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Anesthesia Foundations II Exam 2 > Pocus (Week 6) > Flashcards

Pocus (Week 6) Flashcards

1
Q

What vertebral level is associated with the nipple line?

A

T4

Nagelhout 7th, Ch. 50, pg. 1150

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2
Q

What vertebral level is associated with the Xiphoid process?

A

T6

Nagelhout 7th, Ch. 50, pg. 1150

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3
Q

What verterbral level is associated with the umbilicus?

A

T10

Nagelhout 7th, Ch. 50, pg. 1150

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4
Q

What vertebral level is associated with the Pubis?

A

T12

Nagelhout 7th, Ch. 50, pg. 1150

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5
Q

Which ventral rami innervate the chest?

A

T1-T6

Nagelhout 7th ed, Ch. 50, pg. 1150

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6
Q

Which ventral rami innervate the abdomen?

A

T6-L1

Nagelhout 7th ed, Ch. 50, pg. 1150

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7
Q

What kind of US artifact is this, and why does it happen?

A

Reverberation

  • Sound waves bounce back and forth between the walls of the needle before returning to the transducer

Miller’s, Ch. 46, Fig. 46.2

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8
Q

What advantages does a linear probe have?

A
  • Higher Scan-density line
  • Produce best image quality

Miller’s, Ch. 46, Somewhere cause they ain’t got damn page numbers

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9
Q

What advantages does a Curvilinear probe have?

A
  • Provide a broad view
  • Used when space is limited
  • Easier to rock

Miller’s Ch. 46, Transducer Selection, Manipulation…

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10
Q

Anesthetic indications for Paravertebral block (PVB)?

A
  • Thoracic surgery
  • Breast surgery
  • Cholecystectomy
  • Herniorrhaphy (Hernia repair)
  • Appendectomy
  • Acute pain management for rib fx

Nagelhout 7th ed., Ch. 50, pg. 1160

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11
Q

Analgesic indications for Paravertebral block (PVB)?

A
  • Rib fx
  • Flail Chest
  • Blunt abdominal trauma
  • Herpes zoster
  • Osteoporosis Vertebral Fx

Nagelhout 7th ed., Ch. 50, pg. 1160

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12
Q

Target for PVB?

A

Unilateral spinal nerves @ the level of the block in the Paravertebral space

Nagelhout 7th ed., Ch. 50, pg. 1160

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13
Q

Block required for the first 5 ribs, Intercostal block or PVB?

A

PVB

Nagelhout 7th ed., Ch. 50, pg. 1161

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14
Q

What block target is the arrow pointing at?

A

Paravertebral space for PVB

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15
Q

Which block target is highlighted pointing at?

A

Erector Spinae Block

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16
Q

Indications for Erector Spinae block (ESB)?

A
  • Lumbar Spine surgery
  • VATS (video-assisted thoracic surgery)
  • Breast Surgery
  • Rib fx
  • Bariatric surgery
  • various abdominal surgeries

Nagelhout 7th ed., Ch. 50, pg. 1166

17
Q

Target for ESB?

A

Fascial plane between ES m. & Transverse process

  • Targets Dorsal/Ventral rami
  • Can have craniocaudal spread over multiple dermatones

Nagelhout 7th ed., Ch. 50, pg. 1166/ APEX Truncal Block, ESB

18
Q

Target for Intercostal Nerve Block (ICB)?

A

Intercostal n. between internal intercostal m. fascia & Pleura

Miller’s 9th ed, Ch. 46, page something

19
Q

Indications for ICB

A

Single dermatome level for Sensory/Motor Block from Xiphoid to pubis

  • Chest/Thorax Acute/Chronic Pain conditions
  • Rib fx
  • Herpes Zoster
  • Chest tube insertion
  • Cholecystectomy

Nagelhout 7th ed, Ch. 50, pg. 1161

20
Q

Quick! How to do a PECS1 block?

A
  • Transducer between Coracoid process & Clavicle
  • Visualize 2nd/3rd rib
  • Insert needle between Pec. Major & Minor distal to thoracoacromial a.
  • Inject 10-15mL of LA

APEX

21
Q

Quick! How to do PECS2 block

A
  • Do PECS1 block
  • Find facial plane between PMi m. & Serratus Anterior m. (3rd/4th rib)
  • Advance needle between PMi m & SA m.
  • Hopefully negative Aspirate, injecto 10-15mL of LA

APEX

22
Q

What kind of Probe type is this?

A

Sector probe

  • Narrow near transducer, widens further as you go

His PPT

23
Q

What kind of probe is this?

A

Linear Array

  • Parallel sound waves
  • Rectangular image

Reed’s PPT

24
Q

What kind of probe is this?

A

Curved/Curvilinear Array

  • It’s a compromise between sector/linear
  • Can visualize them deep thangs

His PPT again

25
Q

How would you describe this?

A

In-plane needle imaging

His PPT

26
Q

Ah, but how would you describe…. this?

A

Out of plane

  • You wouldn’t go for a vein like that, but whatever

His PPT

27
Q

How much local anesthetic would you use for a TAP block?

A

20-30 mL per side

of 0.2-0.5% Ropivicaine or
0.25%-0.5% Bupivicaine

High volume, low concentration

His ppt again

28
Q

Identify each layer of the TAP block (imagine is a subcostal TAP block)

A
  • SQ - Subcutaneous
  • EOM - External oblique m.
  • IOM - Internal oblique m.
  • Green line is the Transverse abdominus plane
  • TAM - Transverse abdominus m.
  • PC- Peritoneal cavity
29
Q

What anatomical structures do you identify for an Anterolateral TAP block?

A
  • Midaxillary Line
  • Superior to & Parallel to Iliac crest

Nagelhout 7th ed. Ch. 50, pg. 1162 & his ppt

30
Q

What anatomical structures do you identify for a subcostal TAP block?

A
  • Probe placed lateral to Xiphoid
  • Parallel & inferior to costal margin

Nagelhout 7th ed. Ch. 50, pg. 1162 & his ppt

31
Q

Adverse events of an ICB?

A
  • Pneumothorax
  • LAST

Nagelhout 7th ed. Ch. 50, pg. 1162

32
Q

What anatomical structures do you identify for a Posterior TAP block?

A
  • Midaxillary line like anterolateral
  • Slide probe posterior until aponeurosis of the Tensor fascia latae is visualized
  • IO m. & TA m. taper off into tendon

Nagelhout 7th ed. Ch. 50, pg. 1162-3

33
Q

Which TAP block approach is this?

A

Subcostal approach

Nagelhout 7th ed. Ch. 50, pg. 1163

34
Q

Which TAP block approach is this?

A

Posterior Approach

35
Q

Which TAP block approach is this?

A

Anteriolateral approach

36
Q

What block is this

A

QL 1 Block

37
Q

What block is this

A

Ilioinguinal Block

38
Q

What block is this

A

Rectus sheath block

Anesthesia Foundations II Exam 2 (6 decks)

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