Regional/Nerve distributions Flashcards

1
Q

What is the innervation to the lower extremity?

A

L2-S3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What nerves form the lumbar plexus?

A

L2-L4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What nerve does the saphenous nerve come from?

A

Femoral nerve (L2-L4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What nerve is responsible fro the medial portion of the leg, ankle and the posterior medial portion of the foot?

A

Saphenous nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What gives sensation to the posterior thigh?

A

Posterior cutaneous nerve of the thigh (S1-S3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What nerves provide sensation to the lateral portion of the leg?

A

Lateral sural cutaneous and superficial peroneal from peroneal division

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What supplies the posterior portion of the leg and lateral portion of the heel and foot?

A

Lateral calcaneal and lateral dorsal cutaneous via the sural nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What nerve supplies sensation over the medial heel?

A

Medial calcaneal nerve from the tibial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where is a popliteal block done?

A

6-7 cm above the popliteal crease either laterally between the vastus lateralis and biceps femoris or posteriorly between semitendinosus and biceps femoris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where is the saphenous nerve block done?

A

At the level of the medial malleolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 5 nerves that need to be blocked for an ankle block?

A
Posterior tibial nerve 
Sural nerve
Deep peroneal
Superficial peroneal
Saphenous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where do you block the posterior tibial nerve?

A

Posterior to tibial artery at level of medial malleolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where do you block the sural nerve?

A

Posterior to the lateral malleolus and lateral to calcaneus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where do you block the deep peroneal nerve?

A

lateral to anterial tibial artery on the anterior portion of the ankle deep to the fascial planes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where do you block the superficial peroneal nerve?

A

Lateral malleolus to anterior tibia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which antiplatelet/anticoag can be continued before neuraxial anesthesia?

A

Aspirin

17
Q

What is an indication for IV regional anesthesia?

A

Extremity surgery of brief duration

18
Q

What are the contraindications to IV regional anesthesia?

A
Sickle Cell disease
Allergy to local
Presence of infection at the site
Inability to place catheter
Patient refusal
19
Q

What are the relative contraindications to IV regional anesthesia?

A

Seizure disorder
High grade heart block
Bleeding disorders
Hepatic failure

20
Q

What are the most commonly used locals in IV regional anesthesia?

A

Procaine and lidocaine

21
Q

After how many minutes is the local less likely to disseminate systemically if tourniquet pressure is lost?

A

20 minutes

22
Q

What are the signs of local toxicity?

A

Ringing in the ears, feeling bad, numbness around the mouth, headache, metallic taste in the mouth

23
Q

How high should the tourniquet pressure be?

A

100 mmHg above systemic

24
Q

What are the symptoms of local toxicity?

A

muscle twitching, LOC, grand mal seizure, vascular collapse

25
Q

What is the treatment for local toxicity?

A

ABCs
BZD or thiopental for anticonvulsant
Bretylium or cardioversion for ventricular arrythmias
Intralipid for bupivacaine toxicity

26
Q

What is the most common cause for regional anesthesia failure?

A

Prolonged tourniquet time

27
Q

What medication can be used to raise the seizure threshold?

A

BZD