Spinal & Epidural Part 1 ( Tubog) Exam 1 COPY

Question 1

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

Answer 1

a. Lower abdomen
b. Perineum
c. Lower extremities

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Question 2

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

Answer 2

a. Orthopedic surgery
b. Vascular surgery on the legs
c. Thoracic surgery (adjunct to GETA)

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Question 3

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

Answer 3

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

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Question 4

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

Answer 4

a. Great mental alertness

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Question 5

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

Answer 5

a. Less urinary retention

d. Quicker to eat, void, and ambulate

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Question 6

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

Answer 6

b. Preemptive anesthesia/analgesia

c. Blunts stress response from surgery

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Question 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

Answer 7

b. Quicker PACU discharge times
d. Avoid unexpected overnight admission from complications of general anesthesia

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Question 8

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

Answer 8

a. Spinal stenosis
b. Kyphoscoliosis
c. Ankylosing spondylitis

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Question 9

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

Answer 9

a. Multiple Sclerosis
b. Post polio syndrome

Neuraxial anesthesia exacerbates a progressive, degenerating disease

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Question 10

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

Answer 10

a. Chronic headache
b. Chronic backache

Question 11

How many attempts at performing SAB/Epidural are recommended?

a. One attempt
b. Two attempts
c. Three attempts
d. Four attempts

Answer 11

c. Three attempts

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Question 12

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

Answer 12

a. Coagulopathy
b. Patient refusal
c. Evidence of dermal site infection

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Question 13

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

Answer 13

a. INR > 1.5
b. Platelets < 100,000
c. Known coagulation disorder
d. Taking anticoagulants

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Question 14

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

Answer 14

b. It indicates the need to consider PT, aPTT, and bleeding time

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Question 15

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

Answer 15

b. 12 to 14 seconds

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Question 16

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

Answer 16

b. 0.8 to 1.1

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Question 17

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

Answer 17

b. 25 to 32 seconds

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Question 18

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

Answer 18

c. 3 to 7 minutes

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Question 19

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

Answer 19

• b. 150,000 - 300,000 mm³

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Question 20

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

Answer 20

C. Decreased intracranial pressure (ICP)

Increased ICP is an absolute contraindication

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Question 21

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

Answer 21

A. 1cm².

*Aortic Stenosis =/< 1.0 cm². or MS < 1.0 cm².

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Question 22

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.

Answer 22

True

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Question 23

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

Answer 23

Angina - C. 5 years
Syncope - B. 3 years
Failure - A. 2 years

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Question 24

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

Answer 24

C. Increased cardiac output

E. Hypertension causes MI

Question 26

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

Answer 26

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)

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Question 27

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

Answer 27

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

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Question 28

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

Answer 28

A. Cervical vertebrae - 7
​
B. Thoracic vertebrae - 12
​
C. Lumbar vertebrae - 5
​
D. Sacrum - 5 (fused)
​
E. Coccyx - 4 (fused)

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Question 29

Which conditions are shown in the spine curvatures diagram?

A. Scoliosis
B. Lordosis
C. Kyphosis
D. Normal curvature

Answer 29

1 - D. Normal Curvature
2 - A. Scoliosis
3 - C. Kyphosis
4 - B. Lordosis

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Question 30

Which part of the vertebra is known as the anterior segment?

A. Lamina
B. Pedicle
C. Vertebral body
D. Spinous process

Answer 30

C. Vertebral body

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Question 31

Which part of the vertebra is known as the posterior segment?

A. Lamina
B. Vertebral arch
C. Vertebral body
D. Spinous process

Answer 31

B. Vertebral arch

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Question 32

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

Answer 32

C. Lamina and pedicle

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Question 33

What does the vertebral foramen house?

A. Intervertebral disks
B. Spinal cord, nerve roots, and the epidural space
C. Ligaments
D. Muscles

Answer 33

B. Spinal cord, nerve roots, and the epidural space

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Question 34

What direction do the transverse processes stick out?

A. Medial
B. Lateral
C. Anterior
D. Posterior

Answer 34

B. Lateral (to the sides)

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Question 35

Which process sticks out towards the back (posterior)?

A. Transverse process
B. Spinous process
C. Superior articular process
D. Inferior articular process

Answer 35

B. Spinous process

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Question 36

True or False

The transverse processes and spinous processes help stabilize and support the spine by providing attachment points for muscles.

Answer 36

True

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Answer 38

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