Brainscape's Knowledge GenomeTM

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


See full index

SUM'20 - Regional > Week 1 Neuroanatomy 3 of 4 (6/2 Mo) > Flashcards

Week 1 Neuroanatomy 3 of 4 (6/2 Mo) Flashcards

1
Q

How to tell an Amide from an Ester?

A

Esters have one “i” and Amides have two “i”

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

Patient with atypical pseudocholinesterase have ?

A

Prolonged duration of action.

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

If someone has Chronic therapy with acetylcholinesterase inhibitors ( edrophonium, physostigmine, echothiophate) what does it then prolong?

A

prolongs the action of ester LA.

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

What is the metabolic end product of ester metabolism that may cause hypersensitivity reation?

A

Para-aminobenzoic acid (PABA)

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

Which LA depresses the activity of pseudocholinesterase by 80%?

A

Dibucaine

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

Which LA can cause methemoglobinemia?

A

Prilocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

If you are giving a patient epinephrine and lidocaine, then the toxic dose of lidocaine becomes?

A

6mg/kg

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

sympathetic blockade causes what?

A

hypotension

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

tell me the process that causes hypotension due to sympathetic blockade?

A

vasodilation leads to decreased preload which leads to hypotention.

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

How do you know when to use phenylephrine over epinephrine?

A

if beta adrenergic affects are not required add phenylephrine instead of epinephrine.

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

Tell me six adverse reactions to neuraxial anesthesia?

A

Urinary retention High block Total spinal anesthesia Cardiac arrest Anterior spinal artery syndrome Horner’s syndrome

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

Tell me 11 complications related to needle placement of neuraxial anesthesia.

A

Backache Dural puncture/leak Diplopia Tinnitus Nerve root damage Cauda equina syndrome Bleeding leading to hematoma Inadvertent spinal block Inadvertent intravascular injection Inflammation Infection

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

Is drug toxicity considered a complication of neuraxial anesthesia?

A

Yes, drug toxicity is a stand alone complication of neuraxial anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Explain to me what a high neural block is?

A

Spinal anesthesia spread towards head causing hypotension, bradycardia and respiratory complications (decreased FRC, dyspnea, inability to cough, apnea)

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

A high neural block can cause phrenic nerve paralysis, tell me what are your phrenic nerves?

A

C3, 4, 5

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

What is the treatment for a high neural block?

A

Intubation and ventilation Supplemental oxygen Fluid (avoid glucose) Ephedrine for bradycardia Phenylephrine for hypotension

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

What causes cardiac arrest during spinal anesthesia?

A

due to increased vagal response and decreased preload

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

what should you avoid during spinal anesthesia to not have cardiac arrest in your patient?

A

avoid hypovolemia and do not allow the HR to drop below 50.

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

hypotension during neuraxial anesthesia is due to what two types of devervation?

A

sympathetic denervation and pharmacological denervation.

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

If the LA blocks what levels you are more likely to have urinary retention?

A

S2,3,4 - leads to loss of micturition reflex.

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

If you lose micturition reflex you have blocked what level? and what will you do to treat this?

A

you have blocked the level of S2, 3, 4 and you will need to place a urinary catheter.

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

what is a fail block and is it considered a complication of neuraxial anesthesia?

A

yes, it is considered a complication of neuraxial anesthesia. It is when a block was performed but intended effect does not occur, or only partially occurs.

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

If you accidentally intravenously inject LA, what may occur (S/S)? What type of neuraxial anesthesia is this most often seen with?

A

Can affect CNS/CVS leading to seizure, unconsciousness, hypotension, arrhythmia and cardiac depression Seen after epidural and caudal block

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

If you accidentally inject LA into the subdural space what occurs?

A

rapid CNS depression

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

Backache associated with neuraxial anesthesia, is it a big deal and how do you treat it?

A

Mild and self-limiting, treat with NSAIDS.

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

PDPH: what positioning is it associated with, and what position decreases the likelihood.

A

increased occurrence while standing or sitting, decreased with lying down.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

PDPH: what causes it?

A

due to leakage of CSF and decreased ICP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

PDPH: Causes what due to traction on CN VI?

A

diplopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

PDPH: The larger the needle the less likely or more likely to occur?

A

high risk with larger needles.

30
Q

What three factors put a patient at higher risk for PDPH?

A

Young age female pregnancy

31
Q

Treatment for PDPH?

A

Recumbent position NSAID IV or oral fluid Cup of Coffee(causes vasoconstriction of cranial blood vessels) Stool softeners Blood patch to seal off the hole in dura

32
Q

Tell me everything you know about spinal or epidural hematoma?

A

Associated with coagulopathies Sharp back pain, leg pain and motor weakness Sphincter dysfunction Surgical decompression is performed (must be performed within 6-8 hours or permanent deficits)

33
Q

True or false, infection is a risk with neuraxial anesthesia?

A

YES, you should try to prevent contamination.

34
Q

What organism is responsible for epidural abscess?

A

caused by Staph.

35
Q

what are the S/S of epidural abscess?

A

Back pain intensify on percussion Nerve root pain develops; motor or sensory deficit; paraplegia

36
Q

How do you diagnose epidural abscess?

A

culture, MRI, CT

37
Q

Treatment of epidural abscess?

