3. Overview of Abdominal Blocks Flashcards

1
Q

A

A

Right hypochondrium

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2
Q

B

A

epigastric

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3
Q

C

A

Left hypochondrium

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4
Q

D

A

Right lumbar

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5
Q

E

A

umbilical region

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6
Q

F

A

left lumbar

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7
Q

H

A

right iliac

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8
Q

I

A

hypogastrium

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9
Q

J

A

L iliac

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10
Q

4 main abdominal muscles: Superficial to DEEP

A

SUPERFICIAL
external oblique
internal oblique
rectus abdominis
transversus abdominis
DEEP

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11
Q

external oblique

A

outermost muscles on each side of rectus abdominis

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12
Q

external oblique muscles extend from

A

lower ribs to pelvis

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13
Q

internal oblique direction

A

opposite external oblique

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14
Q

rectus abdominis

A

6 pack

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15
Q

linea alba

A

connective tissue separating the muscles on each side of rectus abdominis

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16
Q

transversus abdominis

A

wraps around spine for protection and stability

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17
Q

what encircles the rectus muscle

A

rectus sheath

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18
Q

where does the rectus sheath extend

A

to the external oblique, internal oblieuq, and transversus abdominis

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19
Q

psoas major origin

A

T12-L4

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20
Q

psoas major insertion

A

lesser trochanter of femur

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21
Q

which muscle is missing? in how many people?

A

psoas minor
40-70%

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22
Q

iliacus origin

A

iliac fossa

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23
Q

iliacus insertion

A

lesser trochanter of femur (w/psoas major)

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24
Q

iliopsoas

A

the unification of the psoas major and iliacus muscle

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25
Q

where does the iliopsoas form

A

in the inguinal region

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26
Q

where does the iliopsoas descend?

A

below the inguinal ligament with the femoral nerve

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27
Q

what nerves are targetd by abdominal blocks

A

intercostal nerves
subcostal nerves
iliohypogastric and ilioingiunal nerves

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28
Q

intercostal nerves

A

T7-T11

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29
Q

subcostal nerves

A

T12

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30
Q

iliohypogastric and ilioinguinal nerves

A

L1-L2

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31
Q

Transversus abdominus plane (TAP)

A

space between transversus abdominis and internal oblique muscles

32
Q

1

A

transverse abdominis muscle

33
Q

2

A

internal oblique muscle

34
Q

3

A

external oblique muscle

35
Q

the TAP plane is superficial to ________ and deep to ______

A

the TAP plane is superficial to the transversus abdominis and deep to internal oblique

36
Q

TAP requires how many injections

A

2 total: 1 injection per side

37
Q

TAP: first “pop”

A

fascia between external and internal obliques

38
Q

TAP: second “pop”

A

internal oblique and transverse abdominus

39
Q

where do abdominal nerves travel

A

to the midline of the abdomen

40
Q

rectus sheath block

A

inject between the rectus muscle and posterior rectus sheath

41
Q

lower abdominal nerves

A

ilioinguiinal
iliohypogastric
genitofemoral

(L1-L2/3)

42
Q

lower abdominal nerves innervate

A

the lower abdominal region in the groin area

43
Q

TAP coverage

A

T10-L1
(lower abdominal area)

44
Q

is the TAP a bilateral or unilateral block

A

TAP only covers 1 side
need to block bilaterally for full coverage

45
Q

TAP volume

A

10-20mL

46
Q

TAP risk from volume of block

A

higher risk of LAST

47
Q

QL block coverage

A

T7-L1
(entire abdominal area)

48
Q

is the QL a unilateral or bilateral block

A

bilateral - must anesthetize both sides

49
Q

QL volume

A

high volume = higher change of LAST

50
Q

QL block injection site

A

around the QL muscle

51
Q

TAP block anesthesia

A

somatic only

52
Q

QL block anesthesia

A

somatic and visceral

53
Q

which block has a longer duration of analgesia: QL or TAP?

A

QL

54
Q

QL block duration

A

24-48 hrs

55
Q

TAP duration

A

8-12 hrs

56
Q

which block is good for midline coverage?

A

rectus sheath block

57
Q

ilioinguinal/iliohypogastric block coverage

A

L1-L3
(lower abdominal)

58
Q

ilioinguinal/iliohypogastric anesthetizes

A

hypogstric region
inguinal crease
upper medial thigh

59
Q

varicocele

A

enlargement of veins that cary blood away from testicle

60
Q

varicocele treatment

A

varicocelectomy to reduce testicle pain and increase fertility

61
Q

hydrocele

A

swelling in the scrotoum due to fluid accumulation in the thin sac surrouding the testicle

62
Q

hydrocele treatment

A

hydrocelectomy

63
Q

which muscle is technically the deepest abdominal muscle but is commonly referred to as a back muscle?

A

QL

64
Q

posterior view: Superficial to Deep back muscles

A

Superficial
latissimus dorsi
erector spinae
quadratus lumborum
Deep

65
Q

yellow

A

latissimus dorsi

66
Q

purple

A

erector spinae

67
Q

blue

A

quadratus lumborum

68
Q

what is anterior to the QL muscle

A

psoas major

69
Q

what is posterior to the QL muscle

A

erector spinae

70
Q

the QL lies anterior to _____ and posterior to ______

A

the QL lies anterior to erector spinae and posterior to the psoas major

71
Q

QL superficial to deep

A

SUPERFICIAL
lats
erector
QL
psoas major
DEEP

72
Q

the QL muscle is ______ to transverse process

A

lateral

73
Q

psoas major is ________ to QL

A

anterior

74
Q

erector spinae is ____ to QL

A

posteriro

75
Q

from a lateral view, the external oblique contacts

A

the external oblique contacts the latissimus dorsi