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JW: Adv Principles A > Unit 1 Module 2 (Exam 1) > Flashcards

Unit 1 Module 2 (Exam 1) Flashcards

1
Q

What is the main reason for obtaining baseline vital signs during pre-op assessment for shoulder surgery?
A. To assess patient hydration
B. To monitor for Bezold-Jarisch reflex
C. To measure respiratory rate trends
D. To identify allergies

A

B. To monitor for Bezold-Jarisch reflex

“we really need to make sure that we are
monitoring our hemodynamics, especially our heart rate and blood pressure. Hence we
need our baseline”

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2
Q

Which of the following diagnoses is NOT commonly associated with shoulder surgeries?
A. Rotator cuff tear
B. Glenohumeral instability
C. Labral tear
D. Subacromial stenosis

A

D. Subacromial stenosis

Slide 7

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3
Q

What should be prioritized in pre-op planning for shoulder surgeries?
Select 2

A. Pre-existing nerve conduction
B. Assessing airway
C. Monitoring body temperature
D. Assessing for Carpal tunnel syndrome

A

A. Pre-existing nerve conduction
B. Assessing airway

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4
Q

Which are the main positioning options for shoulder surgeries? Select 3

A. Beach chair
B. Sitting Position
C. Supine
D. Prone
E. Lateral decubitus

A

A. Beach chair
B. Sitting Position
E. Lateral decubitus

“the beach chair we use, because as you can see in the picture on the right, the knees are flexed, the legs are elevated and it
prevents the pulling of the hamstrings to the gluteal muscles and then our lower
back muscles.”

Slide 8

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5
Q

What is a critical consideration for securing the patient during shoulder surgery positioning?

A. Positioning the arms for IV access
B. Rotating the patient frequently
C. Securing the head, neck, hips, and legs
D. Keeping the patient supine at all times

A

C. Securing the head, neck, hips, and legs

Slide 8

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6
Q

Securing the head and neck during positioning for shoulder surgeries prevents __________.

A. Muscle strain
B. Airway obstruction
C. Blood pooling
D. Skin breakdown

A

B. Airway obstruction

Slide 8

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7
Q

True or False

The ultimate responsibility with positioning lies only with the surgeon and the anesthesia provider.

A

False

“it is a shared responsibility”
* Surgeon
* Anesthesia provider
* Operating room nurses
* PA/RNFA
* Scrub Tech
* Other O.R. personnel

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8
Q

Positioning the patient in surgery involves __________ and potential risks.
A. Physiologic changes
B. Extended surgical time
C. Reducing blood flow
D. Increasing airway resistance

A

A. Physiologic changes

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9
Q

What happens to central blood volume in the sitting position?

A. It increases due to improved venous return
B. It decreases due to pooling in the lower body
C. It remains unchanged
D. It increases due to elevated heart rate

A

B. It decreases due to pooling in the lower body

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10
Q

Due to pooling of blood in the lower body during the sitting position, which parameters might increase in response to BP and CO decreasing?

A. Heart rate and systemic vascular resistance
B. Cardiac output and arterial blood pressure
C. Functional residual capacity and CBF
D. Blood pressure and respiratory rate

A

A. Heart rate and systemic vascular resistance

Slide 10

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11
Q

How does the sitting position affect lung volumes and functional residual capacity (FRC)?
A. Both decrease
B. Both remain unchanged
C. Both increase
D. Lung volumes decrease, while FRC increases

A

C. Both increase

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12
Q

What is a neurovascular consideration in the sitting position?
A. Increased cerebral blood flow
B. Increased intracranial pressure
C. No change in cerebral blood flow
D. Decreased cerebral blood flow

A

D. Decreased cerebral blood flow

Slide 10

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13
Q

What is the incidence rate of venous air embolism in patients in the sitting position?
A. 10%
B. 25%
C. 40%
D. 60%

A

C. 40%

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14
Q

Which of the following positions are associated with venous air embolism?
A. Supine, lateral decubitus, reverse Trendelenburg
B. Sitting, prone, reverse Trendelenburg
C. Supine, prone, Trendelenburg
D. Sitting, lateral decubitus, Trendelenburg

A

B. Sitting, prone, reverse Trendelenburg

Slide 11

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15
Q

To prevent venous air embolism, it is important to maintain __________ at the wound site.

A. Negative pressure
B. Neutral pressure
C. Venous pressure above 0
D. Arterial pressure above 0

A

C. Venous pressure above 0

Slide 11

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16
Q

What increases the risk of venous air embolism in the sitting position during surgery?
A. Open venous vessels above the heart level
B. Use of mechanical ventilation
C. Reduced systemic vascular resistance
D. High central venous pressure

A

A. Open venous vessels above the heart level

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17
Q

Approximately what percentage of the population has a patent foramen ovale, increasing the risk of severe VAE?
A. 10–20%
B. 20–30%
C. 30–40%
D. 40–50%

A

B. 20–30%

Air may reach the cerebral and coronary circulation via a patent foramen ovale

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18
Q

Venous air embolism occurs when air enters open venous vessels and travels to the __________ and interfers with blood flow to the pulmonary artery.

A. Left atrium
B. Superior vena cava
C. Pulmonary veins
D. Right ventricle

A

D. Right ventricle

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19
Q

Which of the following are potential consequences of venous air embolism?
Select 3

A. Pulmonary edema
B. Reflex bronchoconstriction
C. Increased arterial blood pressure
D. Acute cardiovascular collapse
E. Reflex bronchodilation
F. Decreased venous blood pressure

A

A. Pulmonary edema
B. Reflex bronchoconstriction
D. Acute cardiovascular collapse and arterial hypoxemia

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20
Q

What is the first step in managing a suspected venous air embolism?
A. Apply bilateral compression of the jugular veins
B. Discontinue nitrous oxide
C. Inform the surgeon
D. Place the patient in a head-down position

A

C. Inform the surgeon and prevent further air entrainment

They can prevent it by further entraining air, by irrigating with whatever irrigant fluid that they have on the table, and applying an occlusive dressing. An occlusive dressing can be in the form of any wetsponge or such as with open craniotomies, they can apply bone wax to secure or to close that areas to avoid further entrainment or further absorption of air from the incision site

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21
Q

What is the purpose of placing the patient in a head-down position during venous air embolism treatment?

A. To increase venous return
B. To trap air in the right atrial apex
C. To reduce arterial pressure
D. To increase systemic vascular resistance

A

B. To trap air in the right atrial apex and prevent pulmonary artery entry

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22
Q

What can be used to directly remove air during venous air embolism management?
A. Endotracheal suction
B. Pulmonary artery catheter
C. Intravenous cannula
D. Right atrial catheter

A

D. Right atrial catheter

Slide 14

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23
Q

Which of the following are treatments for venous air embolism? Select 2

A. Use inhalational anesthetics to reduce air expansion
B. Discontinuing nitrous oxide
C. Bilateral compression of jugular veins.
D. Placing the patient in a head-down position

A

B. Discontinuing nitrous oxide
C. Bilateral compression of jugular veins.

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24
Q

In venous air embolism management, cardiovascular collapse is treated using __________.

