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Fa: Anatomy 2 > 8. Performing Hip & Lower Extremity Blocks > Flashcards

8. Performing Hip & Lower Extremity Blocks Flashcards

1
Q

which 5 nerves are anesthetized for ankle block

A

tibial
sural
deep peroneal
superficial peroneal
saphenous

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2
Q

femoral block landmarks

A

inguinal ligament
femoral arterial pulse

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3
Q

NAVEL

A

lateral
nerve
artery
vein
empty
lymphatic
medial

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4
Q

femoral block most medial

A

vein

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5
Q

femora block middle

A

artery

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6
Q

femoral block most lateral

A

nerve

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7
Q

where does the femoral nerve lie

A

within the fascia iliaca compartment

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8
Q

probe placement femoral block

A

parallel to inguinal ligament
at the level of femoral crease

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9
Q

needle insertion femoral block

A

in-plane towards nerve

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10
Q

where do you stop your needle femoral block

A

underneath the fascia iliaca ligament

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11
Q

LA volume femoral block

A

10-20 mL

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12
Q

how long can you leave a femoral catherin in

A

48 hrs

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13
Q

where do the fascial layers lie FICB?

A

superficial to the iliacus and psoas muscle

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14
Q

2 fascial layers FICB

A

fascia lata
fascia iliaca

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15
Q

most superficial layer

A

fascia lata

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16
Q

fascia iliaca compartment location

A

between fascial iliaca and iliopsoas muscle

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17
Q

what is in the fascia iliaca compartment?

A

femoral
lateral femoral cutaneous
obturator

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18
Q

where is LA deposited FICB

A

fascia iliaca compartment

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19
Q

1st “pop” FICB

A

fascia lata

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20
Q

2nd “pop” FICB

A

fascia iliaca

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21
Q

needle insertion FICb

A

lateral to femoral nerve
superficial to iliacus muscle

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22
Q

which block has more volume: femoral or FICB

A

FICB

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23
Q

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

A

FICB

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24
Q

historal FICB approach

A

infrainguinal

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25
Q

current FICB approach

A

suprainguinal

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26
Q

why is suprainguinal FICB favored?

A

more spread
more reliable obturator block

27
Q

suprainguinal landmark

A

deep circumflex iliac artery

28
Q

adductor canal location

A

medial-mid thigh

29
Q

adductor canal muscles

A

sartorius
vastus medialis
adductor longus

30
Q

what is inside adductor canal

A

saphenous nerve
femoral artery
femoral vein

31
Q

pt positioning adductor canal

A

supine
thigh abducted
thigh rotated for medial access

32
Q

probe placement adductor canal

A

anteromedial mid-thigh

33
Q

adductor canal landmark

A

femoral artery

34
Q

where is the femoral artery located

A

under the sartorius muscle

35
Q

needle insertion adductor canal

A

in-plane
lateral to medial

36
Q

what muscle should the needle pass through adductor canal

A

satorius muscle

37
Q

where is saphenous nerve adductor canal

A

adjacent to superficial femoral artery
between sarotius and vastus medialis

38
Q

saphenous volume

A

15-20 mL

39
Q

IPACK targeted nerves

A

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

40
Q

what are you avoiding blocking in IPACK

A

avoid blocking trunks of tibial and common peroneal

this causes motor block

41
Q

blocking trunk of tibial SE

A

inhibit plantarflexion of foot

42
Q

blocking trunk of common peroneal SE

A

foot drop

43
Q

dorsiflexion

A

foot and shin approximate closertogether

44
Q

plantaflexion

A

move foot downward away from body

45
Q

IPACK landmark

A

lateral condyle of femur

46
Q

IPACK LA placement

A

between lateral condyle and popliteal artery

47
Q

probe placement IPACK

A

medial thigh
1-2 fingers above patella

48
Q

what is the needle inserted through in IPACK

A

vastus medialis

49
Q

LA volume IPACK

A

15 mL

50
Q

transgluteal sciatic markings

A

line from great trochanter to posterior iliac spione
midpoint line caudal

51
Q

transgluetal sciatic needle insertion

A

5 cm caudad along perpendicular line

52
Q

popliteal block LA location

A

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

53
Q

posterior politeal needle insertion

A

between biceps femoris and smitendinosus and meimebranosus muscles

54
Q

what 3 things are you palpating in posterior popliteal appraoch

A

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

55
Q

posterior popliteal u/s goal

A

identify where sciatic nerve bifucates

56
Q

lateral popliteal needle insertion

A

between biceps femoris and vastus lateralis

8cm cephalad of politeal crease in intertendinous groove

57
Q

why is u/s nice for politeal block

A

u/s guidance reduces volume of block

58
Q

which blocks have longest onset and duration of peripheral blocks

A

sciatic nerve block due to largest nerve

59
Q

SPEDI block

A

combo block to cover entire leg except upper medial thigh

60
Q

what does SPEDI block

A

sciatic and saphenous with 1 penetration and 2 injection

61
Q

fastest was to anesthetize a leg

A

SPEDI block

62
Q

SPEDI advantages

A

1 needle stick
faster (1.8 min to full anesthesia)

63
Q

SPEDI disadvantages

A

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

Fa: Anatomy 2 (16 decks)

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