Cervical and brachial plexus Flashcards
what nerves makeuo the cervical plexus
C1-C5
where is the phrenic nerve situated
C3-C5
C4 - 70%
what nerves make up the Brachial plexus
C5-T1
Label
interscalene is for what sx
Shoulder
major complications with Supra and Infraclavicualr
Pneumothorax
what block is most frequently used for lower arm / hand
Axillary
Brachial Pleaxus:
what are all the divsions
Roots
trunks
Divisions
Cords
Branches (terminal)
Randy Travis Drinks Cold Beer
label the divisions and all else blank
another picture
name the roots
C4
C5
C6
C7
C8
T1
Name the trunks
Superior
Middle
Inferior
name the divisions
3 ventral
3 dorsal
Name the cords
Lateral
medial
Posterior
name the branches (terminal)
rememebr MARMU
Musculocutaneous
Axillary
Radial
Median
Ulnar
picture of all that
(notice the Dorsal divisions all sit on the posterior cords)
another picture
Label
lable this
Ultrasound:
what is the greatest advantage of US guided regional anesthestic
ability to see where the tip of the needle is in relation to anatomical structures
and see the spread of LA
Ultrasound:
can allow the provider to use less what
LA
Ultrasound:
can (increase or decrease) complications?
decrease
Ultrasound:
what freq penetrate deeper? Low or high
Low
(like a long distance runner slow and goes further)
Ultrasound:
what type of freq US probes are good for visualizing shallow lying structures less than 4 cm from the skin
High
Ultrasound:
what is the freq of high freq US probes
10-13 mHz
Ultrasound:
what freq US prob is good for visualizig deep structures
Low
Ultrasound:
what is the freq of Low freq US probes
2-5 MHz
Ultrasound:
if sound passess through it’s called ______ and appears ______ on US machine? give ex of a structure
Anechoic (no echo)
appears black
liquid (LA)
Ultrasound:
if sound is almost entirely reflected it’s called ______ and appears ______ on US machine? give ex of a structure
Hyperechoic
bright white
Bone
Ultrasound:
if sound is modestly reflectly it’s called ______ and appears ______ on US machine?
Hypoechoic
gray
Ultrasound:
how do you differentiate an artery from a vein
Atreries pulsate and are NOT compressible
Veins are compressible
Ultrasound:
what approach affords full visualization of needle tip and shaft?
In-plane
Ultrasound:
what approach shows only the tip of the needle, no visualization of needle en route
out of plane
Label
Pronated Dermatomes
- C8
- C7
- C6
- C5
- T1
- C8
LABEL
SUPINATED DERMATOMES
- C7
- C6
- C5
- T1
- C8
label the nerve in the UE pronated
A) median
B) Ulnar
C) Radial
D) median antebrachial cutaneous
E) Musculocutaneous
F) axillary
G) Supraclavicular
H) Intercostobrachial
Label the nerve in the UE Supinated
A) median
B) Ulnar
C) Radial
D) median antebrachial cutaneous
E) Musculocutaneous
F) axillary
G) Supraclavicular
H) Intercostobrachial
what nerve
Median
what nerve
ulnar
what nerve
radial
Characteristics of movement of fingers, wrist, and elbow in response to stimulation:
What uis unique about the radial nerve
only one with extension
Causes extension of elbow
which nerve causes this with stimulation:
Supination of forearm
Radial
which nerve causes this with stimulation:
pronation of forearm
Median
which nerve causes this with stimulation:
flexion of wrist
ulnar
and
median
which nerve causes this with stimulation:
flexion of elbow
musculocutaneous
which nerve causes this with stimulation:
extension of wrist and fingers
radial
Again only one that causes extension
what type of block is a good adjunct to shoulder surgery (not interscalene)
Cervical plexus block
just a fact to remember.
Both cervical plexus and intercostal blocks have multiple injection sites or levels
what is a complication of cervical plexus block
Horner’s syndrome
S/S of horner’s sysndrome
ipsilateral ptosis
miosis
facial and arm flushing
anhydrosis
nasal congestion
cervical plexus block:
inject __ to __ mLs of LA per level you wish to block
3-5 mL
Remember 4 mL (C1-C4)
Cervical plexus only consist of C1-C4
