Module 5: Part 1

Question 1

regional anesthesia may lead to reductions in

Answer 1

• stress response
• systemic analgesic requirements
• opioid-related side effects
• general anesthesia requirements
• possibly the development of chronic postop pain

Question 2

Fascial Plane Blocks
(FPBs)

Answer 2

• popular alternative to conventional peripheral nerve blocks or thoracic epidural analgesia
• rely on depositing a large LA volume into fascial planes in which target nerves are contained

regional anesthesia
inject into “plane” between 2 discrete fascial layers
LA spreads to plane’s nerves & adjacent tissue = analgesia

Question 3

a properly performed interscalene block…

Answer 3

almost invariably blocks the ipsilateral phrenic nerve

careful consideration must be given to patients with severe pulmonary disease or preexisting contralateral phrenic nerve palsy.

Question 4

bilateral ____________ blocks are always contraindicated

Answer 4

interscalene

Question 5

Brachial plexus block at the level of the cords provides excellent anesthesia for

Answer 5

procedures at or distal to the elbow.

Question 6

bier block

Answer 6

IV regional anesthesia

intense surgical anesthesia for relatively short (45–60 min) extremity surgeries

Question 7

a femoral nerve block alone…

Answer 7

will seldom provide adequate surgical anesthesia

provides postop analgesia for hip, thigh, knee, & ankle procedures.

Question 8

Popliteal nerve blocks provide excellent coverage for

Answer 8

foot and ankle surgery

Question 9

popliteal nerve blocks spare

Answer 9

much of the hamstring muscles, allowing lifting of the foot with knee flexion and thus facilitating ambulation.

Question 10

t/f: All sciatic nerve blocks fail to provide complete anesthesia for the leg and ankle

Answer 10

TRUE; the medial leg and ankle are innervated by the saphenous nerve.

Question 11

when a ____________ block is added to a sciatic nerve block, complete anesthesia below the knee is provided

Answer 11

saphenous (or femoral)

Question 12

a complete ankle block requires a series of ____________ nerve blocks

Answer 12

5

Question 13

The superficial cervical plexus block targets the

Answer 13

cutaneous branches of the cervical plexus

Question 14

the deep cervical plexus block targets the

Answer 14

C2 to C4 nerve roots as they emerge from the vertebral foramina.

Question 15

____________ blocks result in the highest blood levels of local anesthetic per dose

Answer 15

intercoastal blocks

Question 16

nerves targeted in the transversus abdominus plane (TAP) block

Answer 16

• subcostal (T12)
• ilioinguinal (L1)
• iliohypogastric (L1)

Question 17

what does a field block target

Answer 17

terminal cutaneous nerves

Question 18

paresthesia technique

Answer 18

Paresthesia (abnormal sensation) is elicited in the area of sensory distribution when a needle makes direct contact with a sensory nerve

If paresthesia occurs, the needle should be redirected. Paresthesia occurring during injection may indicate an intraneural location of the needle tip.

Question 19

nerve stimulation technique

Answer 19

an insulated needle concentrates electrical current at the needle tip, while a wire attached to the needle hub connects to a nerve stimulator—a battery-powered machine that emits a small amount (0–5 mA) of electric current at a set frequency (usually 1 or 2 Hz).

Question 20

ultrasound technique

Answer 20

has overwhelmingly become the dominant modality taught for nerve localization and needle guidance in recent years.