46. Peripheral nerve blocks

Question 1

Cervical plexus block. Height and examples

Answer 1

C1-C4
Lymph node dissection, endarterectomy, plastic surgery

Question 2

Brachial plexus anatomy

Answer 2

Question 3

Interscalene block

Answer 3

For shoulder surgery
Blocks sup / middle trunk C6 level
Close to phrenic nerve can cause respiratory issues (due to diaphragm), Bezold Jarish reflex (decrease HR and BP)

Question 4

Supraclavicular block

Answer 4

For elbow, forearm, hand
Blocks distal trunk
Risk of pneumothorax, phrenic nerve block, Horness syndrome, neuropathy

Question 5

Suprascapular block

Answer 5

Sup trunk + C5, C6 +- C4
For shoulder.
Less risk for phrenic nerve block

Question 6

Infraclavicular block

Answer 6

Block brachial plexus
Deep and slow onset

Question 7

Risk for intercostal block

Answer 7

Risk for pneumothorax
Risk for LAST

Question 8

TAP block nerves

Answer 8

Blocks subcostal, ilioinguinal, Iliogastric nerves

Question 9

Lumbar plexus

Answer 9

In psoas compartment (between psoas and quadratum lumborum)
Contains obturator, femoral and lateral femoral cutaneous

Question 10

Sacral plexus

Answer 10

Perineal cutaneous nerve + sciatic nerve

Question 11

Sciatic nerve

Answer 11

Tibial nerve (med) + common peroneal (lat)

Question 12

Ankle innervation

Answer 12

5 nerves. 4 from sciatic nerve: Tibial, sural, sup peroneal, deep peroneal
5th Saphenous

Question 13

At what current motor blocks occur

Answer 13

< 0.5 mA

Question 14

Speed of US in soft tissue

Answer 14

1540 m/s

Question 15

sacral plexus?

Answer 15

Sup inf gluteal
Sciatic nerve (tibial common peroneal)
Post femoral

Question 16

Technique to reducing the risk of nerve injury

Answer 16

No technique is better

Question 16

Anesthetic for Bier block and which one not and why

Answer 16

chloroprocaine 0.5%, lidocaine 0.5%, or prilocaine 0.5%
No Bupi due to severe LAST

Question 17

Medial malleolus innervation
Lateral

Answer 17

Medial tibial
Lateral Sural

Question 18

Lumbar plexus

Answer 18

Question 19

Last incidence

Answer 19

1 / 1000