Positioning Flashcards

1
Q

The most common 3 causes of legal settlement against CRNAs due to missed documentation?

A
  1. mal-Patient Position.
  2. Not using protective padding.
  3. Preexisting patient conditions.

NOT CHARTING IS THE PROBLEM!!!

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2
Q

What is the most common nerve injury?

A

Ulnar nerve

About 28%

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3
Q

What increases the risk of nerve injury?

A
Inadequate/inappropriate positioning.
Preexisting patient conditions.
General anesthesia (can't move/talk).
Extremes of size (large or small).
Procedures lasting >4hrs
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4
Q

What are the four types of nerve injury?

A

Transection.
Compression.
Stretch.
Kinking.

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5
Q

The brachial nerves begin from what area of the spinal cord?

A

C5-T1

but can be C4-T2

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6
Q

How many roots are there?

A

5

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7
Q

How many cords are there?

A

3

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8
Q

How many divisions are there?

A

6
(3 anterior
3 posterior)

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9
Q

How many trunks are there?

A

3

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10
Q

List the brachial plexus deviations in order

A
Roots
Trunks
Divisions
Cords
Branches
(Randy Travis Drinks Cold Beer)
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11
Q

What are the 5 peripheral nerves (branches)

A
  1. Musculo-cutaneous.
  2. Axillary.
  3. Radial.
  4. Median.
  5. Ulnar.
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12
Q

The naming/labeling of the nerves within the brachial plexus is in relation to what anatomic structure?

A

The Brachial Artery

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13
Q

Only three of the branches make it to the hand- what are they?

A

Radial.
Median.
Ulnar.

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14
Q

What does the musculo-cutaneous nerve innervate?

A

Bicep and skin of forearm.

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15
Q

What does the axillary nerve innervate?

A

Mostly deltoid and shoulder

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16
Q

What does the ulnar nerve innervate?

A

Ring ringer split in half and pinky

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17
Q

What does the radial nerve innervate?

A

Thumb and mostly back of hand side.

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18
Q

From what level of the spinal column does the ulnar nerve originate?

A

C8

19
Q

What does the median nerve innervate?

A

Middle of hand, mostly palm side of hand. and nail beds of middle fingers.

20
Q

Where in the spinal column do the cardiac nerves originate?

A

T1-T4

21
Q

Where in the spinal column do the respiratory nerves originate?

A

C3-C4-C5 (keep the man alive)

22
Q

As a spinal anesthetic “moves up”, what is the first sign in the hand that this is happening?

A

Ulnar nerve will be effected. May have pinky numbness.

Originates from C8.

23
Q

The main etiology behind nerve injury is due to what?

A

Ischemia

24
Q

Where are the most common points of nerve injury in the arm?

A

Points of joints and bony prominences

25
Q

Where does the lumbar plexus extend from?

A

L1-L5

26
Q

What is the only branch from femoral that makes it all the way to the foot/ankle?

A

Saphenous

27
Q

What is the most important nerve running through the groin that can be damaged?

A

Femoral nerve

28
Q

Where does the Sacral plexus extend from?

A

L4-coxis

29
Q

What is the major nerve from the sacral plexus that can be injured?

A

Sciatic nerve

30
Q

Which two nerves make up the sciatic nerve?

A

Tibial and common peroneal

31
Q

At what spinal level is the nipple line involved?

A

T4

32
Q

At what spinal level is the xyphoid process involved?

A

T6/T7

33
Q

At what spinal level is the belly button involved?

A

T10 (Butt-ten)

34
Q

What does the axillary roll prevent?

A

Compression of brachial nerves and artery

35
Q

What injury is possible with fracture table?

A

Groin area compression.

36
Q

Which nerve can be injured with tourniquet use and BP cuffs?

A

Radial nerve

37
Q

Which nerve is most commonly damaged from stirrup use?

A

Common peroneal nerve

38
Q

Three anesthetic techniques/factors are involved in risk of nerve injury- what are they?

A

General anesthesia.
Hypotensive.
Neuromuscular blockade

39
Q

Does risk of nerve injury increase or decrease as length of surgery increase?

A

Risk of injury will increase as length of procedure increases

40
Q

What is the most common metabolic cause of spontaneous neuropathy?

A

Diabetes

41
Q

West Zone 1 pressures

A

Alveolar>Arterial>venous

42
Q

West Zone 3 pressures

A

Arterial>Venous>Alveolar

43
Q

West Zone 2 Pressures

A

Arterial>Alveolar>Venous