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Anatomy II > Hip and Lower Extremity Overview > Flashcards

Hip and Lower Extremity Overview Flashcards

1
Q

What are the 4 major nerves of the leg?

A

Femoral
Lateral femoral cutaneous
Obturator
Sciatic

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2
Q

Femoral nerve innervates what?

A

Anterior thigh and knee
(the medial lower leg through the saphenous nerve branch of the femoral nerve)

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3
Q

Sciatic nerve innervates what

A

Posterior thigh
Posterior knee
Everything below the knee execpt the medial portion (covered by the saphenous branch)

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4
Q

Sciatic branches into 4 nerves

A
  1. Deep peroneal
  2. Superficial peroneal
  3. Tibial
  4. Sural
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5
Q

What is the largest branch of the lumbar plexus?

A

Femoral nerve

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6
Q

Is the femoral nerve motor or sensory?

A

Both

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7
Q

Is the saphenous branch of the femoral nerve motor or sensory?

A

Sensory

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8
Q

What is the longest spinal nerve in the body?

A

Sciatic

Also provides motor innervation to the leg

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9
Q

Obturator nerve

A

Covers the upper medial portion of the thigh

Anterior branches can also innervate the hip and knee joints

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10
Q

Lateral Femoral Cutaneous Nerve

A

Hip and upper lateral portion of the thigh

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11
Q

Innervation of the foot

A

Sciatic Nerve

Common Peroneal Nerve
Superficial and Deep Peroneal

Tibial Nerve
Posterior Tibia
Sural

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12
Q

Femoral and Fascia Iliaca Block tries to cover what?

3 things

A
  1. Femoral and saphenous (reliably blocked)
  2. Lateral femoral cutaneous (L2-L3) [reliably blocked]
  3. Obturator (L2-L4) [not reliable]

Blocks everything but sciatic innervaiotn

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13
Q

Femoral Nerve block

A
  • Uses smaller amount of local (~20mL) around the femoral nerve
  • Infrequently blocks obturator
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14
Q

FICB (Fascia Iliaca Compartment Block)

A
  • More lateral than the femoral block
  • Larger volume of LA (~40mL)
  • More success at blocking obturator
  • Further away from the artery than the femoral block
  • Better at blocking the lateral femoral cutaneous nerve, good for hip and femoral neck fractures
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15
Q

Good and Bad for the Femoral Block and FICB?

A

Good:
Great coverage for the knee
Bad:
Also blocks motor function so patients can not ambulate

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16
Q

Saphenous Nerve Block

A
  • Can be blocked at the groin level by the femoral and FICB
  • Can also be blocked more distal mid-thigh (at this lvl it is also called an adductor canal block)
17
Q

Spahenous Nerve Block Advantage

A

Preserves all motor function

18
Q

Spahenous Nerve Block Disadvantage

A

Only blocks the medial aspect of the knee and lower leg/foot

19
Q

Obturator Nerve Block Indications

A

Cysto: TURBT

Prevent movement if patient not paralyzed

20
Q

Does spinal anesthesia reliably block the oburator nerve reflex?

A

NO

21
Q

Sciatic Nerve Block: Transgluteal

A

Sedation is needed due to patient discomfort (pain and butt exposure)

High block that is able to cover the:
Posterior thigh and knee
Part of the hip
Everything below the knee execpt the medial portion (covered by the saphenous branch)

22
Q

Sciatic Nerve Block: Popliteal

A
  • When the block is in the popliteal fossa it anesthetizes everything in the lower leg except for the medial aspect.
  • Does not block the knee or posterior thigh
  • Most common block for sciatic nerve blockade
23
Q

Sciatic popliteal fossa anatomy

A

Sciatic nerve branches into the medial (tibial nerve) and lateral (common peroneal nerve)

24
Q

The popliteal block is indicated for what surgeries?

A

Ankle

25
Q

How is complete anesthesia of the leg achieved?

A

Combinaiton block:
Sciatic + fermoral or FICB

26
Q

IPACK Block?

A

Infiltration Between the Popliteal Artery and Capsule of the Posterior Knee Block

27
Q

IPACK advantages

A

Sensory not Motor blockade of the posterier knee

Sciatic blocks motor and sensory of posterior knee

28
Q

IPACK disadvantage

A

Only blocks posterior knee, need to combine with another block for complete coverage of the knee

29
Q

Block of Choice: Hip

A

Fascia Iliaca

30
Q

Block of Choice: Anterior Thigh

A

Fasica Iliaca or Femoral

31
Q

Block of Choice: Knee

A
  • Fascia Iliaca or Femoral (motor block)
  • Saphenous (motor sparring)
  • +/- IPACK (motor sparring)
32
Q

Block of Choice: Tibia

A

Popliteal

33
Q

Block of Choice: Ankle

A

Popliteal
+/- Saphenous

34
Q

Block of Choice: Foot

A

Ankle or Popliteal

Anatomy II (10 decks)

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