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Regional > Military Upper Ext and other Stuff > Flashcards

Military Upper Ext and other Stuff Flashcards

1
Q
A
  1. Roots
  2. Trunks
  3. Divisions
    4 Cords
    5 Superior
    6 Middle
    7 Inferior
    8 Lateral
    9 Posterior
    10 Medial
    11 Axillary
    12 Radial
    13 Medial
    14 Ulnar
    15 Musculocutaneous
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2
Q
A
  1. C6
  2. C7
  3. C5
  4. C8
  5. T1
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3
Q
A
  1. C8
  2. C7
  3. C6
  4. C5
  5. T1
  6. C8
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4
Q

Cervical plexus block are from what cervical nerves

A

C1-C4

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5
Q

Interscalene blocks consist of what cervical nerves

A

C5-T1

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6
Q

The intrescalene block is preformed at what level

A

C6 verterbral body

aka

Chassaignac’s Tubercle

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7
Q

If C3 and C4 become blocked while doing an interscalene block what will your patient present with

A

Horner syndrome and hoarseness

Horner syndrome:

miosis

Anhydrosis

Pitosis

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8
Q

Interscalene blocks always result in ________ because of the close proximity of the _______ to C3-C5?

A

Hemidiaphram paresis

phrenic nerve

Page 25 Military book

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9
Q

Resp contraindication of intrascalene block would be

A

Any one unable to tolerate a reduction in pulmonary function of greater than 30 %

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10
Q

What part of the bracheal plexus is involved in the interscalene blocks? Root, Trunk, cords, Divisions or Terminial branches

A

ROOT

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11
Q

For an interscalene block how much Local is sufficient for the block

A

30-40 ml

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12
Q

What surgery might the interscalene block not be useful for??

A

Hand and forearm specifically in the ulnar distribution becasue of its C8 and T1 origin. The local dosen’t spread that far caudal usually.

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13
Q

Suprascapular Blocks what part of the Bracheal plexus

A

The Trunks:

superior

middle

Inferior

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14
Q

At what level is it most likely to block ALL of the bracheal plexus?

CORDS

DIVISIONS

TRUNKS

ROOTS

???????

A

The Trunks because in this area the brachial plexus form 3 compact nerves in very close proximity to eachother.

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15
Q

What nerves form the Superior trunk

A

Cervical nerve 5 and 6

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16
Q

What nerves form the middle trunk

A

C7

17
Q

What nerves form the inferior trunk

A

C 8 and T1 nerve roots

18
Q

With the supraclavicular block what is the most frequent complication?

A

Pneumothorax

19
Q

What resp complication can the supraclavicular block have on the resp system besides a pneumo??

A

50% get a diaphramatic hemiparesis with minimal reduction in FRC

20
Q

How much Local is used in the supraclavicular block

A

30-40 ml

21
Q

Infraclavicular blocks involve what part of the brachial plexus?

ROOT

TERMINAL BRANCHES

CORDS

TRUNKS

DIVISIONS

A

CORDS

22
Q

Does the infraclavicular block produce respiratory depression

A

NO

23
Q

Using a twitch monitor which muscle is aceptable for appropriate postioning of the needle in a supraclavicular block??

A

extension or flexion of the digits

ulnar or median nerve

24
Q

Using a twitch monitor which muscle is aceptable for appropriate postioning of the needle in a infraclavicular block??

A

Finger and or thumb stimulation

25
Q

What is the most distal block preformed on the brachial plexus

A

The Axillary Block

26
Q

Advantages of the Axillary block

A

Can access the artery to hold pressure should a puncture happen, very little risk of resp issues related to the phrenic nerve or pneumothorax

27
Q

What are the terminal nerve branches of the brachial plexus

A

Axillary

musculocutaneous

radial

median

ulnar

28
Q

What nerve must be blocked separately if an axillary block is used

A

Muscuocutaneous

29
Q

Axillary blocks are use for what types of surgeries

A

Hand and forearm

30
Q

Supra and infra clavicualr blocks are used for blocks are use for what types of surgeries

A

elbow and uper arm surgery

31
Q

Positioning is key for an axillary block. Inability to do what would prohibit the use of this block

A

abduct the arm more than 45 degrees at the shoulder

32
Q

what must you have for a beir block

A

IV distal to the cuff

33
Q

This block is typically used for less then ____ minutes

A

60 min

34
Q

How high is the tourniquet pumped up to??

A

250 mm/Hg or 100 mm/Hg above the SBP

35
Q

In the double Lumen cuff which cuff is inflated first the proximal or distal?

A

Proximal because after 60 min tourniquet pain usually begins and the arm is numb under the distal cuff before you have to inflate it, reducing tourniquet pain.

36
Q

Amount of Local used for an upper ext beir block is??

A

30 - 50ml of 0.5% Lidocaine or about 3ml/kg

Regional (24 decks)

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