Flashcards in Spinal Anesthesia Quiz Deck (63)
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1
What are two other names for Spinal Anesthesia?
1. Subarachnoid Block
2. Intrathecal
2
How many vertebrae in the spinal anatomy?
33
3
List the vertebral regions and their associated #s.
-7 Cervical
-12 Thoracic
-5 Lumbar
-5 Sacral
-4 Coccygeal
4
What is the High point on the vertebral column while laying supine?
L3-L4
5
What is the low point on the vertebral column while laying supine?
T4
6
How many pairs of spinal nerves are there?
31
7
The VERTEBRAL COLUMN extends from the?
base of the skull and the foramen of Magnum to the tip of the coccyx
8
The SPINAL CORD extends from the?
foramen magnum to the L1 in the adult and L3 in the newborn
9
During spinal anesthesia, what 9 structures does the needle pass through?
1. skin
2. subcutaneous
3. tissue
4. supraspinous ligament
5. interspinous ligament
6. ligamentum flavum
7. epidural space
8. dura mater
9. arachnoid mater
10
When utilizing the lateral approach to spinal anesthesia, what two structures do you not pass through?
1. Supraspinous Ligament
2. Interspinous Ligament
11
The spinal cord is enlarged in what two regions?
1. Cervical Enlargement(C5-T1)-The ventral rami(branches) within this segment form the Brachial Plexus
2. Lumbosacral Enlargement(L2-S3)-contributed corresponding nerves to create the Lumbosacral Plexus
12
What are the meninges?
non nervous system support tissue that provides a protective covering for the cord and nerve roots from the foramen magnum to the base of the caudal equine.
13
What are the linings of the meninges and what is their order?
Dura mater(farthermost from the Brain)
Arachnoid mater
Pia mater(closest to the Brain)
14
What are 3 characteristics of the Subarachnoid space?
-filled with CSF
-contained between Pia and Arachnoid maters
-mater and fluid protect the cord from shock and are the medium for the interaction with LA and opioids
15
Where does the blood supply to the spinal cord and the nerve roots come from(2)?
1. anterior spinal artery
2. paired posterior spinal arteries
16
Where is the principal site of action for neuaxial blockade?
Nerve Root
17
What are 3 abnormal curvatures of the spine?
1. scoliosis
2. kyphosis
3. lordosis
18
What is Scoliosis?
the most common abnormal curvature and is a lateral curve
19
What is kyphosis?
excessive posterior curvature or "hump" usually seen in the thoracic region
20
What is Lordosis?
hollowing of the back, may occur as a result of obesity as the body attempts to restore center of gravity. A temporary Lordosis may occur during pregnancy.
21
What anatomical level is T4?
Level of the nipples
22
What anatomical level is T10?
Level of the umbilicus
23
What anatomical level is T12?
Inguinal or groin region
24
What is the result of blocking the B-fibers?
venodilation with hypotension; lose preload; 1st nerve blocked bc it is most DISTAL
25
What is the result of blocking the C and A delta fibers?
loss of pain and temperature; 2nd nerve to be blocked
26
What is the result of blocking the A-gamma fibers?
loss of muscle tone; 3rd nerve to be blocked
27
What is the result of blocking the A-beta fibers?
loss of touch and pressure sensation; 4th nerve to be blocked
28
What is the result of blocking the A-alpha fibers?
loss of MOST motor function and proprioception; larger and more central; 5th nerve to be blocked
*****last and farthest away*****
29
What is a Differential Block?
Its when a LA interrupts nerve transmission of autonomic nerves but not sensory or motor nerves(because of variation of susceptibility)
30