A. Vasopressors like ephedrine and phenylephrine
B. Bronchodilators like albuterol
C. Antiarrhythmics like amiodarone
D. Diuretics like furosemide

A

A. Vasopressors like ephedrine and phenylephrine

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25
Q

Why is the superior vena cava and right atrium junction ideal for CVP catheter placement in VAE? Select 2

A. It minimizes interference with arterial blood flow
B. It is close to the SA node, aiding in identification
C. It is close to the AV node, aiding in identification
D. It is where air tends to accumulate

A

B. It is close to the SA node, aiding in identification
D. It is where air tends to accumulate

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26
Q

The Doppler Ultrasound transducer is a non-invasive indicator of a venous air Embolism (VAE) in the sitting patient. Where do you place the probe on the chest?

A. over the left ventricle
B. over the mediastinum
C. over the right atrium
D. over the pulmonary artery

A

C. over the right atrium

Doppler ultrasound at the second or third intercostal space

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27
Q

What is the most sensitive non-invasive indicator of venous air embolism?

A. Mill-wheel murmur
B. Decreased end-tidal CO2
C. Doppler ultrasound
D. Transesophageal echocardiography

A

C. Doppler ultrasound

the transducer at the second or third intercostal space to the right of the sternum (over the right atrium)

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28
Q

The most definitive tool for diagnosing venous air embolism is __________.

A. Doppler ultrasound
B. Mill-wheel murmur auscultation
C. Transesophageal echocardiography
D. Pulse oximetry

A

C. Transesophageal echocardiography

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29
Q

The characteristic sound of venous air embolism detected by stethoscope is a __________ murmur.
A. Mill-wheel
B. Pericardial rub
C. Continuous hum
D. Diastolic click

A

A. Mill-wheel

Slide 17

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30
Q

A sudden drop in end-tidal CO2 during surgery indicates __________.
A. Increased pulmonary perfusion
B. Decreased lung perfusion
C. Improved gas exchange
D. Hyperventilation

A

B. Decreased lung perfusion due to air embolism

Slide 17

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31
Q

What is a key consideration when positioning a patient in the sitting position?
A. Ensuring pressure on the eyes to stabilize the head
B. Hyperextending the neck to maintain alignment
C. Flexing the neck to secure the airway
D. Padding all pressure points to prevent injury

A

D. Padding all pressure points to prevent injury

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32
Q

What are key measures to take when positioning a patient in the sitting position?
Select 2

A. To ensure easier access for surgical tools
B. Avoid pressure on the eyes
C. Place the patient’s head in a hyperextended position
D. Secure the head properly to prevent slipping

A

B. Avoid pressure on the eyes - using goggles if needed
D. Secure the head properly to prevent slipping - ABD pads, coban, Allen head rest

You can see that the head is super
neutral. I love that, not only neutral, right? Super neutral, as you can see with
the figure 26-1

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33
Q

What is the primary reason for intentional hypotension during shoulder surgery?
A. To improve oxygen delivery to the brain
B. To minimize anesthetic drug requirements
C. To prevent retinal ischemia
D. To enhance surgical field visibility

A

D. To enhance surgical field visibility

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34
Q

What is a potential complication of prolonged induced hypotension? Select 2

A. Increased blood flow to the eyes
B. Ischemic optic neuropathy
C. Retinal ischemia
D. Hyperperfusion of the surgical field

A

B. Ischemic optic neuropathy
C. Retinal ischemia

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35
Q

What are key components of eye protection during surgery? Select 2

A. Preventing blindness
B. Using gauze to cover the eyes
C. Preventing dry eye syndrome
D. Avoiding pressure on the eyes

A

A. Preventing blindness
D. Avoiding pressure on the eyes

Foam/hard plastic goggles may not be suitable for prone position

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36
Q

How should an arterial line be aligned to monitor cerebral perfusion pressure during surgery?
A. At the level of the
B. At the external meatus of the ear
C. At the level of the wrist
D. At the base of the skull

A

B. At the external meatus of the ear

Circle of Willis

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37
Q

When using non-invasive blood pressure monitoring, where should the cuff be placed during shoulder surgery?
A. On the non-operative arm
B. On the operative arm
C. On the lower leg
D. On the operative wrist

A

A. On the non-operative arm

you have your blood pressure, you have your pulse ox, you have your IV, all on the non-operative side

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38
Q

What is the standard decrease in blood pressure per centimeter of height gradient between the heart and brain?
A. 0.57 mmHg
B. 0.67 mmHg
C. 0.77 mmHg
D. 1.07 mmHg

A

C. 0.77 mmHg
There is a 77% or 0.77 mmHg decrease for every centimeter height gradient between brain and heart

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39
Q

What is the normal distance range between the heart and brain in centimeters?
A. 5–15 cm
B. 10–20 cm
C. 10–30 cm
D. 15–35 cm

A

C. 10–30 cm

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40
Q

What should you do if the calculated cerebral perfusion pressure is too low during surgery?

A. Administer less fluid to decrease blood pressure
B. Reduce diastolic pressure further
C. Tank the patient with fluids to increase diastolic pressure
D. Use nitrous oxide to maintain systolic pressure

A

C. Tank the patient with fluids to increase diastolic pressure

Tanking means increasing the administration of fluid so that your diastolic increases, but you maintain your systolic below 100 by giving them gas or propofol.

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41
Q

If the BP at the heart/arm is 120/80, and there is 20 cm distance to the head then the BP at the brain is at?

A. 95/55
B. 100/60
C. 105/65
D. 125/75

A

C. 105/65

20 cm X 0.77=15
120 sBP – 15 = 105
80 dBP -15 = 65

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42
Q

What is the most commonly preferred anesthetic for shoulder procedures?
A. Spinal anesthesia
B. Local anesthesia
C. General endotracheal anesthesia
D. Sedation only

A

C. General endotracheal anesthesia with muscle relaxation

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43
Q

Which block is most commonly used for shoulder procedures?
A. Epidural block
B. Brachial plexus block
C. Femoral nerve block
D. Transversus abdominis plane

A

B. Brachial plexus block

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44
Q

You can use either a _________ or ____________ approach for anesthesia of the shoulder by targeting the brachial plexus.
Select 2

A. Interscalene
B. Lumbar plexus
C. Femoral
D. Supraclavicular
E. Axillary

A

A. Interscalene
D. Supraclavicular

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45
Q

What is the Bezold-Jarisch reflex characterized by?
A. Bradycardia and hypotension
B. Tachycardia and hypertension
C. Hypertension and increased preload
D. Tachycardia and decreased intraventricular volume

A

A. Bradycardia and hypotension

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46
Q

What is the primary cause of the Bezold-Jarisch reflex during shoulder surgery in the sitting position?

