LE blockade (Part 1)

Question 1

the LS plexus is created by the nerve roots of

lumbosacral plexus

Answer 1

L4-L5 and S1-S3

Question 2

primarily forms the sciatic nerve

Answer 2

the LS plexus

Question 3

The lumbar plexus specifically is formed by the ____________ of ____________

Answer 3

the ventral rami of L1-4,

Question 4

the lumbar plexus is occasionally formed by distribution from

Answer 4

T12

Question 5

the sacral plexus arises from (2)

Answer 5

L4-5 and S1-4.

Question 6

which 3 major nerves from the lumbar plexus contribute to the lower limb

Answer 6

Femoral and Obturator: L2 – L4
Lateral femoral cutaneous: L2-3

Question 7

femoral and obturator nerve location

Answer 7

L2-L4

Question 8

lateral femoral cutaneous nerve lovation

Answer 8

L2-L3

Question 9

the LS plexus provides motor and sensory innervation to …

Answer 9

the anterior portion of the thigh

Question 10

the LS plexus provides sensory innervation to

Answer 10

the medial leg

Question 11

the sacral plexus arises from

Answer 11

L4 to L5 and S1 to S4

Question 12

the sciatic nerve innervates the ____________ thigh and most of ____________

Answer 12

innervates the posterior thigh and most of the leg and foot

Question 13

the sciatic nerve divides to become

Answer 13

the tibial and common peroneal nerves

Question 14

S1-S3 form the …

Answer 14

posterior femoral cutaneous nerve

Question 15

the femoral cutaneous nerve provides sensory innervation to ____________

Answer 15

posterior thigh

Question 16

femoral nerve block innervation

Answer 16

main hip flexors and extensors (motor) and most of sensory of hip, front of thigh, knee, medial foot (saphenous nerve branch)

Question 17

joints affected by femoral nerve block

Answer 17

hip, knee, ankle (medial)

Question 18

femoral nerve block provides post-op analgesia for

Answer 18

hip, thigh, knee, and ankle

Question 19

Provides sole motor innervation to quads

Answer 19

femoral nerve

Question 20

knee buckling with weight bearing is a sign of

Answer 20

femoral nerve block

Question 21

T/F a femoral nerve block alone is sufficient for surgical anesthesia

Answer 21

false

Question 22

femoral nerve block ultrasound approach

Answer 22

High-frequency linear US placed transversely over femoral crease; set depth to 2-4 cm

Question 23

femoral nerve block landmarks on ultrasound

Answer 23

Identification of femoral artery and vein deep to fascia iliaca (NAVEL) but anterior to the iliopsoas muscle

Question 24

femoral nerve is ____________ to the artery

Answer 24

lateral

Question 25

how does the femoral nerve appear on ultrasound

Answer 25

spindle-shaped honeycomb

Question 26

femoral nerve block needle

Answer 26

Needle 50-100 mm, 22 g, short bevel, insulated stimulating needle inserted in-plane in lateral to medial orientation

Question 27

femoral nerve block goal

Answer 27

place needle tip adjacent to the lateral aspect of the femoral nerve

Question 28

with a femoral nerve block you should hold the needle….then advance….

Answer 28

hold the needle perpendicular, then advance gently with the PNS set to 1.0 mA, and then lowered to <0.5 mA once twitch is elicited.

Question 29

the 1st pop you feel with a femoral nerve block is

Answer 29

the fascia lata

Question 30

the second pop you feel with a femoral nerve block sis

Answer 30

the fascia iliaca

Question 31

stop advancing the nerve with a a femoral nerve block when

Answer 31

Stop when stimulation elicits the hallmark “patellar snap” (motor response of quadriceps muscle group)

Question 32

femoral nerve block local anesthetic amount

Answer 32

20-30 mL of local anesthetic

never inject again, high resistance

Question 33

continuous femoral nerve block works well for…

Answer 33

OR and postoperative analgesia

Question 34

how is needle inserted for continuous femoral nerve block

Answer 34

Needle inserted in-plane 2cm lateral to pulse

Question 35

goal of femoral nerve block

Answer 35

to place catheter in vicinity of femoral nerve deep to fascia iliaca

Question 36

which local anesthetic is used for continuous femoral nerve block

Answer 36

Ropivicaine 0.2% 20 ml initial bolus then 5 ml/hr with 5 ml/h patient-controlled bolus