Nerve Blocks Flashcards
Palmar digital nerve
prox to cartilages of the foot
needle of Palmar digital nerve
24-25G
1.5ml
palmar digital nerve block alleviates pain originating from
sole
DIPJ
PIPJ
dorsal laminae
pastern region
fetlock region
Palmar abaxial sesamoid nerve
flex FL
weight bearing HL
at level of prox ses bones - feel vein and nerve and pull dorsally
needle Palmar abaxial sesamoid nerve
23-25G
2ml
Palmar abaxial sesamoid nerve alleviates pain from
foot
pastern region
fetlock region
low 4 pt nerve block Palmar nerve
weight bearing
btw suspensory lig and ddft
prox to tendon sheath
direct needle distally
needle low 4 pt nerve block
23-25G
2ml on each side
low 4 pt nerve block - palmar metacarpal nerve
distal to head of the splint bone
4pt nerve block can alleviate pain from
foot
pastern
fetlock
6 pt nerve block also includes
dorsal metatarsal nerves
needle for navicular bursa
18G
navicular bursa
always under radiographic control
skin bleb
prox interphalangeal joint
distal to distal palmar process of PP and lateral to CDE
needle directed distal and axial
needle for prox interphalangeal joint
20G
3-4ml mepivacaine
metacarpophalngeal/Mtphalangeal joint dorsal approach
standing or flexed
medial/lateral to common digital extensor
metacaropophalngeal joint allevaites pain
suspensory lig
prox aspect of oblique and straight sesamoidean ligs
metacarpophalngeal joint needle
10ml mepivacaine
20G
digital flexor tendon sheath
palmar aspect og the pastern btw the prox and distal annular ligaments
needle for digital flexor tendon sheath
20G
10ml mepivacaine
What carpal joints communicate
carpometacarpal and middle carpal
carpal joints
btw extensor carpi radialis and common digital extensor tendons
10ml mepivacaine
tarsometatarsal joint
prox to head of Mt IV
needle directed distally and dorsomedially
needle tarsometatarsal joint
20G
3-4ml mepivacaine
centrodistal joint
block if no response to TMT joint
btw T1, T2 and Tc and T3
22-25G
3-4ml mepivacaine
Tarsocrural joint
into any pouch - dorsomedial
20G
20-30ml mepivacaine
3 joints of the stifle
medial femorotibial joint
lateral femorotibial joint
femoropatellar joint
femoropatellar joint
btw middle and lateral patellar lig
needle of femoropatellar joint
19-20G
lateral femorotibial joint
btw lateral patellar lig anf long digital extensor tendon
needle of lateral femorotibial joint
20G
medial femorotibial joint
btw medial CL and medial patellar lig
needle medial femorotibial joint
20G
drugs used
mepivacaine
bupivacaine
lidocaine
palmar digital nerve block alleviates pain from
sole
distal interphalangeal
proximal interphalangeal
dorsal laminae
pastern
fetlock
palmar digital abaxial sesamoid block alleviates pain from
foot
pastern
fetlock
wait time for joints
10-60mins
wait time for proximal limb
20-60mins
wait time for distal limb
10mins
what LA is less irritant
mepivacaine
prilocaine
bupivacaine
fast acting LA
mepivacaine
prilocaine
slower acting LA
bupivacaine
patient prep for perineural analgesia
clean area - clip
anti septic scrub
alcohol with swab then spray
patient prep for intrasynovial
aseptic
clip
5min scrub
alcohol wash
sterile gloves
nerve blocks of FL
deep digital
prox palmar
abax sesamoid
4pnt
high palmar
lat palmar
ulnar
n. medianus & musculocutaneus
lateral palmar nerve - lateral approach
subcarpal block
standing or flexed
23-25G
3ml mepivacaine
lateral palmar nerve - medial approach
subcarpal block
no risk of penetrating carpal sheath
subtarsal block
limb flexed
SDFT pushed medially
23G - 3-4ml mepivacaine
distal to head of MtIV
what disease is substarsal block good for
proximal suspensory desmopathy
tibial nerve block
10cm proximal to tuber calcanei
cranial to common calcaneal tendon
skin bleb
20G - 10-15ml mepivacaine
peroneal nerve block
btw long and lateral digital extensor tendons
supf and deep branches
10cm proximal to suber calcanei
skin bleb
19-20G - 20ml mepivacaine
(10ml into heel bulb and 10ml as youre withdrawing needle)
tibiral and peroneal nerve block desensitises
entire hock region
distal crus and distal aspect of the limb
toe drag shows block worked