A. Increased cardiac output
B. Decreased preload
C. Excessive sedation
D. Hypervolemia
E. Overuse of muscle relaxants

A

B. Decreased preload due to venous pooling

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47
Q

What physiological condition is associated with a hypercontractile ventricle in the Bezold-Jarisch reflex?
A. Increased afterload
B. Increased intraventricular volume
C. Decreased intraventricular volume
D. Decreased myocardial contractility

A

C. Decreased intraventricular volume

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48
Q

Which intervention can help prevent the Bezold-Jarisch reflex during surgery?

A. Administering preemptive Zofran
B. Reducing muscle relaxant dosage
C. Decreasing the patient’s preload
D. Avoiding the sitting position

A

A. Administering preemptive Zofran

We usually need to increase preload because this is usually related to venous pulling because of the sitting position

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49
Q

Which nerve is affected in hemidiaphragmatic paresis during a brachial plexus block and can cause respiratory depression?

A. Sciatic nerve
B. Median nerve
C. Vagus nerve
D. Phrenic

A

D. Phrenic

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50
Q

Horner syndrome, a possible side effect of a brachial plexus block, includes all of the following symptoms EXCEPT:
A. Ptosis
B. Miosis
C. Hyperhidrosis
D. Anhidrosis

A

C. Hyperhidrosis

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51
Q

What is a key concern with hoarseness and dysphagia following a brachial plexus block?

A. Increased risk of airway obstruction
B. Loss of motor function in the arms
C. Increased pain perception
D. Bradycardia

A

A. Increased risk of airway obstruction

…they don’t have a lot of control over their
secretions or what if there could be passive or active regurgitation… leading to aspiration pneumonitis.

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52
Q

Which postop PACU factors should be addressed in a shoulder surgery patient?

A. Pain management plan
B. Presence of nerve injury
C. Postoperative anesthesia type
D. Elderly
E. Extent of surgical positioning

A

A. Pain management plan - opioids vs RA
B. Presence of nerve injury
D. Elderly- delirium/confusion

Admitted vs discharged

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53
Q

What are essential preoperative anesthetic considerations for patients with elbow fractures? Select 2

A. NPO status
B. Bowel function
C. Nerve injury assessment
D. Soft tissue damage
E. Elbow range of motion exam

A

A. NPO status
C. Nerve injury assessment

Preop
* Fracture?
* Nerve injury?
* Mobility
* Typical assessment

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54
Q

What are the most common patient positions for elbow procedures?
A. Prone or sitting
B. Supine or Trendelenburg
C. Lateral or prone
D. Supine or lateral

A

D. Supine or lateral

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55
Q

Why is the infraclavicular or axillary approach preferred for brachial plexus block in elbow surgeries?

A. It provides better coverage for the shoulder.
B. It reduces the risk of respiratory complications.
C. It ensures full coverage of the elbow region.
D. It avoids nerve injury completely.

A

C. It ensures full coverage of the elbow region

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56
Q

What happens to cardiac output in the lateral decubitus position?

A. It increases significantly due to venous pooling.
B. It remains unchanged unless venous return is obstructed.
C. It decreases due to increased vascular resistance.
D. It fluctuates depending on the patient’s lung volume.
E. It remains unchanged regardless of positioning.

A

B. It remains unchanged unless venous return is obstructed.

…venous return is obstructed, such as with the use of a kidney rest

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57
Q

What is a possible effect on arterial blood pressure in the lateral decubitus position?

A. It increases due to venous congestion.
B. It remains constant unless the patient is ventilated.
C. It decreases due to decreased vascular resistance
D. It fluctuates based on lung compliance.

A

C. It decreases due to decreased vascular resistance

right side > left side

Slide 33

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58
Q

In a ventilated patient in the lateral decubitus position, what is a key concern for the dependent lung? Select 2

A. Hyperventilation
B. Decreased ventilation
C. Increased perfusion
D. Increased ventilation
E. Decreased perfusion

A

B. Decreased ventilation - dependent lung is relatively underventilated due to compression by the weight of the mediastinum and abdominal contents

C. Increased perfusion -Gravity causes pulmonary blood flow to favor the dependent lung

V/Q Mismatch–> Hypoxemia

Slide 33

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59
Q

What factors further decrease dependent lung ventilation in the lateral decubitus position for ventilated patients?

A. Paralysis and open chest procedures
B. Supine positioning with mechanical ventilation
C. Vascular resistance and venous pooling
D. Spontaneous ventilation and lateral supports

A

A. Paralysis and open chest procedures

Slide 33

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60
Q

For spontaneously breathing patients in the lateral decubitus position, what is typically observed in the dependent lung?

A. Decreased ventilation
B. Decreased perfusion and ventilation
C. Increased ventilation
D. Increased perfusion with no ventilation changes

A

C. Increased ventilation

without V/Q mismatch

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61
Q

Ventilation in the ____ lung is increased during mechanical ventilation due to increased compliance.

A. Dependent
B. Non-dependent
C. Lower
D. Middle

A

B. Non-dependent

The nondependent lung is relatively overventilated because its compliance is increased

Slide 35

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62
Q

What is the primary purpose of placing an axillary roll in the lateral decubitus position?

A. To prevent respiratory compromise in the dependent lung.
B. To maintain proper alignment of the non-dependent shoulder.
C. To elevate the dependent arm for improved circulation.
D. To avoid compression of the neurovascular bundle in the dependent axilla.

A

D. To avoid compression of the neurovascular bundle in the dependent axilla.

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63
Q

The axillary roll in the lateral decubitus position is placed ______ to the dependent axilla.

A. Above
B. Directly in
C. Just caudad
D. On the shoulder

A

C. Just caudad

”..of course it’s over the chest level as opposed to the arm level of the patient.

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64
Q

When in the lateral decubitus position, to confirm neurovascular integrity in the dependent arm, the ______ pulse should be checked periodically.

A. Radial
B. Brachial
C. Carotid
D. Ulnar

A

A. Radial

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65
Q

Where is a pulse oximeter placed to monitor for neurovascular compromise in the lateral decubitus position?

A. Non-dependent hand
B. Dependent hand
C. Non-dependent foot
D. Dependent shoulder
E. Non-dependent axilla

A

B. Dependent hand

Slide 37

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66
Q

To prevent stretching of the brachial plexus, the upper arm should rest on a ______.

A. Foam wedge
B. Rolled towel placed in the axilla
C. Flat surface directly on the patient’s chest
D. Allen arm rest

A

D. Allen arm rest

Slide 38

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67
Q

Why is it important to on the dependent eye in the lateral decubitus position?

