Regional - Quiz 2
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 are the primary neurotransmitters of the sympathetic nervous system? (two answers)
- A.
Norepinephrine
- B.
Acetylcholine
- C.
Serotonin
- D.
Dopamine
- 15.What is the primary neurotransmitter of the parasympathetic nervous system?
- A.
Norepinephrine
- B.
Glutamate
- C.
Dopamine
- D.
Acetylcholine
- 16.Upon injection of local anesthetic for spinal anesthesia, which fibers are blocked first?
- A.
C fibers of sympathetic system
- B.
Alpha delta fibers of sympathetic system
- C.
B fibers of sympathetic system
- D.
Alpha delta fibers of parasympathetic system
- 17.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
- 18.Which of the following will not effect the level of spinal anesthesia?
- A.
Contour of Spinal Cord
- B.
Dosage of LA used
- C.
Cardiac status of pt
- D.
Intrabdominal pressure
- 19.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
- 20.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
- 21.How would you make an isobaric 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
- 22.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
- 23.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
- 24.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
- 25.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
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