7. Performing Abdominal Blocks

Question 1

most common approach for TAP block

Answer 1

lateral

Question 2

probe placement lateral TAP

Answer 2

above and parallel to iliac crest

Question 3

needle insertion TAP

Answer 3

in-plane approach
medial to probe

Question 4

LA insertion location TAP

Answer 4

TAP plane
- between internal oblique and transversus abdominis

Question 5

subcostal TAP block location

Answer 5

inferior to costal margin

Question 6

subcostal TAP indication

Answer 6

upper abdominal incisions

Question 7

probe placement QL block

Answer 7

between iliac crest and inferior border of ribcage
where the external oblique and lats contact

Question 8

QL1

Answer 8

lateral QL

Question 9

LA placement QL1

Answer 9

lateral to the QL muscle
closest to ab muscles
closest to TAP block

Question 10

QL2

Answer 10

posterior QL

Question 11

LA placement QL2

Answer 11

between QL and lats
(posterior to QL)

Question 12

QL3

Answer 12

anterior QL

Question 13

needle passes through what in QL3

Answer 13

QL muscle

Question 14

LA placement QL3

Answer 14

between QL and psoas major

Question 15

which block anesthetizes ventral rami of lower thoracic nerves

Answer 15

QL3

Question 16

pt positioning QL1

Answer 16

supine

Question 17

pt position QL2

Answer 17

supine

Question 18

pt position QL3

Answer 18

lateral

Question 19

QL muscle looks like

Answer 19

flag from flag pole

Question 20

which QL block achieves most cephalad spread

Answer 20

QL3

Question 21

QL volume

Answer 21

30 mL each side

Question 22

LA placement rectus sheath

Answer 22

between rectus muscle and posterior rectus sheath

Question 23

what shouldyou avoid during rectus sheath block

Answer 23

inferior and superior epigastric arteries

Question 24

rectus sheath volume 2 point block

Answer 24

20 mL each side

Question 25

2 point rectus sheat indication

Answer 25

peri-umbilical surgery

Question 26

rectus sheath volume 4 point block

Answer 26

20 mL each injection
2 injections per side

Question 27

4 point rectus sheath indication

Answer 27

midline laparotomy

Question 28

probe placement rectus sheath

Answer 28

transverse on abdomen
lateral to umbilicus

Question 29

needle insertion rectus sheath

Answer 29

lateral to medial

Question 30

rectus sheath needle is deep to

Answer 30

rectus abdominus

Question 31

rectus sheath needle is superficial to

Answer 31

posterior retus sheath

Question 32

rectus sheath volume

Answer 32

10 mL each side

Question 33

LA placement ilioinguinal/iliohypogastric

Answer 33

between internal oblique and transversus abdominis
(TAP plane)

Question 34

first “pop” ilioinguinal

Answer 34

external oblique

Question 35

2nd “pop” ilioinguinal

Answer 35

internal oblique

Question 36

difference between ilioinguinal and TAP location

Answer 36

ilioinguinal is closer to the ilioinguinal/iliohypogastric nerves

Question 37

does ilioinguinal or TAP require less LA?

Answer 37

ilioinguinal

Question 38

proble placement ilioinguinal

Answer 38

medial to anterior-superior iliac spine
angled towards umbilicus

Question 39

abdominal block advantages

Answer 39

1. can be performed when neuraxial is CI
2. preserves bladder
3. preserves motor
4. avoids HD instability
5. lower risk of neuraxial injury

Question 40

abdominal block disadvantages

Answer 40

1. TAP only somatic
2. higher volume
3. incr LAST risk
4. bilateral block required

Question 41

what can you hit if you advance needle too dip

Answer 41

bowel

Question 42

abdominal block complications

Answer 42

1. organ damage
2. bowel perf
3. transient femoral nerve palsy