PRAC: Nerve Block Flashcards
1
Q
What should nerve block sites be scrubbed with?
A
Chlorhexidine
2
Q
Which anaesthetics can be used for nerve blocking?
A
Lidocaine: 1-2hrs
Mepivicain: 2-3hrs
Bupivicaine: 3-6hrs
3
Q
What does a palmar/planter digital block? Volume required?
A
- 70% foot including sole
- most of DIP j
- 2-4ml
4
Q
3 approaches to the DIP j specificaly?
A
- dorsal midline
- approach later/medial to extensor tendon (not really necessary, will stil go though tendon)
- palmar/plantar approach
5
Q
Approaches to the navicular bursa
A
> midline navicular position
- horizontal approach
- 30* oblique approach
6
Q
Appraoches to the PIPj?
A
> dorsal - abaxial to extensor tendon - level of palmar process P1 > palmar/plantar - V shaped notch - dorsal:distal palmar P1 - Distal:eminence collateral ligament and proximal P2 - Distal:insertion SDFT
7
Q
What does the low palmar/plantar nerve block?
A
- metatarsal nerve
- palmar/plantar nerve
> avoid DFSTS - dorsal subcutaneous ring block (skin sensation, hindlimbs)
8
Q
What does an abaxial sesamoid block?
A
- lat and med palmar/plantar digital NVBs (nerves palamr aspect of bundle VAN)
9
Q
What does low 4 point block?
A
- lat and med PALMAR nn. (between suspensory and DDFT)
- lat and med PALMAR METACARPAL nn. (distal to button of splint)
10
Q
What does low 6 point block?
A
- lat and med PLANTAR nn.
- lat and med PLANTAR METATARSAL nn.
- DORSAL METATARSAL nn.
11
Q
Where is the PDNB placed?
A
[palmar digital]
- NVB just proximal to the collateral cartilage of the distal phalanx
- PDN most palamr
- aim distally
12
Q
Where is the ASNB placed?
A
[abaxial sesamoid]
- palapate NVB at level of base of prox sesamoids
- aim distally
13
Q
Landmarks of low 4 point?
A
- palmar nerve: between DDFT and SL
- palmar metacarpal n : below level of button of splint
14
Q
Landmarks of DIP joint block?
A
- midline, 1cm prox coronary band
- aim slightly distal to the perpendicular
- needle should penetrate dorsal pouch of the joint (extends proximally to about the centre of middle phalanx)
