Spinal & Epidural Part 1 ( Tubog) Exam 1 COPY Flashcards
Which areas are specifically mentioned as relevant for surgical procedures involving a neuraxial anesthesia? (Select all that apply)
a. Lower abdomen
b. Perineum
c. Lower extremities
d. Upper extremities
a. Lower abdomen
b. Perineum
c. Lower extremities
Slide 5
Which types of surgery could involve Neuraxial Anesthesia? (Select all that apply)
a. Orthopedic surgery
b. Vascular surgery on the legs
c. Thoracic surgery (adjunct to GETA)
d. Neurosurgery
a. Orthopedic surgery
b. Vascular surgery on the legs
c. Thoracic surgery (adjunct to GETA)
Slide 5
Which of the following statements are true about the advantages of neuraxial anesthesia? (Select all that apply)
a. It reduces the need for narcotics
b. It increases postoperative ileus
c. It reduces thromboembolic events
d. It reduces respiratory complications
e. It increases PONV
f. It increases Bleeding
a. It reduces the need for narcotics
c. It reduces thromboembolic events
d. It reduces respiratory complications
also
reduces Postoperative ileus
reduces PONV
reduces Bleeding
Slide 6
Which of the following benefits of neuraxial anesthesia are associated with mental alertness post-surgery?
a. Great mental alertness
b. Increased confusion
c. Sedation
d. Improved cognitive function
a. Great mental alertness
Slide 7
According to the image, which of the following are benefits related to patient comfort and recovery? (Select all that apply)
a. Less urinary retention
b. overnight admission from complications of general anesthesia
c. Increased stress response from surgery
d. Quicker to eat, void, and ambulate
a. Less urinary retention
d. Quicker to eat, void, and ambulate
Slide 7
Which benefits of neuraxial anesthesia are highlighted in terms of reducing surgical stress? (Select all that apply)
a. Great mental alertness
b. Preemptive anesthesia/analgesia
c. Blunts stress response from surgery
d. Increased urinary retention
b. Preemptive anesthesia/analgesia
c. Blunts stress response from surgery
Slide 7
Which benefits related to discharge times are mentioned in the image? (Select all that apply)
a. Longer hospital stays
b. Quicker PACU discharge times
c. Delayed discharge from recovery
d. Avoid unexpected overnight admission from complications of general anesthesia
b. Quicker PACU discharge times
d. Avoid unexpected overnight admission from complications of general anesthesia
Slide 7
Which of the following are considered deformities of the spinal column that serve as relative contraindications for neuraxial anesthesia? (Select all that apply)
a. Spinal stenosis
b. Kyphoscoliosis
c. Ankylosing spondylitis
d. Herniated disc
a. Spinal stenosis
b. Kyphoscoliosis
c. Ankylosing spondylitis
Slide 8
What preexisting diseases of the spinal cord are listed as relative contraindications for neuraxial anesthesia? (Select all that apply)
a. Multiple Sclerosis
b. Post polio syndrome
c. Amyotrophic Lateral Sclerosis (ALS)
d. Spinal muscular atrophy
a. Multiple Sclerosis
b. Post polio syndrome
Neuraxial anesthesia exacerbates a progressive, degenerating disease
Slide 8
Which of the following conditions are relative contraindications for neuraxial anesthesia as listed in the image? (Select all that apply)
a. Chronic headache
b. Chronic backache
c. Inability to perform SAB/Epidural after 2 attempts
d. Migraine
a. Chronic headache
b. Chronic backache
How many attempts at performing SAB/Epidural are recommended?
a. One attempt
b. Two attempts
c. Three attempts
d. Four attempts
c. Three attempts
Slide 8
Which of the following are absolute contraindications for neuraxial anesthesia as mentioned in the image? (Select all that apply)
a. Coagulopathy
b. Patient refusal
c. Evidence of dermal site infection
d. History of mild hypertension
a. Coagulopathy
b. Patient refusal
c. Evidence of dermal site infection
Slide 9
Which conditions are considered absolute contraindications for neuraxial anesthesia due to coagulation issues? (Select all that apply)
a. INR > 1.5
b. Platelets < 100,000
c. Known coagulation disorder
d. Taking anticoagulants
a. INR > 1.5
b. Platelets < 100,000
c. Known coagulation disorder
d. Taking anticoagulants
Slide 9
What is the significance of “Nagelhout x 2” in the context of neuraxial anesthesia?
a. It refers to the use of two different anesthetic agents
b. It indicates the need to consider PT, aPTT, and bleeding time
c. It suggests doubling the dosage of anticoagulants
d. It is a measure of anesthesia depth
b. It indicates the need to consider PT, aPTT, and bleeding time
Slide 9
What is the normal range for Prothrombin Time (PT) as shown in the image?
a. 10 to 12 seconds
b. 12 to 14 seconds
c. 14 to 16 seconds
d. 16 to 18 seconds
b. 12 to 14 seconds
Slide 9
According to the image, what is the normal range for International Normalized Ratio (INR)?
a. 0.5 to 0.8
b. 0.8 to 1.1
c. 1.1 to 1.4
d. 1.4 to 1.7
b. 0.8 to 1.1
Slide 9
What is the normal range for Activated Partial Thromboplastin Time (aPTT) as indicated in the image?
a. 20 to 25 seconds
b. 25 to 32 seconds
c. 30 to 35 seconds
d. 32 to 38 seconds
b. 25 to 32 seconds
Slide 9
What is the normal bleeding time range provided in the image?
a. 1 to 3 minutes
b. 3 to 5 minutes
c. 3 to 7 minutes
d. 5 to 7 minutes
c. 3 to 7 minutes
Slide 9
According to the image, what is the normal range for platelet count?
