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Lower Extremity Nerve Blocks Flashcards

0
Q

Regional anesthesia can be useful for patient who have had a history _______ after GA?

A

Nausea and vomiting

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1
Q

Admin benzo’s before regional anesthesia can take care what 2 things regarding the patient?

A
  • anxiety

- seizures (that could possibly occur from LA toxicity)

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2
Q

When administering regional anesthesia to a patient who has pre-existing neurological deficits, what must you make sure to do?

A
  • informed consent

- document very well what the pre-op deficit is

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3
Q

What are the classes of local anesthetics?

A
  • esters (one i esters)

- amides (two i amides)

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4
Q

Which LA has the greater potential for producing and allergic reaction?

A

Esters

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5
Q

LA toxicity depends on 4 factors?

A
  • site of injection
  • total dose
  • anesthetic used
  • use of epi
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6
Q

In what order of structure will cause maximum to minimum absorption of LA?

A
  • intercostals, caudal, epidural, brachial plexus, sciatic, lumbar plexus and femoral
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7
Q

4 ways you can locate a nerve?

A
  • anatomic relationships
  • paresthesias
  • nerve stimulator technique
  • ultrasound
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8
Q

The sciatic nerve block, blocks which nerves?

A
  • L4- S3
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9
Q

Sciatic nerve block provides anesthesia to what aspect of the leg?

A
  • the foot, lower extremity distal to the knee and posterior leg
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10
Q

For the sciatic nerve block a line is drawn from what anatomical structure to what anatomical structure?

A
  • the greater trochanter to the posterior superior iliac spine
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11
Q

For the sciatic nerve block a 2nd line is drawn from what anatomical structure to what anatomical structure?

A
  • the greater trochanter to the sacral hiatus
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12
Q

For the sciatic nerve block, after drawing the 2 lines, where is the needle inserted?

A
  • where the latter line intersects the perpendicular line
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13
Q

Dorsiflexion or eversion of the foot indicates stimulation of which nerve?

A
  • common peroneal
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14
Q

Plantar flexion of the foot and toes indicates stimulation of which nerve?

A
  • tibial nerve
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15
Q

How much volume of LA do you inject into sciatic nerve

A
  • 20 to 30ml
16
Q

A femoral nerve block provides anesthesia to what aspect of the leg?

A
  • anterior portion of the thigh, knee and small part of medial foot
17
Q

A femoral nerve block results in the inability to…

A
  • abduct leg or extend the lower leg
18
Q

Placement of the needle for a femoral nerve block is?

A
  • lateral to the femoral artery and inferior to the inguinal ligament
  • needle inserted perpendicular to the skin, then advanced cephalad
19
Q

Volume of LA injected for e femoral nerve block?

A
  • 25 - 35ml
20
Q

A popliteal nerve block is indicated for what kind of surgery?

A
  • foot and ankle surgery
21
Q

Major landmarks for the popliteal nerve block:

A
  • popliteal fossa crease
  • bicep femoris tendon
  • semitendinosus and semimembranosus
22
Q

In the popliteal nerve block, the needle is inserted approx how many centimeters above the popliteal crease?

A
  • 7cm
23
Q

Ankle blocks are indicated for what kind of surgeries?

A
  • below the ankle procedures
24
Q

How much volume do you inject per nerve you are blocking in the ankle block?

A
  • 5 to 7ml
25
Q

What should you not use when admin an ankle nerve block?

A
  • epi mixed with the LA
26
Q

Which nerve should you block first when doing an ankle block?

A
  • tibial nerve (b/c it is the largest)
27
Q

Name the 5 nerves blocked in the ankle nerve block?

A
  • posterior tibial nerve
  • superficial peroneal nerve
  • deep peroneal nerve
  • saphenous nerve
  • sural nerve
28
Q

When admin LA to block the deep peroneal nerve, what is your anatomical landmark?

A
  • hallucis longus tendon (upon contact with the bone withdraw the needle slightly, aspirate and admin medication)
29
Q

To block the posterior tibial nerve in an ankle nerve block, whar are your anatomical landmarks?

A
  • posterior tip of the medial malleolus

- posterior to the tibial artery

30
Q

What is the gold standard use of equipment for placement of nerve blocks?

A
  • ultrasound

Flashcards (5 decks)

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