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LA Sx Exam 1 RUSVM > Diagnostic Nerve Blocks > Flashcards

Diagnostic Nerve Blocks Flashcards

1
Q

Why is local anesthesia used in horses?

A

To localize lameness

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2
Q

Where should you begin when doing nerve blocks?

A

Begin distally and work proximally (especially w/ perineural block)

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3
Q

Which direction should your needle be directed when doing locoregional blocks?

A

Distally- avoids injecting limb proximally and anesthesia diffusing up limb

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4
Q

Why should you avoid sedating a horse when using nerve block diagnosis?

A

This can change the gait and you need a baseline before blocking
Horses may have a more violent reaction to needles when mildly sedated (you may be at greater risk)

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5
Q

At what grades should you avoid using LA for lameness evaluation?

A

Grade I and IV

If the horse is too lame you risk catastrophic failure- never a reason to block

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6
Q

What are agents used in local anesthesia?

A

2% lidocaine
2% Mepivacaine (most common)
0.5% Bupivacaine

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7
Q

How long does mepivacaine last?

A

30 minutes-2 hrs. with a rapid onset

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8
Q

How long does Bupivacaine last?

A

5-6 hrs. –. NOT USED for DX!

This is used for shoeing manipulations/therapeutic effect

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9
Q

What are the four methods of LA nerve block?

A

Regional
Direct infiltration of site
Intraarticular
Perineural

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10
Q

What is the most common nerve block LA?

A

Perineural

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11
Q

T/F: Presence of skin sensation does NOT mean failure of block at nerve body

A

TRUE

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12
Q

Where do you inject your LA for a palmar digital block?

A

Right above collateral cartilage over palpable neurovascular bundle (palmar digital VAN)

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13
Q

What position should the leg be in when giving a palmar digital block?

A

Hold limb up- should be non-weight bearing

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14
Q

What are the anesthetized structures associated with palmar digital nerve block?

A 
Entire sole
Navicular apparatus
ST of heel
Coffin joint
Digital portion of DDFT
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15
Q

What are some reasons of failure of palmar digital nerve block?

A

Adhesion between navicular bone and DDFT
OA of coffin bone
Accessory nerve supply from dorsal digital branches

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16
Q

What are the structures anesthetized in the abaxial/basi-sesamoid block?

A 
Entire foot + P2
Distopalmar P1
Proximal & Distal Interphalangeal joints
Distal SDFT & DDFT
Distal sesamoidean ligament
Digital annular ligament
17
Q

What nerves does a low & high 4-point block anesthetize?

A

Lat/Med palmar & Lat/Med palmar metacarpal nerves

18
Q

Where are your landmarks for the lateral/medial palmar metacarpal nerve block?

A

Between palmar MCIII and MCII and IV

Stay at distal aspect of splint bone- more associated with cannon bone

19
Q

What are the landmarks for the L/M Palmar nerve block?

A

Between SL and DDFT

20
Q

Why should the low 4-point block be a sterile prep?

A

Due to increased risk for DDFT sheath

21
Q

What are the anesthetized structures in a low 4-point block?

A

Everything from fetlock distally

22
Q

What nerve block anesthetizes the origin of the suspensory ligament?

A

Lateral palmar nerve block

23
Q

Where should the lateral palmar nerve block be given?

A

Mediolateral direction on the distal 1/3 of groove along medial aspect of accessory carpal bone
May have resistance due to extra fascia here

24
Q

What structures are anesthetized with a high 4-point block?

A

Suspensory ligament
Flexor tendons
MCIII, MCIV

25
Q

What doe radiographs show when trying to localize lameness?

A

Identifies osseous abnormalities

26
Q

How many views should always be done at the minimum?

A

4 views
2 obliques
1 lateral
1 DP

27
Q

What is the only modality that provides real time evaluation of both ST and some bone?

A

US

Excellent for stifles

28
Q

What is needed when ultrasounding superficial structures?

A

Stand-off pad

29
Q

When is a nuclear scintigraphy indicated?

A

Lameness site cannot be determined (grad 1/intermittent lameness)

30
Q

What is the pharmaceutical compound used in bone scans?

A

Technetium-99

31
Q

What is the modality of choice when imaging bone-especially skull?

A

CT

32
Q

What is the modality of choice when imaging soft tissue not accessible with US?

A

MRI

LA Sx Exam 1 RUSVM (14 decks)

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