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Regional Exam 3 > Module 8 > Flashcards

Module 8 Flashcards

1
Q

The biggest muscle in your neck is the

A

Sternocleidomastoid muscle

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2
Q

The brachial plexus comes out of the

A

Anterior & Middle Scalene muscle

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3
Q

What nerve runs anterior to the anterior scalene

A

Phrenic Nerve ( C3, C4, C5)

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4
Q

What is the percentage of phrenic nerve involvement?

A

100%

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5
Q

Phrenic nerve innervates the

A

Diaphragm

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6
Q

What muscle runs along the ribs

A

Serratus Anterior Muscle

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7
Q

What nerve runs along the serratus muscle?

A

Long Thoracic nerve

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8
Q

The thoracic nerve roots from

A

C6 or C7

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9
Q

The phrenic nerve also partially innervates the

A

Pericardial area

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10
Q

Supraclavicular nerve innervation (from cervical plexus)

A

C3 & C4

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11
Q

Axillary nerve innervation (superior lateral brachial cutaneous nerve)

A

C5 & C6

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12
Q

Radial nerve innervation (inferior lateral brachial cutaneous nerve)

A

C5 & C6

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13
Q

Intercostobrachial nerve innervation

A

T2

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14
Q

Medial brachial cutaneous nerve

A

C8, T1 & T2)

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15
Q

Medial antebrachial cutaneous nerve innervation

A

C8 & T1

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16
Q

Lateral antebrachial cutaneous nerve innervation

A

C5, 6 & 7

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17
Q

Radial nerve inneravtion (superficial branch)

A

C6-C8

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18
Q

Median nerve (palmar branch & palmar digital branches)

A

C6-8

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19
Q

Ulnar nerve innervates

A

C7/8- T1

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20
Q

What area do we try & numb for shoulder surgery

A

C5, C6, C7

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21
Q

Interscalene block does NOT cover

A

T1 & T2

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22
Q

T1 & T2 are your

A

Intercostal brachial & your medial brachial cutaneous nerves

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23
Q

What is done to block T1 & T2

A

Ring Block

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24
Q

Per McP, the median & radial is innervated by

A

C5C6

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25
The musculocutaneous nerve runs through the
Coracobrachialis muscle
26
The musculocutaneous nerve will
Break off in the axillary region & is called the cat eye
27
What landmarks are used in the shoulder?
Scapula, Acromion & Coracoid process
28
The brachial plexus includes
C5, C6, C7, C8 & T1
29
What are the roots of the brachial plexus
C5, C6, C7, C8 & T1
30
What are the components to the Trunks?
Superior, Middle & Inferior
31
What are the components of the Divisions
3 Anterior & 3 Posterior
32
What are the components for the Cords?
Lateral, Posterior & Medial
33
What are the components of the Terminal branches?
Musculocutaneous Nerve, Axillary Nerve, Radial Nerve, Median Nerve & Ulnar
34
What nerve is important to point out during an axillary block?
Musculocutaneous nerve (cat eye)
35
An interscalene block will be
Ulnar sparing
36
What block is associated with the Roots
Interscalene (C5-C7)
37
What block is associated with the Trunk?
Supraclavicular
38
What block is associated with Trunks & Divisions?
Supraclavicular
39
Which block is associated with the Cords
Infraclavicular Block
40
Which block is associated with the Terminal Branches?
Axillary Block
41
The median nerve is associated with
Flexion
42
The radial nerve is associated with
Extension
43
Ulnar will provide what type of motion?
Twist flex
44
Where is the supraclavicular block performed?
Right above the clavicle (honeycomb on ultrasound around arteries)
45
The infraclavicle runs below
The PEC/DELT groove
46
The Musculocutaneous nerve involves what part of the arm?
Lateral Forearm
47
Which block is used for shoulder surgery
Interscalene
48
when placing an interscalene block, what will you see on ultrasound
Stoplight C5, C6, C7 (inject here)
49
When placing an interscalene block, how is your needle oriented?
Going from posterior to anterior, though the middle scalene first
50
If you are having trouble placing an interscalene block, what can help you re-orient yourself?
The SCM muscle is the tip & look for stoplight underneath
51
Is ulnar sparing okay for shoulder surgery
Yes
52
Phernic nerve paralysis is problematic in
COPD, lung problems, breathing problems, home O2, sarcoidosis
53
What medication is given to patient who are HOTN & bradycardic?
Ephedrine since phenylephrine will cause reflex bradycardia & will decrease CO
54
What has happened if a patient is hoarse after interscalene block?
Recurrent Laryngeal Nerve injury
55
Which block is best for a lower arm procedure?
Axillary
56
The supraclavicular block is below the
Trunks/Division
57
What will be visualized on the ultrasound machine when placing a supraclavicular block?
Honeycomb (cluster of grapes) & aim for 8 ball in the corner pocket
58
What is the needle approach with supraclavicular block
Lateral medial approach
59
Which block is best for placing a catheter?
Infraclavicular
60
With the infraclavicular block, we know that the artery is
Surrounded by 3 cords/3 nerve parts of the brachial plexus
61
Which block is also okay for lower arm
Infraclavicular
62
With the axillary block, what is seen near the Axillary Artery?
Medial, Ulnar & Radial nerves Will also see musculocutaneous nerve
63
At what level do the divisions being
1st Rib
64
What are the complication associated with Interscalene block
Hemidiaphragmatic Paralysis Pneumothorax Vascular Puncture/Injection HOTN/Bradycardis syndrome Recurrent Laryngeal Epidural/Spinal
65
Where is the Supraclavicular located?
Distal Trunks & Proximal Divisions
66
What is the needle approach with Supraclavicular blocks
Lateral to Medial
67
What artery is important in relationship to Supraclavicular
Subclavian
68
What is the patient position for Supraclavicular block?
Semi-Sitting
69
When is it best to use the infraclavicular block?
Unable to abduct arm Unable to tolerate phrenic nerve paralysis Long term catheters
70
What are the landmarks for infraclavicular block?
Coracoid Process Clavicle (Midsagital)
71
What are the landmarks for the axillary block?
Axilla Artery Deltopectoral Groove
72
What are the terminal branches of the axillary block?
Musculocutaneous Median Ulnar Radial
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Regional Exam 3 (4 decks)

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