Unit 1 Module 3 (Exam 1) Flashcards
Which patient group is most likely to undergo spinal decompression due to degenerative spine disease?
A. Patients over 60 years old
B. Patients under 60 years old
C. Patients with sedentary life styles
D. Patients with no history of back pain
B. Patients under 60 years old
Slide 3
What is the most common spinal condition in patients over 60 years old?
A. Herniated disc
B. Degenerative disc disease
C. Spinal stenosis
D. Spondylolisthesis
C. Spinal stenosis
Slide 3
What type of anesthesia is typically required for most spine surgeries?
A. Regional anesthesia
B. Conscious sedation
C. Local anesthesia
D. General endotracheal anesthesia
D. General endotracheal anesthesia
slide 5
Airway management during spine surgery can be challenging due to surgical __________ and patient __________.
A. equipment; medications
B. monitoring; blood pressure
C. positioning; anatomy
D. sedation; anesthesia type
C. positioning; anatomy
Slide 5
Motor and sensory monitoring in spine surgery is critical to avoid __________ of nerve conduction.
A. enhancement
B. severance
C. paralysis
D. relaxation
B. severance
MEPs and SSEPs must be monitored
Slide 5
Why are paralytic agents often avoided during spine surgeries?
A. Paralytics cause excessive sedation.
B. Paralytics can impair nerve monitoring
C. Paralytics increase the risk of airway complications.
D. Paralytics are unnecessary for general anesthesia cases.
B. Paralytics can impair nerve monitoring
Slide 5
Patients undergoing spine surgery may experience large __________ due to the complexity of the procedure.
A. blood loss
B. electrolyte shifts
C. fluid intake
D. clot formation
A. blood loss
Slide 5
Which is NOT a condition that may require reconstructive spine surgery?
A. Scoliosis
B. Kyphosis
C. Kyphoscoliosis
D. Olecranonaplasty
D. Olecranonaplasty
Reconstructive surgery
* Scoliosis
* Kyphosis
* Kyphoscoliosis
* Revision of previous thoracolumbar fusions
Slide 6
A __________ is often performed to remove part of a herniated disc that is pressing on a nerve.
A. microdiscectomy
B. spinal fusion
C. kyphoplasty
D. thoracotomy
A. microdiscectomy
Slide 6
True or False
Spinal fusion can be performed through either an anterior or posterior approach.
True
Slide 6
Which of the following characteristics define scoliosis?
Select 2
A. Lateral rotation of the spine greater than 10°
B. Posterior curvature of the spine
C. Vertebral rotation
D. Degeneration of intervertebral discs
A. Lateral rotation of the spine greater than 10°
C. Vertebral rotation
Slide 7
Types of scoliosis include congenital, idiopathic, and __________.
A. degenerative
B. traumatic
C. infectious
D. neuromuscular
D. neuromuscular
Slide 7
Back pain in adult scoliosis is often caused by arthritis and __________.
A. spinal cord swelling
B. disc degeneration
C. muscle spasms
D. nerve regeneration
B. disc degeneration
back pain because of the misalignment of the vertebrae causing compression of the nerves
slide 8
Spinal stenosis can cause pain that worsens when a patient is __________.
A. lying down
B. eating
C. swimming
D. standing
D. standing or walking
Slide 8
Radiculopathy is caused by the compression or __________ of a nerve at the spinal column.
A. stretching
B. pinching
C. relaxing
D. dissolving
B. pinching
Slide 8
What is a common respiratory complication in thoracic scoliosis?
A. Restrictive lung disease
B. Obstructive lung disease
C. Pulmonary embolism
D. Chronic bronchitis
A. Restrictive lung disease
Decreased chest wall compliance
Slide 10
What preoperative assessment is crucial for patients with thoracic scoliosis?
A. Neurological testing
B. Exercise tolerance
C. Bone density testing
D. Thyroid function tests
B. Exercise tolerance
Slide 10
True or False
Pulmonary function tests (PFTs) are irrelevant in the preoperative assessment of scoliosis patients.
False
Pulmonary function tests (PFTs) are relevant in the preoperative assessment of scoliosis patients.
Review: normal values for tidal volume, minute ventilation, functional residual capacity, forced vital capacity are FEV1 and then expiratory flow rates and peak
Slide 10
What is a primary cause of chronic hypoxemia in patients with thoracic scoliosis?
A. V/Q mismatch
B. Obstructive airway disease
C. Coronary artery disease
D. Chronic kidney disease
A. V/Q mismatch
Causing chronic hypoxemia
Slide 11
What condition is associated with increased pulmonary vascular resistance in scoliosis patients?
A. Myocardial infarction
B. Cor pulmonale
C. Aortic stenosis
D. Hypotension
B. Cor pulmonale
Slide 11
Which cardiac changes may be seen on an EKG in patients with cor pulmonale?
Select 2
A. Left ventricular hypertrophy
B. Right ventricular hypertrophy
C. Right atrial enlargement
D. Left atrial enlargement
E. Atrial fibrillation
B. Right ventricular hypertrophy (RVH)
C. Right atrial enlargement (RAE)
Slide 11
Which preoperative test helps assess pulmonary hypertension in scoliosis patients?
A. Electroencephalogram
B. Echocardiogram
C. Pulmonary function test
D. Chest X-ray
B. Echocardiogram (echo)
..with a pre-op echo or a Doppler ultrasound result that measures the pulmonary artery systolic pressure…
Slide 11
In surgeries with significant blood loss, platelet abnormalities and __________ coagulopathy may occur.
A. respiratory
B. peripheral
C. chronic
D. dilutional
D. dilutional
Slide 12
The breakdown of primary clots, known as __________, can increase the risk of bleeding during surgery.
A. hypercoagulation
B. fibrinolysis
C. thrombocytosis
D. hemostasis
B. fibrinolysis
Slide 12