Maintaining Adequate Distance for TEE in Neurosurgery

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What is the objective of minimizing vena cava pressure during spinal surgery?

To increase blood diversion to the epidural plexus

To prevent bleeding during spinal surgery

To reduce the risk of air embolism

To avoid compression of the inferior vena cava (correct)

Why should unnecessary adjuncts in the oral cavity and pharynx be avoided during procedures that require substantial neck flexion?

To prevent airway obstruction (correct)

To reduce neck flexion risks

To avoid tongue injury

To prevent macroglossia

Which surgical positions introduce a risk of air embolism due to efforts to minimize vena cava pressure?

Prone position only

Lateral decubitus position

Wilson, Andrews, and Jackson variants (correct)

Supine position

What can occur as a consequence of compression ischemia at the base of the tongue during surgical procedures?

Macroglossia Signup and view all the answers

Which is NOT a potential outcome of placing unnecessary adjuncts in the oral cavity and pharynx during surgical procedures?

Cervical spine stabilization Signup and view all the answers

Why is it important to flex the neck substantially during both cervical and posterior fossa procedures?

To facilitate surgical access Signup and view all the answers

What is the recommended distance to be maintained between the chin/mandible and the sternum/clavicle to prevent excessive reduction of the oropharynx's anterior-posterior diameter?

Two fingerbreadths Signup and view all the answers

Why do centers that routinely use transesophageal echocardiography in neurosurgery mostly use pediatric diameter probes?

To prevent trauma to pharyngeal and perilaryngeal structures Signup and view all the answers

What has been hypothesized as a cause of rare instances of unexplained postoperative quadriplegia related to the sitting position?

Stretching or compression of the cervical spinal cord Signup and view all the answers

Why do some clinicians justify using evoked response monitoring during the positioning phase for patients at high risk during a sitting procedure?

To detect early signs of spinal cord compression Signup and view all the answers

Why is neck flexion considered a relative contraindication to using the sitting position in patients with significant degenerative disease of the cervical spine?

It may result in stretching or compression of the cervical spinal cord Signup and view all the answers

What aspect requires consideration when using the sitting position in patients with associated cerebral vascular disease?

Implications for arterial blood pressure management Signup and view all the answers

Why is it important to raise the safe lower limit for neck flexion in some patients?

To reduce the risk of upper airway obstruction Signup and view all the answers

What can happen if substantial or sustained retractor pressure is applied during surgery?

Decreased spinal cord perfusion Signup and view all the answers

In what group of patients should the safe lower limit for neck flexion be raised?

Patients with known cerebral vascular disease Signup and view all the answers

Why should the configuration with the head-holder support attached to the thigh portion of the table be avoided?

It can lead to upper airway obstruction Signup and view all the answers

What can sustained neck flexion during surgery lead to in some patients?

Decreased spinal cord perfusion Signup and view all the answers

What is a potential consequence of applying substantial retractor pressure to brain or spinal cord tissue?

Damage due to decreased spinal cord perfusion Signup and view all the answers