Ap2 Epidural Slide Show Through Slide 23Done

Front 1

Anesthesia component renders pts

Back 1

motionless, still, blocking them motionless for surgery; blocking sensory and motor

Front 2

Analgesia component of epidural

Back 2

preferentially blocking sensory over motor; goal is to preserve motor function.

Front 3

Can epidural be targeted to be anesthesia or analgesia?

Back 3

yes

Front 4

Dermatomes of the head, neck, chest, face is the

Back 4

cervical region

Front 5

arms are divided between

Back 5

thoracic and cervical

Front 6

legs' dermatomes are divided between

Back 6

lumbar and sacrum

Front 7

chest dermatomes are divided between

Back 7

chest and thoracic

Front 8

chest to groin dermatome

Back 8

thoracic

Front 9

which less dense? spinal epidrual?

Back 9

epidural

Front 10

which epidural location usu uses fluro?

Back 10

cervical

Front 11

ligaments you go through to get to epidural space

Back 11

suprapinous ligament,interspinous ligament,ligamentum flavum

Front 12

path of needle for epidural

Back 12

supraspinous ligament to interspinous ligament, ligamentum flavum, to epidural; if go thru dura in csf

Front 13

does epidural go through dura?

Back 13

no spinal does, where csf is

Front 14

what is in the epidural space?

Back 14

air,nerve roots, veins, fat

Front 15

if u go beyond epidural where are u?

Back 15

dura, spinal cord/csf,nerve roots

Front 16

two epidural approaches and which is best for lumbar/thoracic

Back 16

paramedian (thoracic); midline (lumbar)

Front 17

epidural sets btween __min

Back 17

5-30min (slower than spinal)

Front 18

when u go into ligamentum flavum into epidural space need something that gives/ what?

Back 18

air, syringe full of saline

Front 19

after catheter goes in, what is your test dose?

Back 19

not intravascular (epidural veins) and not into dura (csf)

Front 20

bony part of scapula

Back 20

T3

Front 21

inferior part of scapula

Back 21

T7

Front 22

lower rib margin

Back 22

L1

Front 23

superior illiac crest is landmark for

Back 23

L3/4

Front 24

for thoracic epidural, where do you go in with local?

Back 24

find spinal process, then .5 finger breadth off midline

Front 25

first bone you hit when go in thoracic is the

Back 25

lamina (so comes back/redirects)

Front 26

two most common things we put into epidural

Back 26

local and opiods

Front 27

opiods from epidurals work on the_____; locals work on____

Back 27

opiods on spinal cord; nerve roots

Front 28

do ionized or non ionized drugs cross the membrane?

Back 28

nonionized

Front 29

more lipid soluble=

Back 29

more potent

Front 30

more protein bound is shorter or longer duration?

Back 30

longer duration b/c harder to eliminate

Front 31

to min toxicity

Back 31

protein bound, metabolized quickly, epinepherine

Front 32

nerves fire at diff frequ. the more times they fire

Back 32

faster blocking

Front 33

local anesthetics block sypathetic ______

Back 33

preganglionic fibers

Front 34

what causes a drop in MAP, decreased SVP, and vasodilation with epidurals

Back 34

blocking of preganglionic sympathetic fibers

Front 35

which type of nerves are the hardest to block

Back 35

thick, mylenated

Front 36

once nonionized form enters membrane, to act it must be in the ____form

Back 36

ionized