself at any given time.

A

Between 30-50ml in the spinal cord

29
Q

The pH of CSF is approximately

A

7.32

30
Q

CSF is secreted by the________ of the within the_________ ventricular system at a rate of approximately________

A

Ependymal cells; Choroid Plexus; 30ml/hr.

31
Q

Iliac crest

A

Tuffer’s line

32
Q

The entire CSF volume in the brain and spinal cord is replace every

A

3-4 hours.

33
Q

Primarily pain stimuli

A

Post central gyrus of the parietal lobe

34
Q

They are responsible for motor-function and

movement away from the

A

painful stimulus is the
“Precentral-Gyrus” of the
parietal lobe.

35
Q

31 pairs of spinal

A 
C8
T12
Lum 5
Sa 5
coccygel 1
36
Q

Gray

A

neuronal cells and unmyelinated fibers

37
Q

The Lateral and Ventral White Matter contains the

A

Descending Motor Tracts.

38
Q

Dorsal Root carries afferent (ascending) signals heading into the spinal cord and brain

A

SENSORY Afferent (ascending) Posterior

39
Q

Ventral Root carries efferent (descending) signals heading out to the periphery

A

MOTOR efferent (descending)

40
Q

White matter contains the various tracts,

A

both ascending and descending, with the Dorsal White Matter containing the ascending sensory tracts.

41
Q

0.75% bupivacaine

A

7.5mg/ml

42
Q

How much bupivacaine to gie

A

10-15mg (2cc)

43
Q

How much bupivacaine to give

A

10-15mg (2cc)

44
Q

The Somatic contains

A

sensory neurons for the control of skin, muscle, and joint movement

45
Q

Primary neurotransmitters are

A

Norepinephrine and Dopamine

46
Q

Systolic 110 preop

A

25 mg of ephedrine with skin wheal lidocaine

47
Q

Systolic <110 preop TIPS

A

25 mg of ephedrine with skin wheal lidocaine

48
Q

Expect sympathectomy what do you have present

A

NEO or EPHEDRINE

49
Q

Parasympathetics The primary neurotransmitter is

A

acetylcholine

50
Q

Spinal anesthesia interrupts sensory, motor, and sympathetic nervous system innervation.
 As LA is injected, it blocks the

A

small “c” fibers of the sympathetic
nervous system 1st, and gradually diffuses into the interior of the nerve where the larger fibers are for sensory and then, motor!

51
Q

 SNS blockade exceeds somatic (sensory)

A

blockade by 2 dermatomes, perhaps more.This explains why hypotension often accompanies even low sensory
blocks

52
Q

C8 landmark

A

Fifth digit

53
Q

T10 landmark

A

Umbilicus

54
Q

T7 landmark

A

Tip of xiphoid/ inferior border of scapula

55
Q

T12 landmark

A

Inguinal ligament

56
Q

S1 landmark

A

Outer side of foot

57
Q

Being heavier than CSF, the LA will settle in

A

the most dependent aspect of the subarachnoid space.

58
Q

When placed supine, the LA tends to gravitate to the

A

thoracic kyphosis, the average position being T-6.

59
Q

If SAB performed in the sitting position, and then patient allowed tonremain sitting, what happens

A

The LA will settle to the lowest point, providing what is

known as a “saddle block

60
Q

Scoliosis=alters

A

the “LOW” point.

61
Q

Kyphosis/Kyphoscoliosis=alters the

A

“LOW” point.

62
Q

Pregnancy=may have decreased SG of CSF allowing for

A

decreased dosage of LA (r/t changes in pH).

63
Q

Previous back surgery may alter anatomy so levels may

A

be different than normal.

64
Q

Elderly=r/t

A

lower levels of CSF

SRNA3AnesthesiaMgt (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions