Term
| % of ulnar nerve injuries associated with general anesthesia |
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Definition
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Term
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Definition
good surgeon exposure
good anesthesia access to pt
support pt safety |
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Term
| the underlying cause of all tissue damage (muscle, nerves, organs) |
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Definition
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Term
| surgical related causes of compartment syndrome |
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Definition
tight wound closures
expanding hematoma
external pressure by a positioning device or leaning surg team member
compression stockings
body weight |
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Term
| positions that result in higher incidence of compartment syndrome |
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Definition
| lithotomy and lateral decubitus positions |
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Term
| 3 most commonly damaged nerves |
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Definition
ulnar
brachial plexus (in the upper extremities)
common peroneal (lower extrem) |
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Term
| 4 symptoms resulting from ulnar nerve damage |
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Definition
progressive weakness
pain
can't open doors or jars
claw hand |
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Term
| where does the brachial plexus arise from? |
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Definition
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Term
| ways to injure the brachial plexus |
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Definition
shoulder depressed
head turned away
arms aBducted >90 degrees
inadequate support of shoulders in prone position
arms above head (Superman Nettle position)
injury occurs most frequently in lateral position |
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Term
| nerve responsible for post operative vision loss (POVL) |
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Definition
| optic nerve (extremely susceptible to hypoperfusion) |
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Term
| surgery related factors contributing to POVL |
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Definition
prone position
prolonged procedure time
large blood loss
low Hct
SBP <100mmHg
emboli
glycine toxicity (often assoc with TURP)
sickle cell |
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Term
| formula for optic perfusion pressure |
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Definition
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Term
| 4 factors reducing outflow that cause POVL |
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Definition
head down position
abdominal pressure increases (prone)
RAP increases
obstruction of jugular veins (extreme neck torquing, tight ETT ties) |
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Term
| synonym for supine position |
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Definition
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Term
| surgical position in which diaphragm is shifted upward, resulting in a decrease in FRC of 800mL in an avg adult male (compared to standing position) |
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Definition
| supine or dorsal decubitus |
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Term
| head should always be placed in what position? |
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Definition
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Term
| why should head not be turned laterally when the arms are aBducted? |
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Definition
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Term
| 2 Nerves that can be damaged if legs remain crossed during surgery (different nerve in each leg) |
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Definition
dependent leg: superficial peroneal nerve
superior leg: sural nerve |
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Term
| arm position to reduce pressure from supporting arm structures (arm board and pad) on the cubital tunnel, reducing ulnar nerve damage |
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Definition
| upper arm should be aBducted <90 degrees with the arm supinated or kept neutral |
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Term
| position that reduces pressure in lower back and helps prevent sciatic nerve injury |
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Definition
| Sitting position (lounging, lawn chair, or beach chair position) |
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Term
| position that decreases FRC and decreases lung compliance more than any other position |
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Definition
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Term
| hair loss due to prolonged pressure on scalp resulting in hair follicle ischemia. (Bonus: what can further complicate this condition?) |
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Definition
| pressure alopecia (further complicated by hypothermia and hypotension) |
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Term
| position that provides optimal exposure for spinal procedures and posterior fossa procedures (neurosurg) |
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Definition
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Term
| is cardiac output increased or decreased in prone position? |
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Definition
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Term
| most common complication of prone position |
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Definition
| eye injuries (most common: corneal abrasions, most dangerous: blindness) |
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Term
| syndrome resulting in paresthesia in arms caused by compression of brachial plexus and subclavian vessels near the first rib |
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Definition
| thoracic outlet syndrome (preop pt's already c/o this should not be placed prone with arms above head) |
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Term
| position that provides access to perineal area. legs are placed in a flexed, aBducted position. |
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Definition
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Term
| amount of blood reintroduced into systemic circulation PER LEG when the legs are raised |
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Definition
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Term
| 2 pts that tolerate lithotomy position the least |
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Definition
| CHF & pts with lung diseases that reduce vital capacity (restrictive diseases) |
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Term
| complications of lithotomy position (and nerve most often injured) |
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Definition
peroneal nerve injury
hip dislocation (both legs should be raised/lowered simultaneously and in same way)
neurovascular injury at hip and knee
compartment syndrome
low back pain
hypotension with lowering of legs |
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Term
| foot drop results from damage to what nerve |
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Definition
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Term
| position often used for thoracic or kidney surgery when supine position does not provide sufficient lateral or posterior lateral exposure |
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Definition
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Term
| most important anatomical part to secure in any surgical position |
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Definition
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Term
| if pt is spontaneously breathing in lateral position, which lung has best ventilation and perfusion? |
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Definition
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Term
| in anesthetized pt in lateral position, indicate which lung is better ventilated, and which lung is better perfused |
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Definition
| ventilation better in nondependent lung; perfusion better in dependent lung |
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Term
1: most common adverse effect of sitting position
2: most dangerous complication of sitting position |
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Definition
1: hypotension
2: venous air embolism |
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Term
| how much does MAP decrease with HOB elevation in sitting position |
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Definition
| MAP decreases 0.75mmHg per cm of elevation |
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Term
| air in cranium at time of closure |
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Definition
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Term
| damage to this nerve results in wrist drop (saturday night palsy) |
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Definition
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Term
| damage to this nerve results in "ape hand" |
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Definition
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Term
| damage to this nerve results from pressure to the medial aspect of the knee and leads to loss of sensation of medial thigh and leg |
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Definition
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Term
| pressure on lateral aspect of knee causes damage to this nerve and results in foot drop and loss of sensation over the dorsum of foot |
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Definition
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Term
| 5 branches of facial nerve from superior to inferior |
|
Definition
Temporal
Zygomatic
Buccal
Mandibular
Cervical
(two zebras bit my cookies) |
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