Term
| What two characteristics does the intrathecal spread of a SAB drug depend on? |
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Definition
| The chemical and physical characteristics of the SOLUTION in relation to the chemical and physical characteristics of the CSF |
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Term
| Where is the CSF produced? |
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Definition
| choroid plexus of the cerebral ventricles |
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Term
| About how much CSF is produced daily? |
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Definition
|
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Term
| What is the "normal" CSF pressure range? |
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Definition
|
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Term
| At any given time, how much CSF is circulating? |
|
Definition
| 150mL, only 30-80mL surrounding the spinal chord |
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Term
| Why do we hydrate postdural puncture headache pts? |
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Definition
| to increase the production of CSF (dehydration reduces production) |
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Term
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Definition
|
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Term
| Does CSF spec grav increase or decrease as a pt ages? |
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Definition
|
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Term
| Does a rise in temp increase or decrease spec grav and by how much? |
|
Definition
| decrease by .001 per 1C rise |
|
|
Term
| pH of CSF? Glucose level? |
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Definition
|
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Term
| What are the four most important factors that drive the level of a block? |
|
Definition
| baricity of solution, pt position during and after injection, drug dose, site of injection |
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Term
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Definition
| the resting position of two fluids with different spec gravs mixed in a single container |
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Term
| describe a hyperbaric solution |
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Definition
| spec grav of solution is greater than CSF, sinks |
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|
Term
| describe a hypobaric solution |
|
Definition
| spec grav is less than CSF, rises |
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|
Term
| if i added sterile water to my local for SAB what baricity would i expect? |
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Definition
|
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Term
| if i add dextrose 5-8% to my local, what baricity would I expect? |
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Definition
|
|
Term
| what solution can i mix my local in to create an isobaric solution? |
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Definition
|
|
Term
| how does pt positioning affect the level of the block? |
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Definition
| spinal curvatures, baricity, and pt position can greatly influence level.....give some scenarios |
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Term
| the greater the volume of local injected the .... |
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Definition
|
|
Term
| what type of SAB injection technique involves the pumping action |
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Definition
|
|
Term
| how does CSF volume correlate with your SAB block? |
|
Definition
| inversely, more volume lower block |
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|
Term
| people with higher intraabdominal pressure will have more or less CSF? |
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Definition
|
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Term
| what two ways does pregnancy affect your SAB? |
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Definition
| It increases intra abd pressure (reduces CSF) and it causes epidural vein engorgement which impinges on the dura and spinal canal reducing its size and CSF volume......SAB will tend to go higher |
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Term
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Definition
| the time it takes for the drug concentration to fall below the minimum needed to get a blocking effect (no further blocking can be achieved) depends upon the pharmacokenetics and pharmacodynamics of the drug |
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Term
| In relation to your sensory block level, describe the height of sympathetic and motor blockade |
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Definition
| symp. is 2 dermatomes higher, and motor is two lower |
|
|
Term
| what two ways is a sympathetic block determined? |
|
Definition
| BP drop and cold temp differentiation |
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Term
| What method best tests for sensory blockade? |
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Definition
|
|
Term
| how would you first treat hypotension? |
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Definition
|
|
Term
| tx of hypotension with normo/tachycardia? brady? |
|
Definition
| alphe agonist for tachy and mixed (alpha and beta) with brady |
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|
Term
| Which system is most effected by SABs? |
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Definition
|
|
Term
| where are the cardiac accelerant fibers located at? |
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Definition
|
|
Term
| at which level do pts feel short of breath due to paralyzed intercostals? |
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Definition
|
|
Term
| Name the fingers blocked with C8 block......C7......C6 |
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Definition
| C8 pincky and fourth, C7 middle and index, C6 thumb |
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