Regional - Quiz 2
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A review of material for test 3. Contains spinal, epidural and combined technique. Not a whole lot from the last week's ppt as Vince really didn't cover it.
- 1.Where would you expect the spinal canal to end on an adult patient?
- A.
L1- L2
- B.
L3
- C.
L5
- D.
Sacral Hiatus
- 2.Where you expect the Spinal Cord to end on an adult patient?
- A.
L1-L2
- B.
L3
- C.
L5
- D.
Sacral Hiatus
- 3.You have just performed spinal anesthesia and found you have a sympathetic blockade at the level of T6. Is this safe for your patient?
- A.
No, they are at increases risk for dural puncture headache.
- B.
Yes, this is considered a safe level of sympathetic blockade.
- C.
No, the patient is at risk for profound bradycardia
- D.
No, the level of blockade. is inadequate.
- 4.You have just performed spinal anesthesia and found you have a motor blockade at the level of T6. Is this safe for your patient?
- A.
No, they are at increases risk for dural puncture headache.
- B.
Yes, this is considered a safe level of sympathetic blockade.
- C.
No, the patient is at risk for profound bradycardia.
- D.
No, the level of blockade is inadequate.
- 5.You are performing an epidural on a with a large abdominal tumor, would you expect this to change your dose of anesthetic used?
- A.
Nope, amount of anesthetic used will stay the same.
- B.
You will require more anesthetic to reach the desired effect.
- C.
This is a contraindication to epidural anesthesia, I would not do the block.
- D.
I would expect to use less anesthetic.
- 6.After performing Spinal anesthesia you have a Sensory blockade at the level of T 10. You would expect to see a sympathetic blockade at the level of _____ and a motor blockade at the level of _____.
- A.
T8, T12
- B.
T 6, T8
- C.
T12, L2
- D.
T12, T8
- 7.Which of the following patients is an Absolute contraindication to spinal anesthesia?
- A.
Mrs. A what has severe mitral stenosis.
- B.
Mr. B who has advanced HIV disease.
- C.
Mrs. C who suffers from scoliosis.
- D.
Mr. D who will have a long procedure.
- 8.The angle of the scapula roughly correlates to which vertebrae?
- A.
C7
- B.
T7
- C.
L3
- D.
L1
- 9.Where is CSF produced?
- A.
Ependymal cells of choroid plexus
- B.
Enterochromatic cells in ventricular system
- C.
In the aquaduct of Sylvius in the 4th ventricle
- D.
In the lymphatic system
- 10.Which area of the brain is responsible for motor function and movement away from painful stimuli?
- A.
Post Central Gyrus
- B.
White matter of spinal cord
- C.
Precentral Gyrus
- D.
Dorsal Root
- 11.How many pairs of spinal nerves do we have?
- A.
24
- B.
29
- C.
30
- D.
31
- 12.Which of the following carries all efferent signals heading out to the periphery?
- A.
Ventral Root
- B.
Dorsal Root
- C.
Unmyelinated fibers of White Matter
- D.
Epineurium
- 13.Where do preganglionic fibers of the parasympathetic nervous system end?
- A.
Sympathetic chain
- B.
In the organ they innervate
- C.
Intermediolateral gray matter
- D.
Sacral nerves
- 14.What is the primary neurotransmitter of the parasympathetic nervous system?
- A.
Norepinephrine
- B.
Glutamate
- C.
Dopamine
- D.
Acetylcholine
- 15.You are the SRNA for a patient who has just been given Spinal anesthesia. The spinal goes higher than expected and the patient becomes profoundly bradycardic. What should you do first?
- A.
Administer 100% O2
- B.
Administer Atropine
- C.
Administer Glycopyrolate
- D.
Administer Epinephrine
- 16.When the CSF if heavier then the LA injected, causing the LA to float up. The local anesthetic solution is said to be…
- A.
Isobaric
- B.
Semibaric
- C.
Hyperbaric
- D.
Hypobaric
- 17.How would you mix a hyperbaric solution of bupivicaine?
- A.
By adding glucose to increase the density
- B.
By mixing equal parts LA and CSF
- C.
By adding 6-8ml of sterile water
- D.
None of above
- 18.After administering a hyperbaric solution of Local anesthetic for spinal anesthesia, what position would you place the pt into in order to achieve a level of T6-7 blockade?
- A.
Supine with head slightly up
- B.
Supine with head slightly down
- C.
Supine level
- D.
Lateral decubitus position
- 19.How would you expect ascites to effect your level of blockade when giving spinal anesthesia?
- A.
The level of your blockade will be lower due to increased intrabdominal pressure
- B.
Level of blockade will not be effected
- C.
Spinal anesthesia is contraindicated for this patient
- D.
The level of blockade will be higher due to increased intrabdominal pressure
- 20.How would you prepare your OR for a patient undergoing spinal anesthesia?
- A.
Prepare your standard monitors, but you do not need your GA drugs drawn up
- B.
Draw up only the medications necessary for a MAC case
- C.
Prepare your room exactly as you would for a GA case
- 21.Which of the following is most frequently added to local anesthetic in order to prolong their duration of action?
- A.
Epinephrine 0.1-0.2 mg
- B.
Phenylephrine 2-5mg
- C.
Ephedrine 5mg
- D.
Atropine .3-.5 mg
- 22.Local anesthetics produce conduction blockade of neural impulses by preventing passage of chloride ions through selective ion chloride channels in nerve membranes.
- A.
True
- B.
False
- 23.Which of the following properly describes the midline approach to spinal anesthesia?
- A.
Identify Tuffiers line and insert needle in center of back at 50-60 degree angle
- B.
Make a skin wheal with lidocaine 1-2 cm lateral to chosen interspace, then direct needle medial and cephalad at 15-20 degrees pointing toward midline
- C.
Use a lateral approach to use the largest interspace L5-S1
- D.
None of above
- 24.Which of the following properly describes the Taylor approach?
- A.
Identify Tuffiers line and insert needle in center of back at 50-60 degree angle
- B.
Make a skin wheal with lidocaine 1-2 cm lateral to chosen interspace, then direct needle medial and cephalad at 15-20 degrees pointing toward midline
- C.
Use a lateral approach to use the largest interspace L5-S1
- D.
None of above
- 25.You are the SRNA for Mr. Goldman who is coming in for emergent repair of a dissecting aortic aneurysm. After the surgery is over he complains of weakness in his legs and urinary incontinence. What artery branches off the aorta and may have been damaged during the procedure to cause Mr. Goldman’s symptoms?
- A.
Artery of Adamkiewicz
- B.
Anterior Spinal Artery
- C.
Posterior Spinal Arteries
- D.
Posterolateral spinal vein
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