positioning/nerve injury Flashcards Preview

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Flashcards in positioning/nerve injury Deck (41)
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1
Q

Supine effects:

circulation

A

minimal

2
Q

Supine effects:

Pulmonary

A
decreased FRC (800cc)
cephalad displacement of diaphragm to compress the lung bases
3
Q

Supine effects:

what should u do to facilitate Venous return

A

flex hips and knees to facilitate venous drainage from lower extremities

4
Q

Supine effects:

what do u wanna make sure you pad

A

occiput

heels

5
Q

Trendelenburg Effects:

Circulation

A

decreased SV- hypotension maybe ( and viscera pushes against the diaphragm, which compresses lung bases and pushes on heart to decrease SV)

6
Q

Trendelenburg Effects:

Pulmonary

A

lung bases compresed

7
Q

Trendelenburg Effects:

what will happen to venous return

A

increase (but may not help the decrease in BP)

8
Q

Trendelenburg Effects:

what could it do to ICP

A

increase it

9
Q

Trendelenburg Effects:

what type of pets would you use this position with caution (not head puts think general population)

A

obese

10
Q

Prone effects:

circulation- what can become compressed

A

inferior venacava

Aorta

11
Q

Prone effects:

Pulmonary- what happens to lung bases

A

forced cephalad

12
Q

Prone effects:

what could hinder venous return

A

vascular compression

13
Q

Prone effects:

turning head in prone may obstruct drainage of what?

A

Jugular veins

vertebral artery

14
Q

Prone effects:
placement of what under the pts sides receive abdominal compression and increases venous return to the heart, and eases ventilation

A

abdominal rolls (chest rolls)

15
Q
Lateral Decubitus (on Ventilator) effects:
increased circulation goes to what lung?
A

dependent lung

16
Q
Lateral Decubitus (on Ventilator) effects:
there may be decreased blood to the kidney if what is being used
A

kidney rest

17
Q
Lateral Decubitus (on Ventilator) effects:
there will be decreased ventilation to what lung?
A

dependent

18
Q
Lateral Decubitus (on Ventilator) effects:
there will be increased ventilation to what lung
A

non dependent lung

19
Q
Lateral Decubitus (on Ventilator) effects:
should there be a problem with venous return
A

no

20
Q
Lateral Decubitus (on Ventilator) effects:
what should be in place and where on all pt's in lateral decubitus
A

axillary rolls

placed under thorax just caudal to axilla

21
Q

Sitting effects:

there is an increase in drainage from where?

A

head/ neck/ and upper body

22
Q

Sitting effects:

what happens to intrathoracic blood volume

A

decreases

23
Q

Sitting effects:

what changes occur to the pulmonary system?

A

none

24
Q

Sitting effects:

what can u do to increase venous return form the lower extremities?

A

use compression stockings

25
Q

Sitting effects:

with the decreased venous return what happens to cerebral perfusion pressure?

A

decreases

26
Q

Sitting effects:

with decreased Venous return what happened to cardiac output

A

decreases

27
Q

Sitting effects:

what is a hazard/potential complication from this position?

A

air embolism

28
Q

Lithotomy effects:

any problems with circulation

A

no

29
Q

Lithotomy effects:

what happens to the lung bases?

A

d/t cephalad displacement of lungs the bases are compressed

30
Q

Lithotomy effects:

how should the legs be raised and lowered

A

together

31
Q

Lithotomy effects:

what is a common compliction

A

nerve injury

32
Q

Lithotomy effects:

what nerves are injured

A
sciatic
Common peroneal
femoral
saphenous
obturator
33
Q

what is the most common postop peripheral neuropathy

A

ulnar nerve injury

34
Q

what is the 2nd most common postop peripheral neuropathy

A

Brachial plexus

35
Q

what causes the ulnar injury

A

compression of medial epicondyle of humorous and sharp edge of OR table

36
Q

the ulnar nerve is stretched when the hand is in what position

A

pronated

37
Q

what causes the brachial plexus injury

A

stretch injury when neck is extended and the head is turned away or the arm is abducted to greater than 90 degrees

38
Q

s/s of median nerve injury

A

“ape hand”

unable to oppose thumb

39
Q

S/S of ulnar nerve injury

A

“claw hand” deformity

40
Q

S/S of radial nerve injury

A

wrist drop

41
Q

what is the most frequently injured nerve in the lower extremity

A

common peroneal n.

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