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APA 3 - Wolfe > Lower Ext - Dr. Moritz > Flashcards

Lower Ext - Dr. Moritz Flashcards

1
Q

Effect of LA on nerves

A

Pain (1st) -> Temperature -> Touch -> Proprioception

Everything we’ve learned is temp 1st than pain..

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2
Q

A popliteal block is essentially what type of block?

A

tibial nerve block

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3
Q

What does the tibial nerve innervate?

A

posterior leg and sole of foot

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4
Q

What type of surgeries is a popliteal nerve used for?

A

“ Great for rear foot case”

Achilles tendon work
Gastrocnemius recession
Clubfoot releases
Post operative pain mgmt.

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5
Q

Anatomy of popliteal block

A

Diamond shaped popliteal fossa

Medial & lateral heads of gractroc

Superiomedially by semitendinosus and semimembranosus

Found 0.5-1cm lateral to popliteal fossa

1.5-2 cm deep in skin

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6
Q

When doing a popliteal block where do you place the intradermal wheal?

A

5-7 cm proximal to crease

0.5-1 cm lateral to midline

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7
Q

How do you know that you are in the correct location during a popliteal block?

A

Plantarflexion of foot

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8
Q

What are the 2 deep and 3 superficial nerves at the ankle

A

2 Deep

  • Posterior tibial
  • Deep perineal

3 Superficial

  • Superficial peroneal
  • Sural
  • Saphenous
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9
Q

What are the 4 terminal nerves of the sciatic nerve

A

Posterior tibial
Deep peroneal
Superficial peroneal
Sural

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10
Q

What is the terminal cutaneous branch of the femoral nerve

A

Saphenous

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11
Q

What is cutaneous innervation of posterior tibial nerve

A

medial posterior heel and plantar foot

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12
Q

Anatomy of posterior tibial nerve

A

7.5 cm proximal to medial malleolus tip and parallel to medial border achilles

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13
Q

The posterior tibial nerve branches into…

A

medial and lateral planter nerves and calcaneal nerves

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14
Q

T/F: saphenous is the only branch to innervate the foot that is not a brach of the sciatic nerve

A

TRUE

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15
Q

Anatomy of saphenous

A

anterior to medial malleolus

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16
Q

Where does the spaphenous nerve terminate

A

1st MTPJ

17
Q

Cutaneous innervation of deep peroneal

A

cutaneous innervation to the 1st dorsal interspace

18
Q

Anatomy of deep peroneal

A

2.5 cm proximal to the ankle joint the nerve lies between Extensor hallucis longus and the Extensor digitorum longus

19
Q

The deep peroneal nerve is lateral to what pulse?

A

dorsalis pedis pulse

20
Q

Cutaneous innervation of superficial peroneal

A

lower anterior leg and dorsal of foot

21
Q

Superficial peroneal branches into what nerves

A

medial and intermediate dorsal cutaneous nerves

22
Q

Anatomy of superficial peroneal?

A

Divide to branches 6.5 cm proximal to the ankle joint

Usually able to visualize the intermediate dorsal cutaneous n. directly (“guitar string”)

23
Q

Cutaneous innervation of sural nerve

A

lateral lower leg and lateral foot

24
Q

Anatomy of sural nerve

A

Courses the lateral tendo-achilles and runs antero-lateral to the small saphenous v.

1.5cm distal to the lateral malleolus

25
Q

Sural nerve provides innervation to which branches?

A

lateral calcaneal branches

26
Q

What is a mayo block used for?

A

commonly used for 1st MTPJ surgery

27
Q

What is an advantage for the mayo block

A

preserves distal surgical tissue planes

28
Q

What are the 4 nerves blocked in a mayo block?

A

Saphenous
Deep peroneal
Medial planter
Medial dorsal cutaneous

29
Q

Anatomy of mayo block

A

1st Interspace

Medial to 1st Metatarsal

Directly plantar to 1st metatarsal

Superficial plantar to 1st Metatarsal

30
Q

Benefits of digital blocks

A

useful for office and surgical setting

provides anesthesia to only the digit being blocked

31
Q

Digital blocks are a __ point block

A

2 point

32
Q

Digital block anatomy

A

2 dorsal digital nerves

2 plantar digital nerves

33
Q

How many sticks for a digital block

A

3

34
Q

What causes pain with nerve blocks?

A

Change in the pH of LA that we use that causes pain (not form the needle)

go at slow rate so pH change is slow

35
Q

what should you never use in a digit block

A

epi

APA 3 - Wolfe (11 decks)

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