10. Wrist Block

Question 1

ulnar nerve lies

Answer 1

beneath flexor carpi ulnaris
medial to ulnar artery

Question 2

median nerve lies

Answer 2

between palmaris longus and flexor carpi radialis

Question 3

radial nerve lies

Answer 3

proximal to styloid process of radius
lateral to radial artery

Question 4

wrist block anesthetizes

Answer 4

hand
digits

Question 5

wrist block indication

Answer 5

hand surgery
finger surgery

Question 6

wrist block targets

Answer 6

radial
median
ulnar

Question 7

alternatives to wrist block

Answer 7

digital block
axillary block
supraclavicular block
infraclavicular block

Question 8

advntages to brachial plexus block

Answer 8

anesthetize arm f/tourniquet
1 injection

Question 9

disadvantages to brachial plexus blocks

Answer 9

higher complications
block motor function

Question 10

ulnar block landmarks

Answer 10

ulnar styloid
tendon of flexor carpi ulnaris
ulnar artery pulse

Question 11

ulnar artery pulse lies

Answer 11

medial to flexor carpi ulnaris

Question 12

ulnar block landmark with u/s

Answer 12

ulnar artery

Question 13

ulnar nerve location on u/s

Answer 13

medial to ulnar artery

Question 14

ulnar block needle insertion

Answer 14

under flexor carpi ulnaris tendon
above styloid process of ulna

Question 15

ulnar block needle advance

Answer 15

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

Question 16

ulnar block volume

Answer 16

3-5 mL

Question 17

what can help block the cutaneous branches of ulnar nerve?

Answer 17

2-3 mL subQ injection above tendon

Question 18

median nerve landmarks

Answer 18

flexor carpi radialis
palmaris longus

Question 19

median nerve needle insertion

Answer 19

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

Question 20

median nerve needle advance

Answer 20

45 degrees until needle hits bone

Question 21

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

Answer 21

withdraw 2-3 mm before injecting

Question 22

median nerve volume

Answer 22

3-5 mL

Question 23

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

Answer 23

withdraw 1-2mm before injecting

Question 24

radial nerve block landmark

Answer 24

radial styloid

Question 25

radial nerve block needle insertion

Answer 25

1cm proximal and medial to radial styloid

Question 26

radial nerve injection is

Answer 26

subQ

Question 27

what should you avoid in radial nerve block

Answer 27

radial artery

Question 28

how do you block the superficial branch of radial nerve

Answer 28

reposition needle dorsally

Question 29

radial nerve block volume

Answer 29

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

Question 30

the radial nerve is ______ to radial artery

Answer 30

lateral

Question 31

median nerve block drug

Answer 31

5 mL 2% lidocaine

Question 32

median nerve block onset

Answer 32

10-20 min

Question 33

median nerve block duration

Answer 33

2-3 hrs

Question 34

ulnar nerve block drug/dose

Answer 34

5 mL 2% lidocaine

Question 35

ulnar nerve block onset

Answer 35

10-20 min

Question 36

ulnar nerve block duration

Answer 36

2-3 hrs

Question 37

radial nerve block drug/dose

Answer 37

10 mL 2% lidocaine

Question 38

radial nerve block onset

Answer 38

10-20 mins

Question 39

radial nerve block duration

Answer 39

2-3 hrs

Question 40

which block requires more extensive infiltration?

Answer 40

radial due to less precise location and division into branches

Question 41

what med can you not give in wrist blocks

Answer 41

epi

Question 42

wrist block complications: ulnar and radial

Answer 42

hematoma

Question 43

wrist block complication: median

Answer 43

pressure induced neuropraxia in carpal tunnel pts