Free LESI Indications Questions and Answers — Questions and Answers

Question 1: You are performing an epidural on a with a large abdominal tumor, would you expect this to change your dose of anesthetic used?

Nope, amount of anesthetic to reach used will stay the same.
You will require more anesthetic to reach the desired effect.
This is a contradiction to epidural anesthesia, I would not do the block.
I would expect us to use less anesthetic (Correct answer)

Correct answer: I would expect us to use less anesthetic

In this scenario, the presence of a large abdominal tumor can affect the spread and distribution of the anesthetic. The tumor may compress the nerves in the epidural space, resulting in a decreased volume of the space available for the anesthetic to spread. As a result, a smaller amount of anesthetic may be required to achieve the desired effect. Therefore, the correct answer is "I would expect to use less anesthetic".

Question 2: Central ray enters 2" medial to the elevated ASIS and 1and a half inches above the iliac crest for the ____________ Projection

AP
AP Oblique (Correct answer)
Lateral
L5-S1

Correct answer: AP Oblique

The given correct answer is AP Oblique. In this projection, the central ray enters 2" medial to the elevated ASIS and 1 and a half inches above the iliac crest. This positioning allows for visualization of the lumbar spine and sacrum in an oblique angle, which helps in evaluating specific structures and detecting any abnormalities.

Question 3: The patients body is rotated at ___________ degrees for the AP Oblique Projections

25
35
45 (Correct answer)
40

Correct answer: 45

The patient's body is rotated at 45 degrees for the AP Oblique Projections. This specific angle allows for a better visualization of certain anatomical structures or organs that may be obscured in other projections. By rotating the body at 45 degrees, it provides a different perspective and helps to highlight specific areas of interest for diagnostic purposes.

Question 4: How many pairs of spinal nerves do we have?

24
29
30
31 (Correct answer)

Correct answer: 31

We have 31 pairs of spinal nerves. The spinal nerves are part of the peripheral nervous system and are formed by the combination of dorsal and ventral roots. There are 31 pairs of spinal nerves in total, with each pair connected to a specific segment of the spinal cord. These nerves are responsible for transmitting sensory information from the body to the brain and carrying motor commands from the brain to the muscles and organs.

Question 5: Where do preganglionic fibers of the parasympathetic nervous system end?

Sympathetic chain
In the organ they innervate (Correct answer)
Intermediolateral gray matter
Sacral nerves

Correct answer: In the organ they innervate

Preganglionic fibers of the parasympathetic nervous system end in the organ they innervate. Unlike the sympathetic nervous system, which has a chain of ganglia outside the target organs, the parasympathetic fibers have shorter preganglionic fibers organs, that directly synapse with postganglionic neurons in the target organ. This allows for more specific and localized control of the parasympathetic response within the organ itself.

Question 6: What is the primary neurotransmitter of the parasympathetic nervous system?

Norepinephrine
Glutamate
Dopamine
Acetylcholine (Correct answer)

Correct answer: Acetylcholine

Acetylcholine is the primary neurotransmitter of the parasympathetic nervous system. It is responsible for transmitting signals between nerve cells and plays a crucial role in regulating various bodily functions, such as digestion, heart rate, and relaxation. Acetylcholine acts as a chemical messenger, binding to receptors on target cells and initiating a response. It is released by parasympathetic neurons and helps in promoting rest and digestion, as opposed to the fight-or-flight response mediated by norepinephrine.

Question 7: When CSF if heavier then the LA injected, causing the LA to float up. The local anesthetic solution is said to be?

Isobaric
Semibaric
Hyperbaric
Hypobaric (Correct answer)

Correct answer: Hypobaric

When the CSF is heavier than the LA injected, it injected, it causes the LA to float up. This means that the local anesthetic solution is less dense than the cerebrospinal fluid, resulting in it being distributed in a higher position within the spinal canal. This phenomenon is known as hypobaric.

Question 8: After administering a hyperbaric solution of Local anesthetic for spinal anesthesia, what position would you place the pt into order to achieve a level of T6-7 blockade?

Supine with head slightly up
Supine with head slightly down
Supine level (Correct answer)
Lateral decubitus position

Correct answer: Supine level

Placing the patient in a supine level position after administering a hyperbaric solution of local anesthetic for spinal anesthesia would help achieve a level of T6-7 blocked. This position ensures that the anesthetic solution spreads evenly in the cerebrospinal fluid, allowing it to reach the desired level of T6-7. Placing the head slightly up or down may cause uneven distribution of the anesthetic, leading to an inadequate blockade. The lateral decubitus position is not preferred in this case as it may also result in uneven distribution of the anesthetic.

Question 9: How would you expect ascites to effect your level of blockade when giving spinal anesthesia?

The level of your blockade will be lower due to increased intrabdominal pressure
Level of blockade will not be affected
Spinal anesthesia is contraindicated for this patient
The level of blockade will be higher due to increased intrabdominal pressure (Correct answer)

Correct answer: The level of blockade will be higher due to increased intrabdominal pressure

Ascites refers to the accumulation of fluids to in the abdominal cavity. When there is increased intrabdominal pressure due to ascites, it can cause compression of the spinal nerves and result in a higher level of blockade during spinal anesthesia. This is because the increased pressure can cause the local anesthetic to spread higher in the spinal canal, leading to a higher level of numbness or paralysis.

Question 10: Local anesthetics produce conduction blockade of neural impulses by preventing passage of chloride ions through selective ion chloride channels in nerve membranes.

True
False (Correct answer)

Correct answer: False

Local anesthetics produce conduction blockade of neural impulses by preventing passage of sodium ions through selective chloride channels. Therefore, the statement is false.

Question 11: Which of the following properly describes the Taylor approach?

Identify Tuffiers line and insert needle in center of back at 50-60 degree angle
Make a skin wheal with lidocaine 1-2 cm lateral to chosen interspace, then direct needle medical and cephalad at 15-20 degrees pointing toward midline
Use a lateral approach to use the largest interspace L5-S1 (Correct answer)
None of the above

Correct answer: Use a lateral approach to use the largest interspace L5-S1

The Taylor approach is a paramedian (lateral) spinal technique that specifically targets the L5-S1 interspace, which is the largest lumbar interspace, making it easier to access even when other interspaces are difficult due to calcification or anatomy. The other options describe either a midline approach with Tuffier's line, a standard paramedian technique at other interspaces, or are simply incorrect — none of them define the Taylor approach's key feature of using a lateral entry to exploit the L5-S1 interspace.

Free LESI Indications Questions and Answers

You are performing an epidural on a with a large abdominal tumor, would you expect this to change your dose of anesthetic used?