Equine Neve Blocks

Question 1

Palmar/Plantar digital nerve block
- landmarks
- nerves blocked
- volume and needle
- what it does

Answer 1

1. Distal aspect of the pastern above the collateral cartilage
2. Medial and lateral palmar/plantar just dorsal to DDF
3. Feel the vein-artery-nerve bundle-inject slightly medial to the bundle
4. Inject 2-3 ml subcutaneously using a 25 Ga or 23 Ga
5. Desensitize the caudal part of the foot and sole
6. The dorsal aspect should still be sensitive
7. Limb non-weight bearing, needle directed towards the bulb of the heel

Question 2

Abaxial or Basi Sesamoid nerve block
- landmarks
- volume and needle
- what it does
- avoid what structure

Answer 2

1. Abaxially and distal to the medial and lateral proximal sesamoid bones
2. Feel the vein-artery-nerve bundle-inject slightly medial to the bundle
3. 2-3 ml subcutaneously using a 25 Ga or 23 Ga
4. Desensitize the entire foot and the pastern
5. The dorsal aspect should still be sensitive
6. Limb non-weight bearing, needle directed towards the bulb of the heel
7. Avoid the tendon sheath
8. Blocks palmar digital nerve including dorsal branch

Question 3

Four point-Low Volar Palmar/Plantar Nerve Block
- what nerves are we blocking?
- landmarks
-avoid what structure
- needle, volume
- what it does

Answer 3

Medially and laterally (2X2)
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Low Palmar/plantar nerve
A. Located between the suspensory ligament and the DDF
B. Avoid the tendon sheath
C. 23-Ga 3/4 inch or 22-Ga 1 inch
D. 4-5 ml
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Palmar/Plantar metacarpal/tarsal nerve
A. Located at the button of the splint bone
B. 25-Ga 5/8 inch or 23-Ga ¾ inch
C. Infiltrate subcutaneously
D. 2-3 ml
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1. Performed weight bearing or non-weight bearing
2. Desensitize the limb distal to the block except on the dorsal aspect of the fetlock
which is innervated by an extension of the medial cutaneous antebrachial nerve
3. Avoid the volar pouch of the fetlock joint, the tendon sheath and palmar/plantar
artery

Question 4

Four point-High Volar Palmar/Plantar Nerve Block
- where is it?
- what nerves are we blocking
- avoid what?

Answer 4

Medially and laterally (2X2)-about 4-5 cm distal to carpus/tarsus
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High palmar/plantar nerve
A. Located between the suspensory ligament and the DDF
B. 22-Ga 1 inch
C. 4-5 ml
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Palmar/plantar metacarpal/tarsal nerve
A. Behind MC/MT II and MC/MT IV
B. 25-Ga 5/8 inch or 23-Ga ¾ inch
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1. Performed weight bearing or non-weight bearing
2. Desensitize the limb distal to the block except on the dorsal aspect of the fetlock
3. Avoid the carpal canal and distal pouch of the carpo-metacarpal joint

Question 5

what nerves are blocked by the palmar-digital block?

Answer 5

palmar digital nerve (medial and lateral)