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Local Anaesthetics and Injections > Mod 6: Regional Anaesthesia > Flashcards

Mod 6: Regional Anaesthesia Flashcards

1
Q

Regional anaesthesia involves?

A

Blocking specific peripheral nerves to achieve anaethesia to large body parts using small amounts of LA.

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2
Q

Why is regional Anaesthesia and excellent option for at risk patients?

A

Does not interfere with body physiology as opposed general or spinal anaethesia.

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3
Q

Regional Anaethesia can be used to reduced amount of general anaesthetic required and to extend anagesia into post op, TRUE or FALSE?

A

TRUE.

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4
Q

What Nerve supplies the outer side of the thigh from hip to knee?

A

Lateral Femoral Cutaneous Nerve. (L2,3)

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5
Q

Which Nerve supplies the back of the Thigh?

A

Posterior Femoral Cutaneous Nerve (S1,2,3)

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6
Q

Which Nerve supplies the upper Thigh (anterior) lateral to medial?

A
  1. Subcostal (T12)
  2. Femoral branch of Genitofemoral (L1)
  3. Ilio-inguinal (L1)
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7
Q

Which Nerve supplies the front of the Thigh?

A

Femoral Nerve (L2,3,4)

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8
Q

Which Nerve supplies the inner Thigh?

A

Cutaneous branch of Obturator Nerve (L2,3)

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9
Q

Which Nerve supplies the Medial aspect of the Shin?

A

Saphenous Nerve (L3,4)

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10
Q

Which Nerve supplies the posterior aspect of the Shin, and lateral side of the foot?

A

Sural Nerve (S1)

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11
Q

Which Nerve supplies the anterior aspect of the Shin and dorsal aspect of the foot?

A

Superficial Peroneal (L4,5 S1)

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12
Q

Which Nerve supplies the upper lateral aspect of the Shin and the 1st web space?

A

Deep Peroneal Nerve (L5)

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13
Q

Which Nerve supplies the lateral aspect of the Knee?

A

Common Peroneal Nerve (L4,5,S1,2)

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14
Q

What are the Nerve supplies to sole of the foot?L

A

Medial: Medial Plantar Nerve, Saphenous N.
Lateral: Lateral Plantar Nerve, Sural Nerve
Heel: Calcaneal Nerve

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15
Q

What are the superficial nerves at the ankle joint?

A
  1. Sural (S1,2)
  2. Saphenous (L3,4)
  3. Superficial Peroneal (L4,5,S1,2)
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16
Q

What are the deep nerves of the ankle joint?

A
  1. Posterior Tibial Nerve (L4,5,S1,2,3)

2. Deep Peroneal Nerve (L5)

17
Q

Complete anaesthesia of skin, subQ tissues, joints, bone can be achieved by?

A

Ankle Block of all 5 nerves crossing the AJ.

18
Q

What volume of LA is usually required for Ankle block?

A

12-18cc’s

19
Q

Epinephrine is contraindicated in ankle block. TRUE or FALSE?

A

TRUE, epinephrine can effect the integrity of the blood supply to the foot.

20
Q

Describe Posterior Tibial Nerve Location.

A

PT Nerve lies in the tarsal space between the medial malleoli and the Achilles tendon, just posterior to PT artery.

21
Q

What is the injection point of PT Nerve?

A

2cm proximal to mid point of medial malleoli, approx half way between malleoli and achilles tendon.
1.5-2cm deep.

22
Q

What Volume of LA is required for PT nerve block?

A

1cc wheal in anticipation of injection

5cc’s of LA at injection site.

23
Q

What could be the possible causes of PT n block failure?

A
  1. Injection into wrong tissue layer (too superficial)

2. Injection distal to early trifurcation.

24
Q

Describe Sural n Location.

A

Sural n. passes posterior to lateral malleoli posterior and deep to peroneal tendons

25
Q

What is injection point of Sural nerve?

A

1cm posterior and 2cm proximal to lateral malleoli, passing posteriorly to border of achilles tendon

26
Q

What volume of LA is required for Sural nerve block?

A

1cc wheal at anticipated injection site

2-3cc’s in infiltration area 1cm posterior and 2cm proximal to medial mall.

27
Q

Describe Deep Peroneal Nerve location.

A

DP n. lies on the interossius membrane between Tib Ant tendon and long extensor tendons, lateral to anterior Tibial artery.

28
Q

What is injection point of DP n?

A

Above superior extensor retinaculum, between Tib ant and extensor tendons lateral to anterior Tibial artery. Needle is inserted as far as Tibia and withdrawn slightly

29
Q

What volume of LA is required for DP n block?

A

1cc wheal at anticipated injection site

2-3cc’s all the way down to the Tibia

30
Q

Describe the location of the Saphenous n.

A

Saphenous n. lies between the medial aspect of the tibial tuberosity to the medial condyle of Tibia. can be either anterior or posterior to Gt Saphenous vein.

31
Q

What is the injection point for Saphenous n?

A

Injection point is same as for DP n. directed medially to medial malleoli staying superfiscial to fascia.

32
Q

What volume of LA is required for Saphenous n. block?

A

2-3cc’s

33
Q

Describe injection point for Superficial Peroneal n.

A

Injection point is same as for DP n. directed laterally to lateral malleoli staying superficial to facia. (stay anterior to small saph vein)

34
Q

Describe the location of Superficial Peroneal n.

A

Superficial to fascia, lying between Peroneus brevis and Extensor digitorum longus tendons

35
Q

What is a Mayo nerve block?

A

a ring block through all tissue planes at the base the 1st and 5th mets used to anaethestize the selected ray. involves 4 injections

36
Q

Why would the Mayo block be used?

A

For procedures of the 1st and 5th ray such as bunion/bunionette sx

Local Anaesthetics and Injections (8 decks)

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