A. To prevent stretching of the extraocular muscles
B. To ensure adequate drainage of tears
C. To maintain proper alignment of the facial structures
D. To avoid blindness, whether temporary or permenant

A

D. To avoid blindness, whether temporary or permenant

Slide 39

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68
Q

What should be done to the dependent ear during lateral positioning?
A. Ensure it is flat against the head without folding.
B. Cover it with a gel pad to prevent pressure sores.
C. Rotate it slightly away from the head.
D. Place it directly on the bed for stability.

A

A. Ensure it is flat against the head without folding.

Slide 39

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69
Q

Why is it important to place a pillow between the knees in the lateral decubitus position?
Select 2

A. To prevent venous stasis
B. To pad bony prominences
C. To stabilize the thighs
D. To avoid nerve stretch

A

B. To pad bony prominences
D. To avoid nerve stretch

Slide 39

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70
Q

Which device can be used to maintain the neck in neutral alignment during the lateral decubitus position? Select 3

A. Axilla roll
B. Donut
C. Pillow
D. Shea
E. Bean bag

A

B. Donut
C. Pillow
D. Shea

Slide 39

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71
Q

True or False

If it looks uncomfortable to you, it is uncomfortable for the patient.

A

True

Slie 39

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72
Q

Which body parts require special attention to avoid pressure-related injuries in the lateral decubitus position? Select 2

A. Independent eye
B. Independent ear
D. Breast
E. Genitalia

A

D. Breast
E. Genitalia

Slide 39

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73
Q

Why is it important to ensure proper abdominal excursion when using a beanbag?

A. To prevent hyperventilation
B. To avoid compression of the dependent lung
C. To allow unrestricted diaphragm movement during ventilation
D. To reduce the risk of venous pooling in the abdomen
E. To stabilize the chest wall

A

C. To allow unrestricted diaphragm movement during ventilation

Slide 40/41

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74
Q

What steps should be taken to ensure proper patient positioning when using a beanbag?
Select 3
A. Insert a hand between the chest and the beanbag to confirm adequate space.
B. Monitor chest and abdominal movement visually.
C. Position the patient during expiration to ensure deflation stability.
D. Assess peak inspiratory pressures
E. Use the beanbag only for non-dependent patients.

A

A. Insert hand between the chest and the beanbag to confirm adequate space.
B. Monitor chest and abdominal movement visually.
D. Assess peak inspiratory pressures

Position the patient during INSPIRATION to ensure deflation stability.

Slide 40/41

75
Q

At what pressure should a tourniquet typically be inflated to for elbow procedures?

A. 50 mmHg above diastolic blood pressure
B. 100 mmHg above systolic blood pressure
C. 100 mmHg above mean arterial pressure
D. 150 mmHg above baseline blood pressure
E. Equal to systolic blood pressure

A

B. 100 mmHg above systolic blood pressure

Usually we inflate the tourniquet 100mmHg more than whatever the assessed systolic blood pressure is for our patients, if our patient’s systolic is 120, usually we inflate the tourniquet at 200.

Slide 42

76
Q

If we are doing an axillary block, we may need a separate block for the __________________ nerve because that is the most common nerve that can be missed.

A. Ulnar
B. Median
C. Radial
D. Musculocutaneous
E. Axillary

A

D. Musculocutaneous

slide 42

77
Q

What should be documented when a tourniquet is used during surgery?
Select 4

A. Inflation pressure and any changes
B. Time of deflation
C. Time of inflation
D. Position of the limb during inflation
E. Total time the tourniquet was inflated
F. Total time the tourniquet was deflated

A

A. Inflation pressure and any changes
B. Time of deflation
C. Time of inflation
E. Total time the tourniquet was inflated

Slide 42

78
Q

What are the 2 most important aspects of immediate post op care for elbow surgery? (select 2)
A.immobility
B.infection
C.pain management
D. DVT

A

A. immobility
C. pain management (opioids, NSAIDs, regional)

slide 43

79
Q

True or false:
During Preop assessment for forearm or hand surgery, you should assess for preexisiting nerve conduction issues

A

true

slide 45

80
Q

Which of the following is NOT typically included in a preoperative assessment for forearm to hand surgery?

a) Fracture location
b) nerve impingement
c) Psychological evaluation
d) traumatic amputation

A

C. psychological evaluation

slide 45

81
Q

According to lecture what type of positioning equipement/ techniques are indicated for forearm/hand surgery (choose 3)
A.supine
B.hand table
C.tube tree
D.Prone
E. lateral decubitus

A

A. supine
B. Hand table
C. tube tree (Castillo loves this thing)

slide 46

82
Q

What is the tube tree NOT used for? according to lecture
A. relives stress/strain at patient connection.
B. slips beneath surgical bad aor bed mattress
C.flexible light weight transparent plastic
D. a place to keep IV easily accessible
E.single adjustment knob for vertical and or 180 degree arc positioning
F.used with disposable or reusable hose

A

D. place to keep IV easily accessible

slide 47

83
Q

What are the 2 types of blocks discussed in lecture for forearm to hand surgery (select 2)
A.brachial plexus
B.axillary block
C. ulnar nerve
D. bier block

A

B. axillary block
D. Bier block

slide 48

84
Q

True or false: Pain management and mobilization are the 2 things to focus on for post op forearm/hang surgery

A

FALSE

IMMOBILIZATION

slide 49

85
Q

Throwback

The bier block is performed by
A. LA injected into the medial nerve
B. IM injection of LA inot extremity and using a tourniquet to isolate it to that muscle
C. IV injection of LA into extremity and letting it circulate before placement of tourniquet
D. IV injection of LA into extremity and isolated using a tourniquet from systemic circulation

A

D. IV injection of LA into extremity and isolated using a tourniquet from systemic circulation

anesthesia pharm lecture 2nd semester

86
Q

Place steps in order for Bier Block:

LA injection
exsangusination
IV D/C
IV start
double cuff

A

IV start
exsanguination
double cuff
LA injection
IV D/C

anesthesia pharm lecture 2nd semester

87
Q

According to statistical evidence 1 in 50 over the age of _________ will have a hip fracture
A.70
B.65
C.55
D. 60

A

D. 60

slide 52

88
Q

Mortality rate for a hip fracture after 1 year is
A. 25-30%
B.22-38%
C.30-35%
D. 20-25%

A

A. 25-30%

during initial hospitilization its around 10%

slide 52

89
Q

Mortality rate in the first year of a hip fracture is contributed to all of the following except (according to lecture)
A. cardiac and pulmonary conditions
B. Deep vein thrombosis
C.infection
D. delirium

A

C. infection

slide 52

90
Q

For hip fractures pain scores are typically lower with what intervention accoridng to lecture
A. precedex drip
B. spinal block
C.early surgery
D. NSAIDs

