11. Digital Block Flashcards

1
Q

volar

A

palm side
anterior

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2
Q

dorsal

A

back on hand
posterior

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3
Q

median hand (anterior/posterio)

A

ulnar
C8-T1

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4
Q

posterior lateral hand

A

radial
C5-C6

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5
Q

anterior lateral hand
fingertips of first 3.5 digits

A

median
C6-C8

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6
Q

digital block indications

A

finger or toe surgery

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7
Q

ring block insertion

A

dorsolateral aspect of base of finger

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8
Q

ring block needle advance

A

until it contacts bone (phalanx)

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9
Q

ring block volume

A

< 2 mL on each side
-1 mL as withdrawing first 1-2 mm after bone contact
- 1 mL as withdrawing to skin

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10
Q

TOTAL ring block volume

A

< 4 mL per digit

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11
Q

transthecal block needle insertion

A

45 degree angle
distal to palmart crease

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12
Q

where is LA injected into for transthecal block

A

flexor tendon sheath

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13
Q

transthecal block volume

A

2-3 mL

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14
Q

resistance during transthecal block indicates

A

needle tip contacting tendon

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15
Q

transthecal advantage

A

single injection

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16
Q

which is more painful ring block or transthecal block?

A

transthecal block

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17
Q

subQ volar digital block needle injection

A

pinch skin on volar side of finger
insert perpendicular

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18
Q

subQ volar block volume

A

2 mL

19
Q

easiest digital block

A

subQ volar

20
Q

least painful digital block

A

subQ volar

21
Q

which digital block require proximal pressure?

A

transthecal
subQ volar

22
Q

why is proximal pressure applied?

A

to ensure more distal spread of local

23
Q

transthecal onset

A

faster
120 sec

24
Q

transthecal duration

A

shorter
3 hrs

25
Q

transthecal pain

A

painful
3.1

26
Q

subQ volar onset

A

slower
140 sec

27
Q

subQ volar duration

A

longer
4.3 hrs

28
Q

subQ volar pain

A

not as bad
2.4

29
Q

which digital block do pts prefer?

A

subQ volar

30
Q

3 sided big toe block how many injections

A

3

31
Q

what injections does the big toe block get?

A

medial
dorsal
lateral

32
Q

big toe block medial insertion

A

perpendicular

33
Q

which toes can the 3 sided block be used for?

A

all of them

34
Q

toe block volume: big toe

A

4-6 mL

35
Q

toe block volume: small toes

A

3 mL

36
Q

digital block complications

A

hematoma
compartment syndrome

37
Q

great toe block volume

A

<6 mL

38
Q

finger and small toe block volume

A

< 4 mL

39
Q

tranthecal and subQ block volume

A

< 2 mL

40
Q

digital block CI

A

epi
pts w/compromised digital circulation

41
Q

pts w/compromised digital circulation

A

diabetes
peripheral vascular disease
raynauds
AV fistula

42
Q

digital block advantages

A

easier
not as painful
lower risk of LAST

43
Q

digital block disadvantages

A

multiple injections
shorter duration