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Fa: Anatomy 2 > 4. Overview of Chest Wall Blocks > Flashcards

4. Overview of Chest Wall Blocks Flashcards

1
Q

true ribs

A

1-7
cartilages attach to sternum

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2
Q

false ribs

A

8-12
cartilages DO NOT attach to sternum

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3
Q

floating ribs

A

11-12

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4
Q

floating ribs only attach to

A

vertebrae

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5
Q

scapula extends to

A

inferior border of 7th rib

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6
Q

how many pairs of intercostal nerves

A

12 pairs

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7
Q

how many pairs of thoracic nerve roots

A

12 pairs

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8
Q

intercostal muscle layers

A

external
internal
innermost

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9
Q

where does the vein, artery , and nerve lie?

A

between internal and innermost muscles
behind the rib

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10
Q

position of vein artery and nerve

A

Superior
Vein
Artery
Nerve
Inferior

(VAN)

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11
Q

what is deep to intercostal muscles

A

lung

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12
Q

what levels do you inject for intercostal block

A

2 levels above and below incision site

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13
Q

inferior border of scapula dermatome

A

T6

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14
Q

injection site for intercostal block

A

angle of rib

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15
Q

what dermatome levels can you use intercostal blocks

A

T6 dermatome and below

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16
Q

intercostal block complication

A
  1. pneumothorax
  2. pt discomfort
  3. LAST
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17
Q

which block has the highest blood level of local anesthetic per volume?

A

intercostal block

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18
Q

do you sedate during intercostal block?

A

yes

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19
Q

which injection site have higher risk of LAST?

A

IV
tracheal

20
Q

Highest to lowest local anesthetic absorption

A

HIGHEST
IV > Tracheal > intercostal
Caudal
Epidural
Brachial Plexus
Axillary
Lower extremity (Femoral)
Sub Q
LOWEST

21
Q

can you use ultrasound for intercostal block?

A

yes - but its not common because you cant visualize the nerve

22
Q

paraverterbal block indications

A

alternative approach to intercostal block by blocking intercostal nerves in paravertebral space

23
Q

what levels do you block with paravertebral

A

2 levels above and below

24
Q

paravertebral space

A

wedge shaped located to side of vertebral commons

25
Q

TPVS contacts ________ medially and ______ laterally

A

TPVS contacts epidural space medially and intercostal space laterally

26
Q

main landmark for paravertebral blcok

A

transverse process of spine
(2-3 cm lateral to spinous process)

27
Q

where should needle contact on insertion for paravertebral block without ultrasound?

A

transverse process

28
Q

which block has higher compliocations: intercostal or paravertebral

A

intercostal

29
Q

which block has higher risk of LAST: intercostal or paraverterbal

A

intercostal

30
Q

which block is easier with ultrasound: intercostal or paravertebral

A

paravertebral

31
Q

which block must use multiple injections: intercostal or paravertebral

A

intercostalw

32
Q

which block for dermatomes above T7?

A

paravertebral

33
Q

paravertebral block complications

A

pneumothorax
epidural injection
hypotension (sympa blockade)

34
Q

PECS 1 block coverage

A

T1

35
Q

PECS 2 block coverage

A

T2-T4
(spreads to axilla)

36
Q

do PECS blocks cover midline?

A

no

37
Q

SAPB compared to PECS

A

SAPB is wider coverage

38
Q

SAPB coverage

A

lateral T2-T9
thoracodorsal nerve
long thoracic nerve
lateral intercostal nerve

39
Q

does SAPB cover midline?

A

no

40
Q

which block is longer and better than intercostal: PECS or SAPB

A

both PECS and SAPB are longer duration than intercostal

41
Q

which is more superficial: SAPB or PECS

A

SAPB

42
Q

which block has lower risk of pneumothorax: SAPB or PECS

A

SAPB

43
Q

which block has more coverage: SAPB or ESPB

A

ESPB

44
Q

TTP block targets

A

anterior branches of intercostal nerves
T2-T6

45
Q

TTP indication

A

minimize sternotomy pain after cardiac

46
Q

TTP coverage

A

median chest

Fa: Anatomy 2 (16 decks)

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