10. Wrist Block Flashcards
wrist anatomy Medial to Lateral
MEDIAL
ulnar nerve
ulnar artery
flexor ulnaris
palmaris longus
median nerve
flexor radialis
radial artery
radial nerve
LATERAL
ulnar nerve lies
beneath flexor carpi ulnaris
medial to ulnar artery
median nerve lies
between palmaris longus and flexor carpi radialis
radial nerve lies
proximal to styloid process of radius
lateral to radial artery
wrist block anesthetizes
hand
digits
wrist block indication
hand surgery
finger surgery
wrist block targets
radial
median
ulnar
alternatives to wrist block
digital block
axillary block
supraclavicular block
infraclavicular block
advntages to brachial plexus block
anesthetize arm f/tourniquet
1 injection
disadvantages to brachial plexus blocks
higher complications
block motor function
ulnar block landmarks
ulnar styloid
tendon of flexor carpi ulnaris
ulnar artery pulse
ulnar artery pulse lies
medial to flexor carpi ulnaris
ulnar block landmark with u/s
ulnar artery
ulnar nerve location on u/s
medial to ulnar artery
ulnar block needle insertion
under flexor carpi ulnaris tendon
above styloid process of ulna
ulnar block needle advance
advance until 0.5-1 cm medial to and underneath flexor carpi ulnaris tendon
ulnar block volume
3-5 mL
what can help block the cutaneous branches of ulnar nerve?
2-3 mL subQ injection above tendon
median nerve landmarks
flexor carpi radialis
palmaris longus
median nerve needle insertion
between palmaris longus and flexor carpi radialis
2-3 cm proximal to distal wrist crease
median nerve needle advance
45 degrees until needle hits bone
what should you do when you hit the bone on median nerve block
withdraw 2-3 mm before injecting
median nerve volume
3-5 mL
what should you do if you get paresthesia with median nerve block
withdraw 1-2mm before injecting
radial nerve block landmark
radial styloid
radial nerve block needle insertion
1cm proximal and medial to radial styloid
radial nerve injection is
subQ
what should you avoid in radial nerve block
radial artery
how do you block the superficial branch of radial nerve
reposition needle dorsally
radial nerve block volume
5 mL proximally/medially
and
5 mL dorsally (superficial)
the radial nerve is ______ to radial artery
lateral
median nerve block drug
5 mL 2% lidocaine
median nerve block onset
10-20 min
median nerve block duration
2-3 hrs
ulnar nerve block drug/dose
5 mL 2% lidocaine
ulnar nerve block onset
10-20 min
ulnar nerve block duration
2-3 hrs
radial nerve block drug/dose
10 mL 2% lidocaine
radial nerve block onset
10-20 mins
radial nerve block duration
2-3 hrs
which block requires more extensive infiltration?
radial due to less precise location and division into branches
what med can you not give in wrist blocks
epi
wrist block complications: ulnar and radial
hematoma
wrist block complication: median
pressure induced neuropraxia in carpal tunnel pts
