lower extremity part 2

Question 1

patient position for infraclavicular block

Answer 1

supine with the arm to be blocked abducted to a 90 degree angle.

Question 2

if pain prevents the patient from abducting the arm for infraclavicular block what must be done

Answer 2

adjustments can be made with skin markings.

Question 3

what two situations should ainfraclavicular block be avoided

Answer 3

ipsilateral catheter

ipsilateral pacemaker

Question 4

does the infraclavicular approach produce phrenic nerve paralysis

Answer 4

no

Question 5

the infraclavicular block does not anesthetize what areas on the arm

Answer 5

upper arm and should are not anesthetized

Question 6

is the musculocutaneous blocked in infraclavicular block

Answer 6

yes

Question 7

patient position infraclavicular block

Answer 7

patient supine, head slightly turned to contralateral side.

Question 8

infraclavicular block what do we identify

Answer 8

coracoid process 2cm medial and 2cm caudal.

Question 9

what length needle do we use for infraclavicular nerve block

Answer 9

8cm

Question 10

what muscle response are we looking for in a infraclavicular block

Answer 10

finger flexion or extension at a current of 0.5ma

Question 11

how much local anesthetic is injected into the infraclavicular block

Answer 11

20-30ml of la

Question 12

when is the axillary nerve block

Answer 12

when forearm and hand surgeries are done

Question 13

what position should the arm be in for axillary block

Answer 13

abducted at 90 degree

Question 14

what nerves are usually missed when doing an axillary lock

Answer 14

muscultaneous medial ulnar

Question 15

axillary block contraindications

Answer 15

neuropathy
Lymphangitis
Caution with bleeding disorders
Hematoma due to puncture of artery
IE-masectomies.

Question 16

do you need to elicit paresthesia when doing an axillary block

Answer 16

no

Question 17

name two advantages of axillary blocks

Answer 17

Less risk of major complications

Suitable for ER and outpatient use

Question 18

in relation to the axillary artery- the median nerve is located

Answer 18

anterior

Question 19

in relation to the axillary artery- the ulnar nerve is located

Answer 19

posterior

Question 20

in relation to the axillary artery- the radial nerve is located

Answer 20

Radial nerve - posterior and somewhat lateral

Question 21

to perform an axillary block

Answer 21

arm abducted 90 degrees
us probe on brachial plexus
needle inserted lateral to the transducer
need pointed medial and inferior
la injected fan like around radial median and ulnar nerve

must separately block the musculocutaneous nerve

Question 22

how much total la used for axillary

Answer 22

20-30

Question 23

musculocutaneous block - when is this added on

Answer 23

commonly included when performing an axillary block to anesthetize the forearm and wrist.

Question 24

after the axillary block- the needle is redirected which direction from the artery and piercing what muscle

Answer 24

superior and proximal to the artery piercing the coracobrachialis.

Question 25

how much local anesthetic is needed for the musculocutaneous block

Answer 25

5-10ml

Question 26

distal nerves are the distal continuation of what two nerves

Answer 26

medial and ulnar

Question 27

solutions for digital blocks should NEVER contain

Answer 27

EPI

Question 28

what is the maximum volume for each digital side nerve block

Answer 28

2ml

Question 29

*caution with tourniquets (if used for surgical procedure):
what 2 dz especially
whats the time limit
avoid what

Answer 29

Pts with Raynaud’s disease
15 minute limit
Do not use if patient has peripheral vascular disease
Avoid rubber bands etc.. Use actual tourniquet for arm