Buy Orthopedic Anesthesia Discussion Assignment

Buy Orthopedic Anesthesia Discussion Assignment
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Buy Orthopedic Anesthesia Discussion Assignment
1. A healthy 24-year-old man fell while he was snowboarding and was found to
have a complete rotator cuff tear of his left shoulder. You would like to
perform a peripheral nerve block under ultrasound guidance for intraoperative
and postoperative analgesia. Which of the following is the most common
complication for which you should counsel the patient?
A. Ipsilateral pneumothorax
B. Ipsilateral phrenic nerve paresis
C. Infection at the site of the peripheral block
D. Peripheral nerve block failure
E. Ipsilateral Horner syndrome
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2. A 35-year-old woman was involved in a motor vehicle accident and broke her
right ulna. She reports using heroin daily. You have already performed an
upper-extremity brachial plexus block, but she reports anesthesia in all digits
except her fifth digit. The surgeon asks you to supplement her block. Where
should you inject local anesthesia?
A. Within the coracobrachialis muscle near its point of insertion on the humerus
B. Medial to the brachial artery in the antecubital fossa
C. Between the humeral and ulnar heads of the flexor carpi ulnaris muscle
D. Posterior to the axillary artery in the axilla
3. You are the anesthesiologist for a 19-year-old man who is scheduled to undergo
resection of his proximal tibia Ewing sarcoma. Where should a peripheral nerve
catheter be placed to provide the greatest analgesia?
A. Between the semimembranosus and biceps femoris muscles
B. Between the greater trochanter and the ischial tuberosity
C. Lateral to the femoral artery in the inguinal groove
D. Deep to the sartorius muscle and medial to the vastus medialis muscle
E. Between the adductor longus and adductor brevis muscles
4. 4. A 13-year-old girl fractured her right ankle during her basketball game. You
decide to perform an ultrasound-guided peripheral nerve block as her primary
anesthetic. She continues to deny anesthesia over her medial malleolus. To
provide complete coverage, you must supplement the:
A. Tibial nerve
B. Deep peroneal nerve
C. Saphenous nerve
D. Sural nerve
E. Superficial peroneal nerve
5. A 68-year-old patient is scheduled to undergo a left total knee replacement. He
has a history of hypertension and coronary artery disease and had drug-eluting
stents placed 6 months ago. His daily medications include aspirin 81 mg (last
taken 1 d ago), clopidogrel 75 mg (last taken 3 d ago), metoprolol 100 mg (last
taken 1 d ago), and a multivitamin (last taken 1 d ago). You are counseling him
regarding his anesthetic options. You advise:
A. Neuraxial anesthesia
B. General anesthesia
C. Femoral nerve block
D. Sciatic nerve block
E. Any are appropriate
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6. An 85-year-old patient with mild dementia, hypertension, paroxysmal atrial
fibrillation on Coumadin, and chronic kidney disease fell and fractured her
femoral shaft. The orthopedic surgeons need to place intramedullary nails. Her
health care proxy is at bedside, and you discuss the risks and benefits of
regional and general anesthesia with the health care proxy. Which of the
following statements is correct?
A. Provided her international neutralized ratio (INR) is less than 1.5, a neuraxial
technique is safe.
B. Provided her INR is less than 1.8, a neuraxial technique is safe.
C. Provided her INR is less than 2.0, a neuraxial technique is safe.
D. Provided her INR is less than 2.0, a neuraxial technique is safe if she receives 1
unit of fresh frozen plasma.
7. A 22-year-old man severed his first and second digits. You elect to place an
infraclavicular catheter for use intraoperatively and postoperatively. To
provide adequate coverage, the cords that must be covered are:
A. Lateral cord
B. Medial cord
C. Posterior cord
D. A, B, and C
E. A and B
F. A and C
8. 8. While snowboarding, a 33-year-old man suffered a bimalleolar ankle
fracture. You are planning a regional anesthetic technique as his primary
anesthetic using nerve stimulation. You elicit a foot twitch of plantar flexion.
This response means that your needle must be located:
A. Medially, within the semitendinosus muscle, and the needle should be redirected
laterally
B. Laterally, eliciting stimulation of the biceps femoris muscle, and the needle
should be redirected medially
C. Near the common peroneal nerve, eliciting a foot twitch, and the needle should
not be redirected
D. Near the tibial nerve, eliciting a foot twitch, and the needle should not be
redirected
9. Before confirmation of the anatomy with ultrasonography, you anticipate that
the femoral nerve is located _____ and is responsible for _____.
A. Lateral to the femoral artery; knee extension
B. Medial to the femoral artery; hip flexion
C. Medial to the femoral artery; knee flexion
D. Lateral to the femoral artery; hip flexion
10. A 73-year-old man is scheduled for a right total knee arthroplasty for severe
osteoarthritis. He has a history of aortic stenosis with an aortic valve area of
1.1 cm2
, hypertension, and chronic obstructive pulmonary disease. He takes
lisinopril daily and is not on home oxygen. The surgeons are eager for him to
engage in physical therapy on postoperative day 0. Consequently, you would
like to minimize weakness of the quadriceps muscle. You believe the best
anesthetic and analgesic plan for this patient is to:
A. Offer a femoral nerve block and general anesthesia
B. Offer a femoral nerve block and spinal anesthesia
C. Offer a saphenous nerve block and general anesthesia
D. Offer a saphenous nerve block and spinal anesthesia
E. Forego a peripheral nerve block given his aortic stenosis and proceed with
general anesthesia
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