10. Wrist Block

Question 1

wrist anatomy Medial to Lateral

Answer 1

MEDIAL
ulnar nerve
ulnar artery
flexor ulnaris
palmaris longus
median nerve
flexor radialis
radial artery
radial nerve
LATERAL

Question 2

ulnar nerve lies

Answer 2

beneath flexor carpi ulnaris
medial to ulnar artery

Question 3

median nerve lies

Answer 3

between palmaris longus and flexor carpi radialis

Question 4

radial nerve lies

Answer 4

proximal to styloid process of radius
lateral to radial artery

Question 5

wrist block anesthetizes

Answer 5

hand
digits

Question 6

wrist block indication

Answer 6

hand surgery
finger surgery

Question 7

wrist block targets

Answer 7

radial
median
ulnar

Question 8

alternatives to wrist block

Answer 8

digital block
axillary block
supraclavicular block
infraclavicular block

Question 9

advntages to brachial plexus block

Answer 9

anesthetize arm f/tourniquet
1 injection

Question 10

disadvantages to brachial plexus blocks

Answer 10

higher complications
block motor function

Question 11

ulnar block landmarks

Answer 11

ulnar styloid
tendon of flexor carpi ulnaris
ulnar artery pulse

Question 12

ulnar artery pulse lies

Answer 12

medial to flexor carpi ulnaris

Question 13

ulnar block landmark with u/s

Answer 13

ulnar artery

Question 14

ulnar nerve location on u/s

Answer 14

medial to ulnar artery

Question 15

ulnar block needle insertion

Answer 15

under flexor carpi ulnaris tendon
above styloid process of ulna

Question 16

ulnar block needle advance

Answer 16

advance until 0.5-1 cm medial to and underneath flexor carpi ulnaris tendon

Question 17

ulnar block volume

Answer 17

3-5 mL

Question 18

what can help block the cutaneous branches of ulnar nerve?

Answer 18

2-3 mL subQ injection above tendon

Question 19

median nerve landmarks

Answer 19

flexor carpi radialis
palmaris longus

Question 20

median nerve needle insertion

Answer 20

between palmaris longus and flexor carpi radialis
2-3 cm proximal to distal wrist crease

Question 21

median nerve needle advance

Answer 21

45 degrees until needle hits bone

Question 22

what should you do when you hit the bone on median nerve block

Answer 22

withdraw 2-3 mm before injecting

Question 23

median nerve volume

Answer 23

3-5 mL

Question 24

what should you do if you get paresthesia with median nerve block

Answer 24

withdraw 1-2mm before injecting

Question 25

radial nerve block landmark

Answer 25

radial styloid

Question 26

radial nerve block needle insertion

Answer 26

1cm proximal and medial to radial styloid

Question 27

radial nerve injection is

Answer 27

subQ

Question 28

what should you avoid in radial nerve block

Answer 28

radial artery

Question 29

how do you block the superficial branch of radial nerve

Answer 29

reposition needle dorsally

Question 30

radial nerve block volume

Answer 30

5 mL proximally/medially and 5 mL dorsally (superficial)

Question 31

the radial nerve is ______ to radial artery

Answer 31

lateral

Question 32

median nerve block drug

Answer 32

5 mL 2% lidocaine

Question 33

median nerve block onset

Answer 33

10-20 min

Question 34

median nerve block duration

Answer 34

2-3 hrs

Question 35

ulnar nerve block drug/dose

Answer 35

5 mL 2% lidocaine

Question 36

ulnar nerve block onset

Answer 36

10-20 min

Question 37

ulnar nerve block duration

Answer 37

2-3 hrs

Question 38

radial nerve block drug/dose

Answer 38

10 mL 2% lidocaine

Question 39

radial nerve block onset

Answer 39

10-20 mins

Question 40

radial nerve block duration

Answer 40

2-3 hrs

Question 41

which block requires more extensive infiltration?

Answer 41

radial due to less precise location and division into branches

Question 42

what med can you not give in wrist blocks

Answer 42

epi

Question 43

wrist block complications: ulnar and radial

Answer 43

hematoma

Question 44

wrist block complication: median

Answer 44

pressure induced neuropraxia in carpal tunnel pts