Spinal & Epidural Anesthesia Flashcards Preview

AP: Cumulative > Spinal & Epidural Anesthesia > Flashcards

Flashcards in Spinal & Epidural Anesthesia Deck (24):
1

Mechanism(s) of local anesthetic action in epidural anesthesia:
 A) direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura 
B) diffusion of local anesthetic into paravertebral regions through the intervertebral foramina 
C) both 
D) neither

C. both

2

what are the absolute indications for spinals or epidurals?

none

3

what is the purpose of spinals and epidurals?

Blunt the “stress response” to surgery
Decreases intraoperative blood loss
Lower incidence of postoperative thromboembolic events
Decreased morbidity and mortality in high-risk surgical patients

4

which patient type has instability at the C1 level?

Down's syndrome

5

what is the first prominent spinous process?

C7

6

At what level does the Illiac Crest cross?

L5

7

what level is the bottom of the scapulae?

T 6-8

8

list the 5 ligaments that support the spine

Supraspinous
Ligamentum Nuchae
Interspinous ligament
Ligamentum Flavum
Longitudinal ligaments

9

Into what space is a spinal inserted?

Subarachnoid

10

The epidural space is superficial or deep to the spinal?

Superficial

11

What are the three layers of protective meninges?

Dura mater
arachnoid mater
Pia mater

12

What effect does the epidural fat have on opioids and lipid soluble local anesthetics?

Reduces the bioavailability

13

At what level does the dura mater terminate?

S2 at Filum terminale

14

What is the purpose of the dentate ligaments?

Anchor the cord in the meninges

15

At what level does the spinal cord terminate in adults? At birth?

L1 in adults
L3 at birth

16

What are the two approaches to spinal anesthesia?

Midline and paramedian

17

What does the paramedian approach bypass?

Supraspinous ligament

18

What can happen if you inject drugs into an epidural too fast?

It may go too high causing respiratory depression and blunting the cardiac accelerator fibers

19

What is the technical term for aspiration before injection into an epidural?

Barbitage

20

What is the treatment for a high spinal?

Supportive and give Epinepherine

21

Why is there a longer sensory than motor block?

Fiber diameter
motor fibers are thicker and have a longer onset and faster offset

22

Why do we check coags before performing a spinal?

Because of the risk of a spinal hematoma

23

Adding epinephrine to a local anesthetic for a spinal would prolong or shorten the duration of action?

Prolong

24

True or false half of you probably will not look at all of these cards

True