A

C. early surgery

slide 53

91
Q

True or false:
Druing preop for hip fracture patients, IVF status, Hgb/Hct, central line/ arterial line needs, baseline VS, and NPO status should be assessed

A

True

slide 53

92
Q

During position for hip fracture surgery we will have the patient
A.prone on a prone table
B. supine on a fracture table
C.lithotomy fracture table
D. lateral on a fracture table

A

B. supine on a fracture table
will move patient after induction

slide 54

93
Q

Which of the following is NOT a benefit of neuroaxial anesthesia compared to general anesthesia
A. decreased DVT
B. shorter length of hospitla stay
C. decreased infection
D. lower incidence of delirium
E. improved post op pain control

A

C. decreased infection

slide 56

94
Q

True or false:
Pain management, mental status, blood transfusion needs, and ICU admission are the 4 things to consider for post op hip fracture

A

true

slide 57

95
Q

Etiology for total hip arthroplasty includes all the following except
A. arthritis
B. degenerative synovium or cartilage disease
C. avascular necrosis
D. fracture
E. tumors
F. congenital deformity
G. dislocation
H. failed reconstructions

A

D. Fracture

osteoarthritis
Rheumatoid arthritis

slide 58

96
Q

During preop for total hip arthroplasty you should assess… (select 3)
A.medications
B.mental status
C. mobility
D. Hgb/hct, coagulation
E. infection

A

A. medications
B. mental status (confusion/delirium)
D. hgb/hct/coags

slide 58

97
Q

Life threatining complictions of total hips arthroplasty include (select 3)
A.Venous thromboembolism (VTE)
B. Bone cement implantation syndrome
C. Fracture of the femoral head
D.intra- and postoperative hemorrhage

A

A. venous thromboembolism
B. bone cement implantation syndrome (BCIS)
D. intra- and postoperative hemorrhage

slide 59

98
Q

Positioning for Total hip arthroplasty includes (select 3)
A. lateral decubitus
B. supine
C. operative side up
D. operative side down.
E. axillary rolll
F. lithotmy

A

A. lateral decubitus
C. operative side up
E. axillary role

slide 60

99
Q

What type of anesthetic will we perfome on a total hip arthroplasy
A. MAC
B. general LMA
C. regional only
D. general ETT

A

D. general ETT
muscle relaxation required

slide 62

100
Q

What are the 3 benefits for Neuraxial anesthesia for total hip arthroplasty (select 3)
A. decreased awareness intraop
B.decreased EBL
C. decreased DVT and PE
D. decreased incidence of post op delirium

A

B.decreased EBL
C. decreased DVT and PE
D. decreased incidence of post op delirium

slide 62

101
Q

What is the primary use of Polymethyl Methacrylate (PMMA) in the context of medical implants?

a) As a bone graft substitute
b) For the fixation of prosthetic implants
c) As a coating for surgical instruments
d) For the manufacture of artificial joints

A

B. fixation of prosthetic implants

slide 63

102
Q

Use of Polymethylmethacrylate (PMMA) can result in (select 2)
A. intramedullary HTN >500mmHg
B. increased SVR
C.Cardiac HTN >200mmHg
D. embolization of fat, bone marrow, or cement

A

A. intramedullary HTN >500mmHg
D. embolization of fat, bone marrow, or cement

slide 63

103
Q

What does the acronym “PMMA” stand for?

a) Polymethyl Methacrylate
b) Prosthetic Medical Material
c) Polymeric Mechanical Adhesive
d) Plastic Molding Agent

A

A. polymethyl methacrylate

slide 63

104
Q

True or false: PMMA absorbs in the peripheral circulation

A

FALSE
systemic absorption
causing vasodilation and decreased SVR

slide 64

105
Q

PMMA can cause CV instability and
A. bleeding
B. HTN
C.microthrombus in lungs
D. increased SVR

A

C. microthrombus in the lungs

vasodilation, decreased SVR, platelet aggregation

slide 64

106
Q

Prevention of Bone cement implantation syndrome (BCIS) includes all of the following except
A. minimize hypotension and hypovolemia
B.maximize FiO2
C.vent hole in femur
D. limit fluids
E.lavage of femoral shaft
F. avoid bone cement

A

D. limit fluids

slide 65

107
Q

Signs and symptoms of BCIS include (select 5)
A.arrhythmias
B.hypoxia
C.hypotension
D.hypertension
E.Pulmonary HTN
F. Increased SVR
G. decreased Cardiac output

A

A. arrythmias
B. hypoxia
C hypotension
E pulmonary hypertension
G decreased CO

slide 66

108
Q

Treatment for BCIS includes (select 3)
A. vasopressors
B.maintain euvolemia
C. limiting fluid intake
D. increased FiO2

A

A. vasopressors
B. maintain euvolemia
D. increase FiO2

slide 67

109
Q

True or False
the most common complications from total hip are cardiac events, PE, infection, pneumonia, respiratory failure, infection

A

true

slide 69

110
Q

Hip arthroscopy is considered
A. non invasive
B.minimally invasive
C.invasive
D.open procedure

A

B. minimally invasive

slide 71

111
Q

Indications for hip arthroscopy include (select 4)
A.replacement
B.osteoarthritis
C.acetabular labral tears
D.loose bodies
E.Femoro-acetabular impingement

A

B.osteoarthritis
C.acetabular labral tears
D.loose bodies
E.Femoro-acetabular impingement

slide 71

112
Q

Positioning for hip arthroscopy includes (select 2)
A. weighted traction
B. prone
C. lateral decubatis
D. supine

A

A. weighted traction
D. supine

slide 72

113
Q

Which of the following is a physiological change associated with the supine position in the cardiac system?

a) Decreased right-sided filling
b) Increased heart rate
c) Increased peripheral vascular resistance
d) Equalization of pressures throughout the arterial system

A

D. equalization of pressures throughout the areterial system

slide 73

114
Q

How does the supine position affect the respiratory system?

a) Increases functional residual capacity (FRC)
b) Improves ventilation of the upper lung lobes
c) Displaces the diaphragm downwards
d) Increases perfusion of the dependent lung segments

A

D. increase perfusion of the dependent lungs

slide 73

115
Q

Which condition can further exacerbate the respiratory changes associated with the supine position?

a) Pregnancy
b) Anemia
c) Hypothyroidism
d) Dehydration

A

A. pregnancy (and obesity)

slide 73

116
Q

Which of the following is NOT a typical cardiac change associated with the supine position?

a) Increased cardiac output
b) Decreased heart rate
c) Increased systemic vascular resistance
d) Increased right-sided filling

A

C. increased SVR

decrease PVR

slide 73

117
Q

In the supine position the diaphragm is displaced ______ by the abdominal viscera
A.posterior
B. lateral
C. cephalad
D. caudad

