2. Overview of Hip/Lower Extremity Blocks Flashcards

1
Q

how many nerves supply the leg

A

4

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2
Q

major nerves to leg

A
  1. femoral
  2. lateral femoral cutaneous
  3. obturator
  4. sciatic
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3
Q

femoral nerve innervation

A

anterior thigh and knee

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4
Q

lateral femoral cutaneous innervation

A

upper lateral thigh
hip

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5
Q

obturator nerve innervation

A

medial thigh
hip joint
knee joint

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6
Q

sciatic nerve innervation

A

posterior thigh
posterior knee
everythin below the knee except the medial portion of the lower leg

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7
Q

which nerve is a branch of the femoral nerve

A

saphenous

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8
Q

saphenous innervation

A

medial lower leg, ankle, foot

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9
Q

branches of the sciatic nerve

A
  1. deep peroneal
  2. superficial peroneal
  3. tibial
  4. sural
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10
Q

largest terminal branch of lumbar plexus

A

femoral nerve

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11
Q

dose the saphenous nerve have motor or sensory?

A

sensory only

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12
Q

longest spinal nerve in the body

A

sciatic nerve

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13
Q

which nerve provides motor innervation to the leg

A

sciatic
femoral

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14
Q

branches of tibial nerve

A

posterior tibial
sural

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15
Q

branches of common peroneal nerve

A

superficial peroneal
deep peroneal

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16
Q
A

saphenous nerve

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17
Q
A

superficial peroneal nerve

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18
Q
A

deep peroneal nerve

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19
Q
A

posterior tibial nerve

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20
Q
A

sural nerve

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21
Q

motor component of femoral nerve

A

quads
leg/knee extension

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22
Q

which blocks work for femoral nerve?

A

femoral nerve block
fascial iliaca block

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23
Q

which blocks for lateral femoral cutaneous?

A

fascia iliaca is better than femoral + fascial iliaca

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24
Q

which blocks for obturator nerve?

A

femoral and fascia iliaca are not reliable for obturator nerve

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25
Q

femoral and fascia iliaca block what nerves?

A

femoral (reliable)
saphenous (reliable)
lateral femoral cutaneous (reliable)
obturator (not reliable)

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26
Q

which lower leg nerve block uses less volume of anesthetic?

A

femoral nerve block

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27
Q

how much volume does femoral block use?

A

20 mL

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28
Q

FICB (fascia iliaca) is more ________

A

lateral

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29
Q

how much volume for FICB?

A

30-40 mL

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30
Q

which block is more reliable for obturator nerve?

A

FICB

31
Q

which block is better at lateral femoral cutaneous nerve?

A

FICB

32
Q

which block is better for hip surgery and femoral neck fractures?

A

FICB

33
Q

which block is further from artery or nerve?

A

FICB

34
Q

which plane is the FICB block delivered?

A

same fascial plane as femoral block

35
Q

downside to femoral and FICB?

A

cause a motor block so only used for non-weight bearing surgeries

36
Q

saphenous advantage

A

preserves motor function

37
Q

saphenous diadvantage

A

only medial knee and lower leg/foot

38
Q

other name for saphenous nerve block

A

adductor canal block

39
Q

locations of needle for saphenous nerve block

A

groin
or
mid-thigh

40
Q

adductor canal block indications

A
  1. total knee
  2. ankle/foot surgery
41
Q

what can supplement an adductor canal block?

A

periarticular injection of local

42
Q

which ankle surgery is fully covered by saphenous nerve block?

A

medial ankle surgery

43
Q

which ankle surgery is not fully covered by saphenous block?

A

lateral ankle surgery

44
Q

what supplements saphenous block for lateral ankle surgery?

A

popliteal block

45
Q

indication for obturator nerve block

A

TURBT

46
Q

does spinal anesthesia block obturator nerve reflex?

A

no

47
Q

sciatic nerve block coverage: transgluteal approach

A

posterior thigh/knee
part of hip
everything below knee except medial

48
Q

which block require sedation

A

transgluteal sciatic approach

49
Q

sciatic nerve branches in popliteal fossa

A

tibial nerve (medial)
common peroneal (lateral)

50
Q

sciatic block coverage: popliteal

A

everything below knee except medial

51
Q

most popular block for ankle surgery

A

popliteal block

52
Q

how can you anesthetize the entire leg?

A

sciatic block with femoral or fascia iliaca

53
Q

IPACK block

A

infiltration between the popliteal artery and capsule of posterior knee

54
Q

what type of block is IPACK

A

sensory only

55
Q

IPACK coverage

A

posterior knee

56
Q

does the sciatic block motor

A

yes

57
Q

traditional total knee blocks

A

femoral
fascia iliaca

58
Q

disadvantage to femoreal and fascia iliaca for total knee

A

no posterior knee coverage
block motor function

59
Q

max covereage total knee block

A

adductor canal
+ IPACK

60
Q

which nerves does the IPACK avoid

A

tibial
peroneal
(branches of sciatic)

61
Q

which nerve does the iPACK hit

A

articular branches

62
Q

femoral/fascia iliaca coverage

A

hip/knee joints
anterior knee
medial posterior knee
anterior/lateral thigh
medial lower leg
medial foot

63
Q

saphenous coveraage

A

medial knee
medial lower leg
medial foot

64
Q

sciatic: transgluteal coverage

A

posterior knee/thich
everything below knee except medial

65
Q

sciatic: popliteal coverage

A

everything below knee except medial

66
Q

IPACK coverage

A

posterior knee

67
Q

which lower leg blocks will block motor?

A

femoral (quads)
fascial iliaca (quads)
sciatic transgluteal
sciatic popliteal

68
Q

hip block of choice

A

fascia iliaca

69
Q

anterior thigh block of choice

A

fascia iliaca
femoral

70
Q

knee block of choice

A

fascia iliaca
femoral
adductor canal
+/- IPACK

71
Q

tibia block of choice

A

popliteal

72
Q

ankle block of choice

A

popliteal
+/- saphenous

73
Q

foot block of choice

A

ankle
popliteal