Notes in 27 Neuraxial

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Published	12/13/2023	When opioids are used in the OB setting, they can cross the placenta and produce {{c1::respiratory depression}} and {{c2::decreased fetal heart rate v…
Published	12/13/2023	In neonates, the dural sac ends at the level of {{c1::S3}}.
Published	12/13/2023	What structures form the anterior border of the intervertebral foramina (2)?{{c1::Vertebral body and intervertebral disc}}
Published	12/13/2023	What structures form the posterior border of the intervertebral foramina?{{c1::Facet joints}}
Published	12/13/2023	The {{c1::facet}} joint is formed by the {{c2::superior articular process}} of the inferior vertebra and the {{c3::inferior articular process}} of the…
Published	12/13/2023	The vertebra are separated by {{c1::intervertebral discs}} that act like shock absorbers.
Published	12/13/2023	{{c1::Degeneration}} of intervertebral discs can cause nerve compression due to decreased size of the {{c2::intervertebral foramina}}.
Published	12/13/2023	The ligamentum flavum is thickest in the {{c1::lumbar}} region.
Published	12/13/2023	The {{c1::posterior longitudinal}} ligament travels along the posterior surface of the vertebral bodies.
Published	12/13/2023	The {{c1::anterior longitudinal}} ligament travels along the anterior surface of the vertebral bodies.
Published	12/13/2023	The {{c1::anterior longitudinal}} ligament attaches to the {{c2::annulus fibrosus}} of the intervertebral discs.
Published	12/13/2023	What ligament is pierced in a paramedian approach to neuraxial anesthesia?{{c1::Ligamentum flavum}}
Published	12/13/2023	What is the anterior border of the epidural space?{{c1::Posterior longitudinal ligament}}
Published	12/13/2023	The epidural space communicates with the {{c1::paravertebral}} space via the {{c2::intervertebral foramina}}.
Published	12/13/2023	The {{c1::plica mediana dorsalis}} is a band of connective tissue between the ligamentum flavum and dura mater that is blamed for difficult epidu…
Published	12/13/2023	The dura mater begins at the {{c1::foramen magnum}} and ends at the {{c2::dural sac}}.
Published	12/13/2023	The sacral hiatus is covered by the {{c1::sacrococcygeal ligament}}.
Published	12/13/2023	The {{c1::sacral cornua}} are boney nodules flanking the sacral hiatus.
Published	12/13/2023	Sensory input to the face is conducted by the {{c1::trigeminal}} nerve.
Published	12/13/2023	Local anesthetics injected into the epidural space can leak through the {{c1::intervertebral foramen}} and cause {{c2::paravertebral}} blocks.
Published	12/13/2023	In epidural anesthesia, there is no {{c1::autonomic}} differential blockade.
Published	12/13/2023	Neuraxial anesthesia affects the respiratory system via impairment of {{c1::inspiration and expiration::inspiration/expiration}}
Published	12/13/2023	Spinal anesthesia can reduce sensory input to the {{c1::reticular activating system}}, causing drowsiness.
Published	12/13/2023	Parasympathetic innervation of the gastrointestinal tract comes from the {{c1::vagus nerve}}.
Published	12/13/2023	How does neuraxial anesthesia affect hepatic and renal blood flow?{{c1::No change (unless hypotension occurs)}}
Published	12/13/2023	Is neuraxial anesthesia contraindicated in patients with peripheral neuropathy?{{c1::Yes}}
Published	12/13/2023	How does hyperglycemia affect specific gravity (CSF)?{{c1::Increases}}
Published	12/13/2023	How does uremia affect specific gravity (CSF)?{{c1::Increases}}
Published	12/13/2023	How does high protein content affect specific gravity (CSF)?{{c1::Increases}}
Published	12/13/2023	How does aging affect specific gravity (CSF)?{{c1::Increases}}
Published	12/13/2023	How does cold temperature affect specific gravity (CSF)?{{c1::Increases}}
Published	12/13/2023	How does warm temperature affect specific gravity (CSF)?{{c1::Decreases}}
Published	12/13/2023	How does liver disease/jaundice affect specific gravity (CSF)?{{c1::Decreases}}
Published	12/13/2023	The {{c1::Greene}} needle is a non-cutting needle with a {{c2::rounded bevel}} tip.
Published	12/13/2023	{{c1::Cutting}}-tip needles are more likely to be deflected.
Published	12/13/2023	During neuraxial anesthesia, the risk of needle deflection is minimized by placing an {{c1::introducer}} needle in the {{c2::interspinous}} ligament.&…
Published	12/13/2023	The Crawford epidural needle has a {{c1::0}}° curved tip.
Published	12/13/2023	The Hustead epidural needle has a {{c1::15}}° curved tip.
