Mod 5: Hallux Digital blocks, Lesser digital blocks, and LA infiltration Flashcards
How many nerves is each digit supplied by?
Four. 2 dorsal, 2 plantar running on the medial and lateral aspects of the digit
Sensation to the dorsal aspect of the Hallux is provided by?
Medial:Medial dorsal digital nerve from medial cutaneous nerve of Superficial Peroneal.
Lateral:Lateral dorsal digital nerve from medial terminal branch of Deep Peroneal.
Sensation to the plantar aspect of the Hallux is provided by?
Medial:1st proper planter digital nerve of Medial Plantar nerve.
Lateral: Terminal branch of 1st common digital nerve from Medial Plantar Nerve.
At the level of the proximal phalanx base, the dorsal digital arteries,veins, and nerves are larger or smaller than their plantar counterparts?
Smaller.
What is the usual volume of LA required for Hallux block?
3-5ml of 1% Xylocaine per Hallux
What is the the dose required for Hallux block?
30-50mg of Xylocaine per Hallux
What are the most suitable syringes for Hallux block?
1 x 5cc or 2 x 3cc
What is the most suitable needle for Hallux block?
25-30 gauge 1 and half inch needle
What is the most suitable needle for drawing up LA solution?
18-21 gauge needle 1 inch
There are 2 techniques to block digits, these are?
2 point Hallux ring block
2 point Hallux block
When documenting the Injection it is important to state what?
- Injection site and technique (block type)
- Quantity, %, type of drug administered
- Effectiveness of block achieved
- Lack of presenting adverse reactions
- Signature.
LA infiltration is not a block of a specific nerve but rather….
…a block of a specific infiltrated area independent of nerve sensory dermatomes and neurotomes.
When is LA infiltration useful?
- Anesthetizing areas difficult to block by regional or specific nerve block.
- For procedures limited to well defined area of the skin or subcutaneous tissue
Name the 2 typre of infiltration.
Deep Infitration (sub q tissues) Superficial Infiltration (dermal tissues)
What are the characteristics of Deep Infiltration (Sub q)?
- May/may not produce wheal
- Can be used for Punch, Incisional, and Excisional biopsies
- Less painful than dermal infiltration
- May take up to 10 mins to work