《临床麻醉学》课程教学课件（PPT讲稿）第十章 椎管内麻醉 Intrathecal Anesthesia

置庆医科大学用属第一运洞 Intrathecal Anesthesia

1 Intrathecal Anesthesia

量庆送科大字闲属烟一 Intrathecal anesthesia: Intrathecal anesthesia result in sympathetic block, sensory analgesia,and motor block (depending on dose, concentration,or volume of local anesthetic)by local anesthetic which is injected into subarachnoid space spinal anesthesia )or the epidural space (epidural anesthesia and bathes the nerve roots in the subarachnoid space or epidural space,respectively

2 Intrathecal anesthesia: • Intrathecal anesthesia result in sympathetic block, sensory analgesia, and motor block (depending on dose, concentration, or volume of local anesthetic) by local anesthetic which is injected into subarachnoid space ( spinal anesthesia ) or the epidural space ( epidural anesthesia ) and bathes the nerve roots in the subarachnoid space or epidural space, respectively

3 置庆医科大学用属第一运洞 Intrathecal block is divided into two classes Subarachnoid block (spinal block): Local anesthetic is injected into subarachnoid space. .Epidural block:Local anesthetic is injected into epidural space

3 Intrathecal block is divided into two classes • Subarachnoid block (spinal block): Local anesthetic is injected into subarachnoid space. • Epidural block: Local anesthetic is injected into epidural space

Anatomy CEAVICAL YERTEIRAE Vertebral column ·7 cervical(C), ·12 thoracic(T), 5lumbar (L), 5 sacral (S)fused as the IA模n镇A柱 sacrum, 4 small coccygeal vertebra (Co)that form the coccyx 9 A.SIDE VIEW B.FRONT VIEW 5-3 VERTEBRAL COLUMN

4 Anatomy Vertebral column • 7 cervical (C), • 12 thoracic (T), • 5 lumbar (L), • 5 sacral (S) fused as the sacrum, • 4 small coccygeal vertebra (Co) that form the coccyx

5 置庆医科大学用属第一运 VERTEBRA FUNCTIONS: PARTS: 5.Movement Spinous 4.Movement Transverse Processes 3.Obstruction Articular 2.Protection- Vertebral arch 1.Support- Body 5-1 FUNCTIONS OF CONSTITUENT PARTS OF A VERTEBRA

5 VERTEBRA

6 量庆送科大字闲属。一运 Inf.articalar process- The vertebral arch encloses the vertebral foramen,each Sup articular process vertebral arch has two Body Vertebeal foramen parts,that is pedicle (root) FROM ABOVE. and lamina.Pedicles have large notches on their Sup.vertebral notch Sup.articlar process inferior surface and smaller notches on their superior Transvers转proce Body surface. 0请SIDE VIEW 5-2 A VERTEBRA

6 The vertebral arch encloses the vertebral foramen, each vertebral arch has two parts, that is pedicle (root) and lamina. Pedicles have large notches on their inferior surface and smaller notches on their superior surface

置庆医科大学用属第一运洞 The inferior and 推号根 推同孔 superior notches from adjacent vertebrae form 稚骨下切迹 intervertebral 推骨上切迹 foramina,through which nerve roots exit the spinal column

7 The inferior and superior notches from adjacent vertebrae form intervertebral foramina, through which nerve roots exit the spinal column

8 量庆送科大字闲属烟一运。 Sacrum Coccyx: Sup.articular facet- *-sup,acral noteh'” Auricular surface The sacral hiatus leads Sacral tuberoaity into the sacral canal, Dorsal sacral foramina Sacral hiatus the inferior end of the nfero-later Sacro-coccygeal notch" vertebral canal. 5-14 SACRUM AND COCCYX,DORSAL SURFACE

8 Sacrum & Coccyx: The sacral hiatus leads into the sacral canal, the inferior end of the vertebral canal

置庆医科大学用属第一运沉 Ligamentum of vertebral column otdi海tra- Supraspinous ligament Interpisous lgameet Interspinous ligament Ligamentum flavum(the yollow ligament) Cal做 basi-vertebeal sein- 5-20 AN INTERVERTEBRAL DISC AND LIGAMENTS,ON MEDIAN SECTION

9 Ligamentum of vertebral column • Supraspinous ligament • Interspinous ligament • Ligamentum flavum(the yollow ligament)

10 量庆送科大字用属漏一适 Spinal meninges 7-spinal cord 8-spinal dura mater 9-arachnoid mater 10-spinal pia mater 333.脊髓的被膜（后面观） Capsules of spinal cord (posterior aspect)

10 Spinal meninges 7- spinal cord 8- spinal dura mater 9- arachnoid mater 10- spinal pia mater