Published	12/13/2023	Withdrawal of an epidural catheter through the needle can cause {{c1::catheter shearing.}}
Published	12/13/2023	What type of spinal needle is this?{{c1::Greene}}
Published	12/13/2023	What type of spinal needle is this?{{c1::Sprotte}}
Published	12/13/2023	What type of spinal needle is this?{{c1::Whitacre}}
Published	12/13/2023	What type of spinal needle is this?{{c1::Quincke}}
Published	12/13/2023	What type of epidural needle is this?{{c1::Tuohy}}
Published	12/13/2023	What type of epidural needle is this?{{c1::Hustead}}
Published	12/13/2023	What type of epidural needle is this?{{c1::Crawford}}
Published	12/13/2023	Caudal anesthesia can provide up to a {{c1::T10}} level sensory block.
Published	12/13/2023	Conditions that increase the ICP are {{c1::relative}} contraindications to caudal anesthesia.
Published	12/13/2023	Caudal anesthesia should be avoided in patients with {{c1::pilonidal cysts}} because the needle may pass through the cyst tract and int…
Published	12/13/2023	Caudal anesthesia is performed in the {{c1::Simm's::lateral}} position or the prone position (with legs in {{c2::frog}} position).
Published	12/13/2023	When performing caudal anesthesia, resistance to injection suggests that the needle tip is in the {{c1::subperiosteal}} area.
Published	12/13/2023	Patients may experience a normal feeling of {{c1::fullness}} in the sacrum during caudal anesthesia.
Published	12/13/2023	In caudal anesthesia, the primary determinant of spread is {{c1::volume of injectate}}.
Published	12/13/2023	In pediatrics, the volume of injectate for caudal anesthesia to block the sacrum is {{c1::0.5}} mL/kg.
Published	12/13/2023	In pediatrics, the volume of injectate for caudal anesthesia to block the sacrum to T10 is {{c1::1}} mL/kg.
Published	12/13/2023	In pediatrics, the volume of injectate for caudal anesthesia to block the sacrum to mid-thoracic is {{c1::1.25}} mL/kg.
Published	12/13/2023	In adults, the volume of injectate for caudal anesthesia to block the sacrum to T10 is {{c1::20}}-{{c1::30}} mL.
Published	12/13/2023	In adults, the volume of injectate for caudal anesthesia to block the sacrum is {{c1::12}}-{{c1::15}} mL.
Published	12/13/2023	{{c1::Decreased}} levels of cAMP will inhibit neurotransmission
Published	12/13/2023	{{c1::Decreased}} Ca2+ conductance will inhibit neurotransmission
Published	12/13/2023	{{c1::Increased}} K+ conductance will inhibit neurotransmission
Published	12/13/2023	Neuraxial opioid-induced pruritis is most common in {{c1::obstetric}} patients.
Published	12/13/2023	Hydrophilic opioids produce a {{c1::biphasic}} respiratory depression.
Published	12/13/2023	Early-phase respiratory depression from hydrophilic opioids is due to {{c1::systemic absorption}}.
Published	12/13/2023	Late-phase respiratory depression from hydrophilic opioids is due to {{c1::ascension toward the brain}}.
Published	12/13/2023	The addition of {{c1::10 mL NaCl}} to {{c2::lipophilic}} opioids will enhance spread in the epidural space.
Published	12/13/2023	Intrathecal opioids may cause urinary retention, which is reversed with {{c1::naloxone}}.
Published	12/13/2023	Intrathecal opioids cause urinary retention most commonly in {{c1::young males}}.
Published	12/13/2023	Administration of epidural {{c2::morphine}} may spread to the {{c1::trigeminal}} nerve and reactivate {{c3::herpes simplex labialis}}.
Published	12/13/2023	Reactivation of herpes simplex labialis after neuraxial anesthesia occurs a few days after {{c1::epidural morphine}} administration.
Published	12/13/2023	What neuraxial opioid is associated with the highest risk of sedation?{{c1::Sufentanil}}
Published	12/13/2023	Most opioids {{c1::do not cross::cross/do not cross}} into breast milk.
Published	12/13/2023	The use of {{c1::air}} for {{c2::loss-of-resistance}} techniques for epidurals is associated with a higher risk of postdural puncture headaches.
Published	12/13/2023	What are the side effects of an epidural blood patch?{{c1::Backache}} and {{c1::radicular}} pain
Published	12/13/2023	{{c1::Chlorhexidine}} skin prep can cause neurotoxicity if not allowed to dry before performing a neuraxial block.
Published	12/13/2023	Warfarin should be held for {{c1::5}} days before neuraxial block placememnt.
Published	12/13/2023	The administration of {{c1::thrombolytics (e.g. tPA, streptokinase)}} is an absolute contraindiction to neuraxial anesthesia.
Published	12/13/2023	Early ambulation {{c1::does not increase}} the risk of transient neurologic symptoms.
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Published	12/13/2023	Differential block is more likely to occur with spinal or epidural anesthesia?{{c1::Spinal}}
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