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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

In what situations are Differential Blocks seen?

Seen in the more Rostral spinal segments of an intrathecal anesthetic. As the spinal spreads from the epicenter of injection, the distal reaches of drug distribution are presumably of lesser concentrations