Regional Anesthesia

Question 1

Where does superficial cervical plexus block take place?

Answer 1

Posterior to the sternrocleiodmastoid muscle mid-clavicle. Blocks cutaneous branches of cervical plexus (C2-C4)

Question 2

Musculocutaneous Nerve (Sensation and Motor)

Answer 2

Provides sensation to L forearm and innervates biceps brachii, brachialis and coracobrachilis.

Question 3

Median Nerve (Sensation and Motor)

Answer 3

Sensation to lateral palmar surface of hand, wrist flexion

Question 4

Radial Nerve (Sensation and Motor)

Answer 4

Sensation to lateral arm, lateral dorsal hand, wrist extension

Question 5

Ulnar Nerve (Sensation and Motor)

Answer 5

Sensation to medial hand, hand closure, thumb adduction)

Question 6

Transversus Abdominis Plane Block. Levels and Nerves

Answer 6

Deposit LA between Internal oblique and transversus abdominis muscle. Levels T7-L1. Iliohypogastric, ilioinguinal, and subcostal.

Question 7

Pudendal Nerve Block

Answer 7

Good for 2nd stage of labor (T12-L1), S2-S4. Performed bilaterally

Question 8

Obturator Nerve (When to block, nerves supplied)

Answer 8

Can be activated with monopolar electrocautery during resection of bladder tumor. If not blocked, will cause adductor jerk and can cause bladder spasm potentially resulting in bladder rupture. Runs from L2-L4 and supplies medial leg.

Question 9

Celiac Plexus Block

Answer 9

Usually performed for pancreatic cancer related pain. Mostly sympathetic discharge; so if blocked, would produce parasympathetic effects. Most common side effect is orthostatic hypotension and second is diarrhea.

Question 10

Deep Cervical Plexus Block

Answer 10

Nerves C2-C4 causing ipsilateral phrenic nerve palsy. Contraindication with co-existing pulmonary diseases