8. Performing Hip & Lower Extremity Blocks

Question 1

which 5 nerves are anesthetized for ankle block

Answer 1

tibial
sural
deep peroneal
superficial peroneal
saphenous

Question 2

femoral block landmarks

Answer 2

inguinal ligament
femoral arterial pulse

Question 3

NAVEL

Answer 3

lateral
nerve
artery
vein
empty
lymphatic
medial

Question 4

femoral block most medial

Answer 4

vein

Question 5

femora block middle

Answer 5

artery

Question 6

femoral block most lateral

Answer 6

nerve

Question 7

where does the femoral nerve lie

Answer 7

within the fascia iliaca compartment

Question 8

probe placement femoral block

Answer 8

parallel to inguinal ligament
at the level of femoral crease

Question 9

needle insertion femoral block

Answer 9

in-plane towards nerve

Question 10

where do you stop your needle femoral block

Answer 10

underneath the fascia iliaca ligament

Question 11

LA volume femoral block

Answer 11

10-20 mL

Question 12

how long can you leave a femoral catherin in

Answer 12

48 hrs

Question 13

where do the fascial layers lie FICB?

Answer 13

superficial to the iliacus and psoas muscle

Question 14

2 fascial layers FICB

Answer 14

fascia lata
fascia iliaca

Question 15

most superficial layer

Answer 15

fascia lata

Question 16

fascia iliaca compartment location

Answer 16

between fascial iliaca and iliopsoas muscle

Question 17

what is in the fascia iliaca compartment?

Answer 17

femoral
lateral femoral cutaneous
obturator

Question 18

where is LA deposited FICB

Answer 18

fascia iliaca compartment

Question 19

1st “pop” FICB

Answer 19

fascia lata

Question 20

2nd “pop” FICB

Answer 20

fascia iliaca

Question 21

needle insertion FICb

Answer 21

lateral to femoral nerve
superficial to iliacus muscle

Question 22

which block has more volume: femoral or FICB

Answer 22

FICB

Question 23

which block is more lateral from femoral nerve: femoral or FICB

Answer 23

FICB

Question 24

historal FICB approach

Answer 24

infrainguinal

Question 25

current FICB approach

Answer 25

suprainguinal

Question 26

why is suprainguinal FICB favored?

Answer 26

more spread more reliable obturator block

Question 27

suprainguinal landmark

Answer 27

deep circumflex iliac artery

Question 28

adductor canal location

Answer 28

medial-mid thigh

Question 29

adductor canal muscles

Answer 29

sartorius vastus medialis adductor longus

Question 30

what is inside adductor canal

Answer 30

saphenous nerve femoral artery femoral vein

Question 31

pt positioning adductor canal

Answer 31

supine thigh abducted thigh rotated for medial access

Question 32

probe placement adductor canal

Answer 32

anteromedial mid-thigh

Question 33

adductor canal landmark

Answer 33

femoral artery

Question 34

where is the femoral artery located

Answer 34

under the sartorius muscle

Question 35

needle insertion adductor canal

Answer 35

in-plane lateral to medial

Question 36

what muscle should the needle pass through adductor canal

Answer 36

satorius muscle

Question 37

where is saphenous nerve adductor canal

Answer 37

adjacent to superficial femoral artery between sarotius and vastus medialis

Question 38

saphenous volume

Answer 38

15-20 mL

Question 39

IPACK targeted nerves

Answer 39

articular branches of tibial n articular branches of common peroneal n articular branches of obturator n superomedial n lateral genicular n

Question 40

what are you avoiding blocking in IPACK

Answer 40

avoid blocking trunks of tibial and common peroneal this causes motor block

Question 41

blocking trunk of tibial SE

Answer 41

inhibit plantarflexion of foot

Question 42

blocking trunk of common peroneal SE

Answer 42

foot drop

Question 43

dorsiflexion

Answer 43

foot and shin approximate closertogether

Question 44

plantaflexion

Answer 44

move foot downward away from body

Question 45

IPACK landmark

Answer 45

lateral condyle of femur

Question 46

IPACK LA placement

Answer 46

between lateral condyle and popliteal artery

Question 47

probe placement IPACK

Answer 47

medial thigh 1-2 fingers above patella

Question 48

what is the needle inserted through in IPACK

Answer 48

vastus medialis

Question 49

LA volume IPACK

Answer 49

15 mL

Question 50

transgluteal sciatic markings

Answer 50

line from great trochanter to posterior iliac spione midpoint line caudal

Question 51

transgluetal sciatic needle insertion

Answer 51

5 cm caudad along perpendicular line

Question 52

popliteal block LA location

Answer 52

bifurcation of sciatic nerve 6-8 cm cephaland of politeal foss

Question 53

posterior politeal needle insertion

Answer 53

between biceps femoris and smitendinosus and meimebranosus muscles

Question 54

what 3 things are you palpating in posterior popliteal appraoch

Answer 54

politeal fossa crease biceps femoris tendon (lateral) semitendinosus (medial)

Question 55

posterior popliteal u/s goal

Answer 55

identify where sciatic nerve bifucates

Question 56

lateral popliteal needle insertion

Answer 56

between biceps femoris and vastus lateralis 8cm cephalad of politeal crease in intertendinous groove

Question 57

why is u/s nice for politeal block

Answer 57

u/s guidance reduces volume of block

Question 58

which blocks have longest onset and duration of peripheral blocks

Answer 58

sciatic nerve block due to largest nerve

Question 59

SPEDI block

Answer 59

combo block to cover entire leg except upper medial thigh

Question 60

what does SPEDI block

Answer 60

sciatic and saphenous with 1 penetration and 2 injection

Question 61

fastest was to anesthetize a leg

Answer 61

SPEDI block

Question 62

SPEDI advantages

Answer 62

1 needle stick faster (1.8 min to full anesthesia)

Question 63

SPEDI disadvantages

Answer 63

incr risk of femoral art puncture harder to visualize enrves incr block failure