A

antibiotics along with pus drainage.

38
Q

Drug toxicity as a complication of neuraxial anesthesia: what are the characteristics of transient neurological syndrome and what is it typically associated with drug wise?

A

Characterized by back pain radiating to legs w/o motor or sensory deficit Resolves spontaneously Associated with hyperbaric lidocaine (12%)

39
Q

Lidocaine neurotoxicity is also called what?

A

Cauda equina syndrome

40
Q

What is cauda equina syndrome? What are the S/S?

A

Motor or sensory loss, or both, usually partial, occurs in the distal legs. LMN type lesions Sensation is usually diminished in the perineal region (saddle anesthesia). Patchy sensory loss Pain with nerve root compression Bowel and bladder dysfunction, either incontinence or retention, may occur. Men may have erectile dysfunction, and women diminished sexual response. Anal sphincter tone is lax.

41
Q

What forms the Brachial Plexus?

A

C5-C8 and T1 (C4 and T2 may also contribute to this plexus)

42
Q

What is the Brachial Plexus?

A

It gives rise to the nerves that innervate the upper limb.

43
Q

What is the acronym we use to remember the break down of the brachial plexus?

A

Robert Taylor Drinks Cold Beer

44
Q

What is the break down of the Brachial plexus?

A

Roots Trunks Divisions Cords Branches

45
Q

Brachial Plexus: Roots = ? Trunks = ? Divisions = ? Cords = ? Branches = ?

A

Roots - five ventral rami (C5-T1) Trunks – superior, middle, and inferior Divisions – anterior and posterior serve the front and back of the limb Cords – lateral, medial, and posterior fiber bundles Branches - musculocutaneous, radial, median, ulnar, (there is also an axillary nerve)

46
Q

When looking at a cross section of the Brachial plexus at axilla what nerve is most superior, medial, lateral, and inferior?

A

most superior - musculocutaneous medial is medain nerve lateral is the radial nerve and inferior is the ulnar nerve.

47
Q

What is the second most common postop peripheral neuropathy?

A

Brachial plexus

48
Q

Tell me when the brachial plexus is injured? (two answers)

A

Injured when arm abduction > 90 degrees or improperly placed shoulder brace

49
Q

What does the axillary nerve innervate and what does an injury look like?

A

innervates the deltoid and teres minor. injury leads to an inability to abduct the arm.

50
Q

What does the musculocutaneous nerve do and what does an injury look like?

A

musculocutaneous nerve sends fibers to the biceps brachii and brachialis. injury leads to an inability to flex the forearm.

51
Q

What does the median nerve do?

A

median nerve branches to most of the flexor muscles of the arm and opponens pollicis. Pronation of forearm Flexion of wrist Opposition of thumb Flexion of lateral three fingers

52
Q

What does a median nerve injury look like?

A

Injury leads to Ape hand- “unable to oppose thumb”

53
Q

if you are unable to abduct your arm, what nerve injury would this be?

A

axillary nerve injury

54
Q

if you have ape hand and are unable to oppose your thumb, what nerve have you injured?

A

Median nerve injury

55
Q

if you are not able to flex your forearm, what nerve have you injured?

A

Musculocutaneous nerve injury

56
Q

What does the ulnar nerve supply?

A

supplies the flexor carpi ulnaris and part of the flexor digitorum profundus

57
Q

What is the most common post op peripheral neuropathy?

A

Ulnar nerve damage

58
Q

What does the Ulnar nerve do as far as movements? (3 movements)

A

Flexion of wrist Adduction of fingers Flexion of medial two fingers (4,5)

59
Q

If you have an injury to the ulnar nerve, what does that look like?

A

injury = claw hand

60
Q

What does the Radial nerve innervate?

A

innervates essentially ALL extensor muscles of arm and forearm

61
Q

What three movements does the Radial nerve make happen?

A

Extension at elbow Supination of forearm Extension of wrist and fingers

62
Q

Injury to the Radial nerve would show up as what?

A

Wrist drop

63
Q

What nerve can be blocked to reduce pain from tourniquet inflation during IV regional neural anesthesia?

A

Intercostobrachial nerve (board question)

64
Q

Supinator is supplied by what nerve?

A

Radial nerve

65
Q

Posterior view of your hand, tell me which parts are supplied by the median, ulnar, and radial nerve?

A

Slide 55

66
Q

Anterior view of your hand, tell me which parts are supplied by the median, ulnar, and radial nerve?

A

slide 55

67
Q

What nerve is the continuation of the Femoral nerve?

A

Saphenous nerve

68
Q

The Sciatic nerve branches into what two main divisions?

A

Tibial nerve and the Common Peroneal nerve (also known as the fibular nerve)

69
Q

the Tibial nerve that branched from the Sciatic nerve then further branches into ?

A

The Sural nerve

70
Q

The Common Peroneal nerve or also known as the fibular nerve further branches into what two divisions?

A

Superficial peroneal and Deep peroneal

71
Q

Tell me all the branching of the Sciatic nerve? (5 answers)

A

Image from ppt 57

72
Q

Know the basic placement of nerves from the Lumbar region to the pelvic area.

A

Image from slide 58

SUM'20 - Regional (17 decks)

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