Module 9: Part 3

Question 1

Rectus Sheath Block Field Block:

Answer 1

Targets anterior cutaneous branches of the seventh through the twelfth intercostal nerves

Question 2

Rectus Sheath Block indications of Single-Injection:

Answer 2

Single-Injection: Surgical anesthesia for superficial midline abdominal wall procedures

Question 3

Rectus Sheath Block indications of Bilateral Continuous Block:

Answer 3

Alternative to thoracic epidural for midline laparotomy incision analgesia

Question 4

Rectus Sheath Block coverage and distribution

Answer 4

Distribution: Elliptical, midline block extending from xiphoid process to symphysis pubis

Question 5

Rectus Sheath Block Limitation:

Answer 5

No analgesia to visceral structures

Question 6

Ultrasound Technique for Rectus Sheath Block: Patient position

Answer 6

Supine Position: Patient lies on their back

Question 7

Rectus Sheath Block Probe Placement:

Answer 7

Linear ultrasound probe placed in a transverse orientation over the midline of the abdomen

Question 8

Anatomy Visualization of Rectus sheath block of Linea Alba

Answer 8

Hyperechoic line at midline

Question 9

Anatomy Visualization of Rectus sheath of block Rectus Abdominis Muscle:

Answer 9

Spindle-shaped, hypoechoic muscle with hyperechoic fascia superficial and deep

Question 10

Needle Insertion of Rectus sheath block: approach and angle

Answer 10

Approach: Enter from the lateral side of the transducer
Angle: Shallow angle relative to the probe to minimize risk of over-penetration

Question 11

Injection techniques of Rectus sheath block

Answer 11

Technique: Needle advanced through rectus muscle to its deep surface; local anesthetic injected to hydrodissect rectus sheath from underlying transversalis fascia

Question 12

purpose of Quadratus Lumborum Blocks

Answer 12

Anesthetize lower thoracic and lumbar regions
Provide analgesia for various abdominal and lumbar procedures

Question 13

Types of QL (Quadratus Lumborum) Blocks

Answer 13

Type 1: Lateral QL Block
Type 2: Posterior QL Block
Transmuscular QL Block

Question 14

Demonstrated benefits in cesarean sections and laparoscopic gynecologic surgeries

Answer 14

Quadratus Lumborum Blocks

Question 15

Clinical trials are ongoing; primarily case series and cadaver studies to date

Answer 15

Quadratus Lumborum Blocks

Question 16

Type 1 Quadratus Lumborum Block: position

Answer 16

Supine or lateral

Question 17

Type 1 Quadratus Lumborum Block:
Needle Insertion

Answer 17

Anterolateral to the transducer

Question 18

Type 1 Quadratus Lumborum Block:
Ultrasound Probe

Answer 18

Linear or large curvilinear, placed in transverse orientation in the midaxillary line

Question 19

Type 1 Quadratus Lumborum Block:
Target

Answer 19

Lateral aspect of the quadratus lumborum muscle, deep to the posterior aponeurosis of the transversus abdominis muscle

Question 20

Type 1 Quadratus Lumborum Block: Local Anesthetic Injection:

Answer 20

Deposited on the lateral aspect of the quadratus lumborum

Question 21

Type 1 Quadratus Lumborum Block:
Indication

Answer 21

Provides analgesia to the lateral aspect of the lower thoracic and lumbar regions