Neuraxial Anesthesia II Exam I

Question 1

• What is the plica mediana dorsalis?
• What is known about its existance?
• Where is it located?

Answer 1

• a connective tissue that is thin as paper that divides the epidural space from right to left.
• The presence of this structure is controversial and not definitively confirmed.
• It is thought to be a band of connective tissue located between the ligamentum flavum and the dura mater.

Question 2

What is the potential impact of the plica mediana dorsalis?

Answer 2

• If it exists, it might act as a barrier within the epidural space
• This barrier could affect how medications spread when injected into the epidural space

Question 3

What is the clinical relevance of the plica mediana dorsalis?

Answer 3

• It is sometimes considered a possible reason for complications in placing an epidural catheter
• It might also play a role in cases where an epidural does not equally effect both sides of the body.

Question 4

In what department will you hear the term plica mediana dorsalis the most?

Answer 4

labor and delivery/ OB

Question 5

What is a differential diagnosis you can say for why your epidural is only blocking one side and not the other (unilateral block)?

Answer 5

a pronounced plica mediana dorsalis

Question 6

16:02