A

c. cephalad

slide 73

118
Q

_____ favors dependent lung segements while _____ favors independent segments
A.SV, CV
B.CV, CV
C.CV, SV
D.SV, SV

A

A. SV , CV

slide 73

119
Q

_____ and may fall below CV in older patients
A . TLC increse
B. FRC increases
C.FRC decreases
D. PVR increase

A

C. FRC decrease (about 800mL)

slide 73

120
Q

The most common postoperative peripheral neuropathy is
A. ulnar neuropathy
B. brachial plexus injury
C. median nerve injury
D. sciatic nerve compression

A

A. ulnar neuropathy

slide 74/75

121
Q

Where are the two major sites of injury at the elbow (select 2)
A. radius
B.humerus
C.condylar grove
D .cubital tunnel

A

C. condylar grove
D. cubital tunnel

slide 75

122
Q

Which two structures form the condylar groove?

a) The medial epicondyle of the humerus and the olecranon process of the ulna
b) The lateral epicondyle of the humerus and the radial head
c) The trochlea of the humerus and the coronoid process of the ulna
d) The capitulum of the humerus and the radial head

A

A. medial epicondyle of the humerus and the olecranon process of the ulna

slide 75

123
Q

Why is the ulnar nerve at risk of compression injury at the elbow?

a) It is deeply located in the elbow joint
b) It passes through a narrow space called the cubital tunnel
c) It is protected by a thick layer of fat
d) It is not innervated by sensory nerves

A

b) It passes through a narrow space called the cubital tunnel

especially in Males where there is less protective adipose tissue

slide 75

124
Q

How should arms be positioned when lying supine
A.supinated
B.pronated
C. lateral

A

A. supinated

slide 75 (what he said in lecture)

125
Q

What type on anesthetic will be used on hip arthroscopy
A. general LMA
B. neuroaxial anesthesia
C. general ETT
D. MAC

A

C. general ETT (due to muscle relaxation requirement)

neuraxial may prolong time to discharge

slide 76

126
Q

Which of the following is NOT a key consideration in the postoperative care of a patient?

a) Type of surgery (inpatient vs. outpatient)
b) Assessment for potential nerve injury
c) weight of the patient
d) Pain management strategies

A

C. weight of patient

will consider AGE for mental status

slide 77

127
Q

Pre op assessment for Hip dislocation include (select 4)
A. Vit C intake
B.NPO status
C. IVF status
D.comorbidities
E.require closed reduction

A

B.NPO status
C. IVF status
D.comorbidities
E.require closed reduction

slide 78

128
Q

Hip Dislocation

What type of sedation is typically used for hip dislocation management?

A) Deep sedation
B) Conscious sedation
C) No sedation required
D) General anesthesia

A

B) Conscious sedation

May be performed in ER

Slide 79

129
Q

Hip Dislocation

Which combination of drugs is commonly used for “conscious sedation” in hip dislocation cases?

A) Fentanyl and Midazolam
B) Ketamine and Propofol
C) Etomidate and Dexmedetomidine
D) Thiopental and Sevoflurane

A

B) Ketamine and Propofol

Sldide 79

130
Q

Hip Dislocation

What medication can be used for muscle relaxation during hip dislocation reduction?

A) Succinylcholine
B) Rocuronium
C) Cisatracurium
D) Pancuronium

A

A) Succinylcholine

Slide 79

131
Q

Hip Dislocation

What are key postoperative considerations for patients after a hip dislocation reduction?
(Select 3 that apply)

A) Pain management
B) Admission for observation
C) Monitoring mental status
D) Immediate discharge
E) Surgical wound care

A

A) Pain management
B) Admission for observation
C) Monitoring mental status

Slide 80

132
Q

Knee Arthroscopy

What factor determine preoperative considerations for knee arthroscopy?

A) Age of the patient
B) Type of anesthesia used
C) Patient’s health status
D) Surgical equipment availability

A

A) Age of the patient

Slide 83

133
Q

Knee Arthroscopy

Which types of patients may undergo knee arthroscopy?
(Select 3 that apply)

A) Healthy young athletes with ligament tears
B) Healthy elderly individuals
C) Patients with comorbidities
D) Pediatric patients with no injuries

A

A) Healthy young athletes with ligament tears
B) Healthy elderly individuals
C) Patients with comorbidities

Slide 83

134
Q

Knee Arthroscopy

What is the standard patient positioning during knee arthroscopy?
(Select 2 that apply)

A) Supine
B) Prone
C) Lateral
D) Knee flexed

A

A) Supine
D) Knee flexed

Slide 84

135
Q

Knee Arthroscopy

What types of anesthesia can be used for knee arthroscopy?
(Select 3 that apply)

A) General anesthesia
B) Neuraxial / regional anesthesia
C) Local anesthesia only
D) Sedation with extraarticular and intraarticular injections

A

A) General anesthesia - use LMA?

B) Neuraxial / regional anesthesia -Spinal may delay discharge

D) Sedation with extraarticular and intraarticular injections

Slide 85

136
Q

Knee Arthroscopy

Which device may be applied during knee arthroscopy depending on the procedure?

A) Catheter
B) Tourniquet
C) Wound vacuum
D) Traction

A

B) Tourniquet

Slide 85

137
Q

Knee Arthroscopy

What is the typical surgical setting for knee arthroscopy?

A) Inpatient surgery
B) Outpatient surgery
C) Emergency surgery
D) Trauma center surgery

A

B) Outpatient surgery

Slide 86

138
Q

Knee Arthroscopy

What are common postoperative pain management strategies for knee arthroscopy?
(Select all that apply)

A) Peripheral nerve block
B) Injections by the surgeon
C) Oral NSAIDs only
D) Spinal anesthesia

A

A) Peripheral nerve block
B) Injections by the surgeon

Slide 86

139
Q

Total Knee Arthroplasty

Which preoperative factors are critical for a total knee arthroplasty?
(Select 3 that apply)

A) Mental status assessment
B) Laboratory evaluation
C) Preoperative medications review
D) Cardiopulmonary bypass preparation

A

A) Mental status assessment - Confusion / delirium

B) Laboratory evaluationHgb, Hct, coagulation

C) Preoperative medications review

+ Typical assessment

Slide 88

140
Q

Total Knee Arthroplasty

What is the standard patient positioning for total knee arthroplasty?

