Innervation and Anesthesia

Question 1

Pudendal Nerve roots

example in pregnancy

Example

Answer 1

S2-S4

fetal head places pressure on vagina, cervix

Question 2

Sciatic nerve roots + fxn

Answer 2

L4-s3
motor: post. thigh
sensory: posteriorlateral leg, foot

Question 3

Sup gluteal n roots and fxn

Answer 3

L4-s1
motor: gluteus medium, minimus

Question 4

Ilioinguinal nerve
sensory fxn:
nerve root:

damage?

Answer 4

sesory fxn: labia, mons pubis
nerve root: L1

damage during c/s

Question 5

Obturator nerve roots
sensory fxn:

damage:

Answer 5

nerve roots: L2-L4
sensory fxn: inner thigh

damage: trocar placement, PLND

Question 6

epidural location (nerve roots)

Answer 6

L3 and L4

Question 7

spinal location (nerve roots)

Answer 7

L3-L4, L4-L5

Question 8

spinal cord ends @ which level?

Answer 8

L1-L2

Question 9

Location of “high spinal”

Answer 9

~T4

Question 10

Epidural “ingredients”

Answer 10

low-dose local anesthetic
opioid agonist (minimized motor n blockade)

Question 11

Epidural side fx

MoA

Answer 11

hypotension

sympathetic nerve blockade -> vasodilation

Question 12

Autonomic Dysreflexia Sx

Answer 12

increased BP
HA
sweating
changes in vision

vasodilation above level of injury

Question 13

Autonomic Dysreflexia MoA

Answer 13

Below T5-T6 injunry, sensory nerves stimulate sympathetic neurons, which goes unopposed (unbalanced)

vasodilation above level of injury 2/2 inhibitory cerebral

Question 14

autonomic dysreflexia stimuli

Answer 14

vagina, bladder, uretha, bowel distention/manipulation

Question 15

mgmt autonomic dysreflexia

and why

Answer 15

neuraxial anesthesia (T10-S4 for labor, T4-S1 for c/s)

blocks neurologic stimuli arising from pelvic organs