Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Regional > Regional Upper extrmities!!! (Josh's perspective) > Flashcards

Regional Upper extrmities!!! (Josh's perspective) Flashcards

Time to get up lift your arms up!!!! stare them down with your biggest and scariest mean mug, and say fuck you upper extremities I got this shit I own you fuck nutz, you want a challenge I accept game on bitch.... I just did this and it felt good!!! true story!!!!

1
Q

Goals of anesthesia

A
  1. prefered by some pt’s
  2. Just as fast
  3. Avoid GA
  4. preemptive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How many cervical nerves do you have

A

8

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

hpw many cervical vertebrae do you have?

A

7

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

What nerves are your vertebra for brachial plexus?

A

C5-T1 (+/- C4 & T2)

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

Mnumonic for brachial plexus

A

Really

Tough

Dogs

Can

Bite

( i know very disapointing i have nothng better)

( i was thinking Redhead Trucker Dikes Can Blow)

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

Brachial plexus Anatomy and Block locations:

Interscalene

A

roots

trunks

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

Brachial plexus Anatomy and Block locations:

supraclavicular

A

trunks

and

divisions

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

Brachial plexus Anatomy and Block locations:

Infraclavicular

A

cords

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

Brachial plexus Anatomy and Block locations:

axillary

A

terminal branches

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

Brachial plexus Anatomy and Block locations: ways to remember

startig at the highest and work down UE with both brachial plexus nerve and and locations

A

Interscalene-roots/trunks

Supraclavicular- truncks/divisions

Infraclavicular- cords

Axillary- terminal branches

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

lable this

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When doing a scalene block you have about a ____% chance of blocking the phrenic nerve?

A

100%

(gottcha)

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

*********************

lable the nerves that inervate this SUPINATED arm

A
  1. Median n
  2. Radial n (superficial br.)
  3. Musculocutaneous n. (lateral antebrachial cutaneous n.)
  4. Radial n. (inferior lateral brachial cutaneous n.)
  5. Axillary n.
  6. supraclavicular n. (cervical plexus)
  7. ulnar n. (palmar digital br.)
  8. Ulnar n. (palmar br)
  9. Median antebrachial cutaneous n.
  10. Intercostalbrachial and nedial brachial cutaneous n.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

lable the cerviacal nerve in supination position

A
  1. C7
  2. C6
  3. C5
  4. T1
  5. C8
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

*************

label this!! Know what part of hand/arm is controlled by which nerve!!

A
  1. Median n.
  2. Ulnar n.
  3. Median antebrachial cutaneous n.
  4. Radial n.
  5. (posterior antebrachial cutaneous n.)
  6. Pasterior brachial cutenuous n.)
  7. (inferior lateral brachial cutaneous n.)
  8. Axillary n.
  9. Supraclavicular n. (cervical plexus)
  10. Intercostabrachial cutaneous n.
  11. Musculocutaneous n. (lateral antebrachial cutaneous n.)
  12. Radial n.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lable the cervical nerves in UE during pronation

A
  1. C8
  2. C7
  3. C6
  4. C5
  5. T1
  6. C8
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

INTERSCALENE: PEARLS

for sx of of what?

A

ahoulder and upper arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

INTERSCALENE: PEARLS

the block often spares distribution of what nerve?

A

ulnar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

INTERSCALENE: PEARLS

needle insertion site?

A

B/t anterior and middle scalene muscles at C6 line

Directed slightly posterior and caudad (toward ass)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

INTERSCALENE: PEARLS

stimulates what nerves?

A

musculacutaneous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

INTERSCALENE: PEARLS

you should go no deeper than what?

A

1.5 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

INTERSCALENE: PEARLS

the block is contraindicated in what disease process? and why?

A

COPD

b/c of phrenic nerve block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

INTERSCALENE: PEARLS

what are you most worried about during this block and why?

A

speed and depth of injection

b/c closeness tp spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

INTERSCALENE: PEARLS

you give a SLOW injection of how much?