- a. 100,000 - 200,000 mm³
- b. 150,000 - 300,000 mm³
- c. 200,000 - 350,000 mm³
- d. 250,000 - 400,000 mm³
- b. 150,000 - 300,000 mm³
Slide 9
Which of the following is NOT listed as an absolute contraindication?
A. Severe or critical valvular heart disease
B. Operation duration longer than local anesthetic
C. Decreased intracranial pressure (ICP)
D. Severe congestive heart failure (CHF)
E. Idiopathic Hypertrophic Subaortic Stenosis
C. Decreased intracranial pressure (ICP)
Increased ICP is an absolute contraindication
Slide 10
Severe or critical valvular heart disease is indicated by aortic stenosis and mitral stenosis with a valve area of less than ____ cm².
A. 1
B. 2
C. 2.5
D. 1.5
A. 1cm².
*Aortic Stenosis =/< 1.0 cm². or MS < 1.0 cm².
Slide 10
True or False
Severe Congestive Heart Failure (CHF) is considered an absolute contraindication if the ejection fraction (EF) is less than 30-40% and Preload dependent.
True
Slide 10
Match the following symptoms with their corresponding average survival times after onset in adults with valvular aortic stenosis:
1. Angina
2. Syncope
3. Failure
A. 2 years
B. 3 years
C. 5 years
Angina - C. 5 years
Syncope - B. 3 years
Failure - A. 2 years
Slide 10
Which of the following is/are NOT part of the “Death Spiral” diagram?
A. Ischemic contractile dysfunction
B. Increased ischemia
C. Increased cardiac output
D. Worsening hypotension
E. Hypertension causes MI
C. Increased cardiac output
E. Hypertension causes MI
Match the characteristics with the appropriate type of anesthesia (Spinal or Epidural):
A. Rapid onset
B. Slow onset
C. Higher than expected spread
D. As expected spread
E. Dense nature of block
F. Segmental nature of block
G. Dense motor block
H. Minimal motor block
I. Likely hypotension
J. Less likely hypotension
A - Rapid onset (Spinal)
B - Slow onset (Epidural)
C - Higher than expected spread (Spinal)
D - As expected spread (Epidural)
E - Dense nature of block (Spinal)
F - Segmental nature of block (Epidural)
G - Dense motor block (Spinal)
H - Minimal motor block (Epidural)
I - Likely hypotension (Spinal)
J - Less likely hypotension (Epidural)
Slide 11
Match the following characteristics with the appropriate type of anesthesia (Spinal or Epidural):
A. Quick onset (5 min)
B. Slow onset (10-15 min)
C. Limited and fixed duration
D. Unlimited duration
E. Placement at any level
F. Placement level at L3-4, L4-5, L5-S1
G. Dose-based (mg) dosing of local anesthetic
H. Volume-based dosing of local anesthetic
I. Gravity influence on position
J. Gravity influence on baricity
A. Quick onset (5 min) - SPINAL
B. Slow onset (10-15 min) - EPIDURAL
C. Limited and fixed duration - SPINAL
D. Unlimited duration - EPIDURAL
E. Placement at any level - EPIDURAL
F. Placement level at L3-4, L4-5, L5-S1 - SPINAL
G. Dose-based (mg) dosing of local anesthetic - SPINAL
H. Volume-based dosing of local anesthetic - EPIDURAL
I. Gravity influence on position - EPIDURAL
J. Gravity influence on baricity - SPINAL
Slide 12
Match the number of vertebrae to their corresponding spinal sections:
A. Cervical vertebrae
B. Thoracic vertebrae
C. Lumbar vertebrae
D. Sacrum
E. Coccyx
- 7
- 5
- 12
- 5-fused
- 4-fused
A. Cervical vertebrae - 7
B. Thoracic vertebrae - 12
C. Lumbar vertebrae - 5
D. Sacrum - 5 (fused)
E. Coccyx - 4 (fused)
Slide 14
Which conditions are shown in the spine curvatures diagram?
A. Scoliosis
B. Lordosis
C. Kyphosis
D. Normal curvature
1 - D. Normal Curvature
2 - A. Scoliosis
3 - C. Kyphosis
4 - B. Lordosis
Slide 14
Which part of the vertebra is known as the anterior segment?
A. Lamina
B. Pedicle
C. Vertebral body
D. Spinous process
C. Vertebral body
Slide 15
Which part of the vertebra is known as the posterior segment?
A. Lamina
B. Vertebral arch
C. Vertebral body
D. Spinous process
B. Vertebral arch
Slide 15
Which structure links the anterior and posterior segments of the vertebra?
A. Spinous process
B. Transverse process
C. Lamina and pedicle
D. Superior articular process
C. Lamina and pedicle
Slide 15
What does the vertebral foramen house?
A. Intervertebral disks
B. Spinal cord, nerve roots, and the epidural space
C. Ligaments
D. Muscles
B. Spinal cord, nerve roots, and the epidural space
Slide 15
What direction do the transverse processes stick out?
A. Medial
B. Lateral
C. Anterior
D. Posterior
B. Lateral (to the sides)
Slide 16
Which process sticks out towards the back (posterior)?
A. Transverse process
B. Spinous process
C. Superior articular process
D. Inferior articular process
B. Spinous process
Slide 16
True or False
The transverse processes and spinous processes help stabilize and support the spine by providing attachment points for muscles.
True
Slide 16
Slide 28
