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68 Cards in this Set

  • Front
  • Back
What types of blocks are known as neuroaxial anesthesia?
Spinal, Epidural, and Caudal
What location for an LP usually avoids potential needle trauma to the cord?
L1-L2 interspace in adults, L2-L3 interspace in peds, L4-L5 interspace in infants
What is the principle site of action for neuraxial blockade?
The nerve root.
How is sympathetic blockade assessed?
Temp. sensitivity.
How is sensory blockade assessed?
Pain, Pressure, light touch
What CV manifestations indicate a sympathectomy?
Decreased HR & possible decreased contractility, Decrease BP
What preoperative intervention can minimize the effect of venous pooling?
Fluid loading of 10-20 ml/kg in the healthy patient
How shoud symptomatic or excessive bradycardia be treated?
How shoud hypotension be treated?
What are the major contraindications to neuraxial anesthesia?
Pt. refusal
Severe hypovolemia
Elevated ICP
Infection @ injection site
Severe stenotic valvular heart disease or ventricular outflow obstruction
Order of tissue penetration for midline approach?
Epidural Space-Epidurals here
Arachnoid space-Spinals here
Signal that you are in the Arachnoid space?
Free flowing CSF
What is differential blockade?
Sympathetic blockade 2 segments higher than sensory block, and motor block 2 segments lower than sensory block
How do spinals and epidurals differ in application?
Epidurals can be performed at any level, and offer incremental dosing.
Spinals are typically all-or-nothing
What are the safeguards against toxicity with epidural blocks?
Test dose to prevent intravascular injection and incremental dosing
How does the volume and concentration of anesthetic differ between spinal and epidural anesthesia?
Spinal anesthetics are more concentrated and of lower volume. The concentration is the key.
Epidural anesthetics are volume based and have greater volumes although the block may be less dense as compared with spinal anesthesia
What approach is most common in pediatric patients?
Caudal epidural anesthesia is one of the most common techniques in pediatric patients
What space does a midline aproach pass through?
Oval space between the bony lamina and the spinous process of the adjacent vertebra
Where do the dural sac, epidural and subarachnoid spaces end?
S2 in adults and S3 in children
Where are the curves located?

High points?

Low Points?
C5, T5, L4, S4

C5, L4

T5, S4
C7 landmark
Most prominent spinal process
T7 landmark
Inferior tip of scapula
Tuffier's line
S2 Landmark
Posterior Superior Iliac Spine
End of cord in adult
What nerves compose the Lateral cord?
What nerves compose the Posterior Cord?
C5-8 & T1
What nerves compose the Medial Cord?
C7 & T1
What nerves compose the musculocutaneous nerve?
What nerves compose the axillary nerve?
What nerves compose the radial nerve?
C5-8 & T1
What nerves compose the medial nerve?
C6-8 & T1
What nerves compose the ulnar nerve?
C8 & T1
What nerves compose the Superior trunk?
What nerves compose the Medial trunk?
What nerves compose the inferior trunk?
C8 & T1
What is the motor innervation of the musculocutaneous nerve?

Biceps flex

Lat. forearm
What is the motor innervation of the axillary nerve?


Lat. upper arm
What is the motor innervation of the radial nerve?

Triceps extension, supinator/extensor of forearm

Post. arm & forearm, thumb/dorsal hand
What is the motor innervation of the medial nerve?

Flexor/pronator muscles of forearm

Palmar surface of hand, index & middle fingers
What is the motor innervation of the ulnar nerve?

Flexor carpi ulnaris (abduct fingers)

Little finger & medial ring finger
What nerves contribute to Lat. Femoral Cutaneous nerve?
What nerves contribute to Femoral nerve?
What nerves contribute to Obturator nerve?
What nerves contribute to Sciatic nerve?
L4,5 S1,2,3
Motor Innervation of Lat. Femoral Cutaneous nerve?

None. Sensory only on leteral thigh
Motor Innervation of Femoral nerve?

Quadriceps femoris

Ant. thigh and knee
Motor Innervation of obturator nerve?

Adduction of leg

Post. medial thigh
Motor Innervation of sciatic nerve?

Splits into peroneal and tibial nerves

Sensory is the posterior leg & foot
Motor Innervation of common peroneal nerve?

Dorsiflex foot

Lateral calf
Motor Innervation of Tibial nerve?

Plantar flex foot

Sensory innervation of superficial and deep peroneal nerves?
Superficial: front of lower leg

Deep: Between great and 2nd toe
What wavelength of light does oxyhemoglobin absorb?
What wavelength of light does deoxyhemoglobin absorb?
What causes pulse ox to stay at 85% despite change in FiO2?
Tx for methemoglobinemia?
Methylene blue
Cause of methhemoglobinemia?
What causes false high sat?

CO poisoning
What is the termination of the femoral nerve?
Saphenous nerve
What is the termination of the sciatic nerve?
The superficial and deep peroneal nerves and the sural nerve
At the post. politeal fossa, the sciatic nerve splits into what nerves?
The peroneal and tibial nerves
Which fibers carry pain impulses?
A gamma and C dorsal root fibers
Which fibers carry postganglionic sympathetic fibers?
C sympathetic fibers
Which fibers carry non-noxious stimul?
A alpha, A beta
Which fibers carry preganglionic autonomic fibers?
B fibers
Which fibers have the fastest conduction velocities?
A fibers, then B, then C
Which fibers are the largest?
A alpha (motor) fibers

Largest take longest to block
Which fibers are the 1st to be blocked?
C sympathetic fibers