A) Supine
B) Prone
C) Lateral
D) Sitting

A

A) Supine

Slide 89

141
Q

Total Knee Arthroplasty

Which types of anesthesia can be used for total knee arthroplasty?
(Select 3 that apply)

A) General anesthesia
B) Neuraxial anesthesia
C) Peripheral nerve block
D) Local anesthesia only

A

A) General anesthesia
B) Neuraxial anesthesia
C) Peripheral nerve block

Slide 90

142
Q

Total Knee Arthroplasty

Why is neuraxial anesthesia often preferred for total knee arthroplasty?
(Select 2 that apply)

A) Decreased 30-day mortality
B) Decreased infection rate
C) Faster surgical procedure time
D) Reduced cost

A

A) Decreased 30-day mortality
B) Decreased infection rate

Slide 90

143
Q

Total Knee Arthroplasty

What types of peripheral nerve blocks are commonly used in total knee arthroplasty?
(Select 2 that apply)

A) Femoral nerve block
B) Sciatic nerve block
C) Brachial plexus block
D) Popliteal nerve block

A

A) Femoral nerve block
B) Sciatic nerve block

Slide 90

144
Q

Total Knee Arthroplasty

What is a key consideration regarding blood loss when a tourniquet is used during total knee arthroplasty?
(Select 2 that apply)

A) Blood loss begins upon tourniquet deflation
B) Blood loss continues for up to 24 hours postoperatively
C) Blood loss is minimized postoperatively
D) Blood loss stops immediately after deflation

A

A) Blood loss begins upon tourniquet deflation

B) Blood loss continues for up to 24 hours postoperatively

Slide 91

145
Q

Total Knee Arthroplasty

What is a potential risk associated with tourniquet use during total knee arthroplasty?

A) Increased infection risk
B) Peroneal nerve palsy
C) Delayed wound healing
D) Hypotension

A

B) Peroneal nerve palsy

Slide 91

146
Q

Total Knee Arthroplasty

Which of the following is a significant postoperative concern associated with tourniquet use?

A) Mild discomfort
B) Significant postoperative pain
C) Numbness in the contralateral leg
D) Delayed mobility

A

B) Significant postoperative pain

Slide 91

147
Q

Total Knee Arthroplasty

Which of the following are components of a total knee replacement (Select 4)?
A) Tibial component
B) Femoral component
C) Patellar component
D) Plastic spacer
E) Meniscus implant
F) Ligament graft
G) Bone cement

A

A) Tibial component
B) Femoral component
C) Patellar component
D) Plastic spacer

Slide 93

148
Q

Total Knee Arthroplasty

Which preoperative factors are critical for a total knee arthroplasty?
(Select 3 that apply)

A) Mental status assessment
B) Laboratory evaluation
C) Preoperative medications review
D) Cardiopulmonary bypass preparation

A

A) Mental status assessment - Confusion / delirium

B) Laboratory evaluationHgb, Hct, coagulation

C) Preoperative medications review

+ Typical assessment

Slide 88

149
Q

Total Knee Arthroplasty

Which of the following is a major postoperative concern following total knee arthroplasty? (Select 2)

A) Significant pain
B) Liver failure
C) Mental status changes
D) Vision loss

A

A) Significant pain
C) Mental status changes

Slide 94

150
Q

Total Knee Arthroplasty

Which pain management techniques are commonly used postoperatively for total knee arthroplasty? (Select 2)

A) Indwelling epidural catheter
B) Continuous peripheral nerve block
C) Spinal cord stimulator
D) Acupuncture

A

A) Indwelling epidural catheter
B) Continuous peripheral nerve block

Slide 94

151
Q

Which of the following strategies help reduce the risk of surgical wound infections? (Select 4)
A) Decreasing traffic in and out of the OR
B) Preoperative antibiotics
C) Using proper prep and draping techniques
D) Allowing the wound to air dry before closure
E) Using hoods

A

A) Decreasing traffic in and out of the OR
B) Preoperative antibiotics
C) Using proper prep and draping techniques
E) Using hoods

Slide 96

152
Q

Which factor is associated with an increased risk of postoperative wound infections? (Select 3)

A) Poor perioperative glucose control
B) Maintaining normothermia
C) Postoperative hypoxia
D) Postoperative hypothermia

A

A) Poor perioperative glucose control
C) Postoperative hypoxia
D) Postoperative hypothermia

Slide 96

153
Q

Amputations

Which preoperative factors should be assessed before an amputation?

A) Presence of comorbidities
B) Psychological support needs
C) Full sensory assessment
D) Type of prosthesis before surgery

A

A) Presence of comorbidities
B) Psychological support needs
C) Full sensory assessment
Pressure ulcers

Slide 97

154
Q

Amputations

Which comorbidity is most commonly associated with amputations?

A) Hypertension
B) Diabetes
C) Asthma
D) Hyperthyroidism

A

B) Diabetes

Slide 97

155
Q

Amputations

What is the standard patient positioning for an amputation surgery?

A) Supine
B) Prone
C) Lateral decubitus
D) Sitting

A

A) Supine

Slide 98

156
Q

Amputations

Which patient group needs padding during amputation surgery?

A) Obese patients
B) Cachectic patients
C) Patients with normal BMI
D) Pediatric patients

A

A) Obese patients
B) Cachectic patients

Slide 98

157
Q

Amputations

Which type of anesthesia is considered for amputation surgery? (Select 2)

A) Local anesthesia
B) General anesthesia
C) Neuraxial anesthesia
D) Conscious sedation

A

B) General anesthesia
C) Neuraxial anesthesia preferred

Slide 99

158
Q

Amputations

What are potential benefits of neuraxial anesthesia in amputation surgery? (Select 2)

A) Decreased incidence of delirium
B) Faster recovery of limb function
C) Reduced blood loss
D) Potential reduction in phantom limb pain

A

A) Decreased incidence of delirium
D) Potential reduction in phantom limb pain

Slide 99

159
Q

Total Knee Arthroplasty

Which preoperative factors are critical for a total knee arthroplasty?
(Select 3 that apply)

A) Mental status assessment
B) Laboratory evaluation
C) Preoperative medications review
D) Cardiopulmonary bypass preparation

A

A) Mental status assessment - Confusion / delirium

B) Laboratory evaluationHgb, Hct, coagulation

C) Preoperative medications review

+ Typical assessment

Slide 88

160
Q

Amputations

What is the primary reason for the application of a tourniquet during amputation procedures?

A) To improve anesthetic depth
B) To minimize variable blood loss
C) To enhance nerve function
D) To maintain body temperature

A

B) To minimize variable blood loss

Slide 99

161
Q

Amputations

Which of the following is a key component of postoperative care after an amputation? (Select 2)

A) Pain management
B) Neurological testing
C) Wound drainage placement
D) Psychological support

A

A) Pain management
D) Psychological support

Slide 100

162
Q

Amputations

What postoperative mental status changes should be monitored after an amputation? (Select 2)

A) Euphoria
B) Confusion
C) Delirium
D) Hallucinations

A

B) Confusion
C) Delirium

Slide 100

163
Q

Amputations

Phantom limb pain is characterized by which of the following? (Select 4)

A) Onset within a few days after surgery
B) Constant and unchanging pain
C) Intermittent pain episodes
D) Pain described as shooting, stabbing, or burning
E) Pain described as squeezing or throbbing

A

A) Onset within a few days after surgery
C) Intermittent pain episodes
D) Pain described as shooting, stabbing, or burning
E) Pain described as squeezing or throbbing

Slide 101

164
Q

Amputations

Which of the following are common triggers for phantom limb pain? (Select 3)

A) Weather changes
B) Emotional stress
C) Pressure on the remaining area
D) Increased water intake

A

A) Weather changes
B) Emotional stress
C) Pressure on the remaining area

Slide 102

165
Q

Amputations

Which of the following are potential causes of phantom limb pain? (Select 3)

A) Remapping of neural circuitry
B) Damaged nerve endings
C) Scar tissue formation
D) Sleep deprivation

A

A) Remapping of neural circuitry
B) Damaged nerve endings
C) Scar tissue formation

Slide 103

166
Q

Amputations

Which imaging techniques can provide insight into the causes of phantom limb pain? (Select 2)

A) X-ray
B) MRI
C) PET scan
D) Ultrasound

A

B) MRI
C) PET scan

Slide 103

167
Q

Amputations

How does pain experienced prior to an amputation contribute to phantom pain?

A) It establishes a pain memory that may persist after the limb is removed.
B) It causes increased sensitivity to pain medications post-surgery.
C) It reduces the likelihood of postoperative pain.
D) It eliminates the need for nerve blocks during surgery.

A

A) It establishes a pain memory that may persist after the limb is removed.

Slide 103

168
Q

Amputations

Which of the following are treatments for phantom limb pain? (Select 4)

A) Biofeedback
B) Relaxation techniques
C) Massage
D) TENS unit (Transcutaneous Electrical Nerve Stimulation)
E) Acupuncture
F) Cognitive-behavioral therapy (CBT)
G) Nerve blocks

A

A) Biofeedback
B) Relaxation techniques
C) Massage
D) TENS unit (Transcutaneous Electrical Nerve Stimulation)

Slide 104

169
Q

Amputations

Which medications are commonly used to manage phantom limb pain? (Select 3)

A) Neuroleptics
B) Antidepressants
C) Sodium channel blockers
D) Corticosteroids
E) Opioids

A

A) Neuroleptics
B) Antidepressants
C) Sodium channel blockers

Slide 105

170
Q

Total Knee Arthroplasty

Which preoperative factors are critical for a total knee arthroplasty?
(Select 3 that apply)

A) Mental status assessment
B) Laboratory evaluation
C) Preoperative medications review
D) Cardiopulmonary bypass preparation

A

A) Mental status assessment - Confusion / delirium

B) Laboratory evaluationHgb, Hct, coagulation

C) Preoperative medications review

+ Typical assessment

Slide 88

171
Q

Ankle/Foot

Which conditions may require surgical intervention? (Select 3)

A) Achilles tendon rupture
B) ORIF malleolar fracture
C) Hallux valgus (bunion)
D) Tension headache
E) Common cold

A

A) Achilles tendon rupture
B) ORIF malleolar fracture
C) Hallux valgus (bunion)

Slide 107

172
Q

Ankle/Foot

Which factors should be assessed during the preoperative phase for ankle/foot surgery? (Select 4)

A) Age of the patient
B) Comorbidities
C) Anxiety levels
D) Pain management needs
E) Eye examination

A

A) Age of the patient
B) Comorbidities
C) Anxiety levels
D) Pain management needs

Slide 108

173
Q

Ankle/Foot

What is the correct patient positioning for ankle/foot surgery? (Select 3)

A) Lateral position
B) Prone position
C) Supine position
D) Fowler’s position

A

A) Lateral position (Achilles tendon)
B) Prone position (Achilles tendon)
C) Supine position

Slide 109

174
Q

Ankle/Foot

Which anesthesia options are available for ankle/foot surgery? (Select 3)

A) General anesthesia
B) Neuraxial anesthesia
C) Regional anesthesia
D) Local sedation

A

A) General anesthesia
B) Neuraxial anesthesia
C) Regional anesthesia

Slide 110

175
Q

Ankle/Foot

What are key considerations for administering Regional Anesthesia for Ankle/Foot surgery? (Select 3)

A) Assessing the current level of sensation
B) Doing ankle block during foot surgery
C) Determining if the podiatrist will perform the injection
D) Avoiding anesthesia to minimize recovery time

A

A) Assessing the current level of sensation
B) Doing ankle block during foot surgery
C) Determining if the podiatrist will perform the injection

Slide 110

176
Q

Ankle/Foot

Which 5 nerves are targeted during an ankle block?

A) Posterior tibial nerve
B) Deep peroneal nerve
C) Superficial peroneal nerve
D) Sural nerve
E) Saphenous nerve
F) Sciatic nerve

A

A) Posterior tibial nerve
B) Deep peroneal nerve
C) Superficial peroneal nerve
D) Sural nerve
E) Saphenous nerve

Slide 111-112

177
Q

Ankle/Foot

What areas are anesthetized by the posterior tibial nerve?

A) Plantar surface of the foot
B) Medial malleolus
C) Dorsum of the foot
D) Interspace between the great and second toe

A

A) Plantar surface of the foot

Slide 111

178
Q

Ankle/Foot

Which of the following statements about the saphenous nerve is true?

A) It provides sensation to the medial malleolus.
B) It is a branch of the posterior tibial nerve.
C) It provides motor innervation to the foot.
D) It plays a role in sensation to the plantar surface of the foot.

A

A) It provides sensation to the medial malleolus.

Slide 111

179
Q

Ankle/Foot

Which areas are innervated by the deep peroneal nerve?

A) Plantar surface of the foot
B) Interspace between the great and second toes
C) Dorsum of the foot
D) Medial malleolus

A

B) Interspace between the great and second toes

Slide 112

180
Q

Ankle/Foot

The superficial peroneal nerve provides sensation to which areas? (Select 2)

A) Dorsum of the foot
B) Lateral foot and 5th toe
C) Plantar surface of the foot
D) Toes 2 through 5 (dorsal side)

A

A) Dorsum of the foot
D) Toes 2 through 5 (dorsal side)

Slide 112

181
Q

Ankle/Foot

The sural nerve provides sensation to which areas of the foot?

A) Lateral foot
B) Medial malleolus
C) Lateral 5th toe
D) Dorsum of the foo

A

A) Lateral foot
C) Lateral 5th toe

Slide 112

182
Q

Ankle/Foot

Which are key postoperative considerations for ankle and foot surgery?

A) Pain management
B) Immobilization
C) Immediate weight-bearing
D) Outpatient surgery

A

A) Pain management
B) Immobilization

Slide 113

183
Q

Ankle/Foot

What surgical setting can most ankle and foot procedures be done?
A) Inpatient hospital stay
B) Outpatient surgery
C) Emergency trauma center
D) Rehabilitation clinic

A

B) Outpatient surgery

Slide 113

JW: Adv Principles A (15 decks)

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