A

30-40 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

INTERSCALENE: PEARLS

what type of spread are you dont want to be getting when doing the block?

A

epidural spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

INTERSCALENE: PEARLS

lable the parts

A
  1. Middle scalene muscle
  2. Anterior scalene muscle
  3. Brachial plexus
  4. Cricord cartilage
  5. Lateral edge of sternocleidomastoid muscle
  6. 1st rib
  7. 2nd rib
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

INTERSCALENE: PEARLS

you want to palpate the scalene froove with pt supine and head ___degrees to contralateral side

A

30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

INTERSCALENE: PEARLS

what type of needle is good? and how is it advanced

A

25g 1.5 inch B-bevel almost perpindicular to skin

advance medial and caudal till paresthesia or evoked contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

INTERSCALENE: PEARLS

what is a pot complication

A

Horner’s syndrome

(combination of drooping of the eyelid (ptosis) and constriction of the pupil (miosis), sometimes accompanied by decreased sweating (anhidrosis) of the face on the same side)

redness of the conjunctiva of the eye is often also present. Apparent enophthalmos is also a frequent symptom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

INTERSCALENE: PEARLS

Ill geive a response and then state the area involed and the problem!

  1. Phrenic
  2. Scapula
  3. Pectoralis
  4. Biceps
  5. Hand
A
  1. diaphram- too anterior
  2. thoracodorsal- too posterior
  3. anterior thoracis-????
  4. muscolocutaneous–good
  5. Distal branches– good
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

INTERSCALENE: PEARLS

complications ? (4)

A

epidural spread

IV injection (vertebral artery)

Phrenic block

Horner’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

SUPRACLAVICULAR:

Advantage?

A

most complete coverage for arm surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

SUPRACLAVICULAR:

position of pt?

A

Supine with head 30 degrees to contralateral side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

SUPRACLAVICULAR:

needle insertion tech?

A

insertion os SCM at the clavicale is noted

move 1 inch lateral

insert needle 1 fingerbreath superior and direct needle caudad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

SUPRACLAVICULAR:

how local is used?

A

25-40 ml

36
Q

SUPRACLAVICULAR:

has the highest incidence of what complication?

A

pneumothorax

37
Q

SUPRACLAVICULAR:

beside pnumo what is another complication ?

A

Horner’s syndrome

38
Q

SUPRACLAVICULAR:

is catheter placement advisable? why or whynot?

A

no

due to mobility of the neck

39
Q

SUPRACLAVICULAR:

label

A
  1. Middle Scalene muscle
  2. brachial plexus
  3. Subclaviian artery
  4. anterior scalene muscle
  5. sternocleidomastoid muscle
  6. subclavian
  7. 1st rib
  8. 2nd rib
40
Q

SUPRACLAVICULAR:

just pictures for a good view point

A
41
Q

INFRACLAVICULAR: PEARLS

what is the insertion site and tech?

A

2cm medial /2 cm caudad from coracoid processs(with arm at side) insert perpendicular

coracoid process-a small hook-like structure on the lateral edge of the superior anterior portion of the scapula. Pointing laterally forward, it, together with the acromion, serves to stabilize the shoulder joint. It is palpable in the deltopectoral groove between the deltoid and pectoralis major muscles

42
Q

INFRACLAVICULAR: PEARLS

is for nerve stimulation were?

A

3rd and 4th fingers

Median nerve

43
Q

INFRACLAVICULAR: PEARLS

the block is usually blocking what part of the brachial plexus?

A

cords

44
Q

INFRACLAVICULAR: PEARLS

what else is the blocked good for besides the median n.

A

reliable for tourniquet pain-intercostobrachial

reliable blocked axillary nerve

think arm

45
Q

INFRACLAVICULAR: PEARLS

is better for placement of what?

A

a catheter

46
Q

INFRACLAVICULAR: PEARLS

a pic for reference

A
47
Q

INFRACLAVICULAR: PEARLS

i’ll say the location and then state what the response indicates

  1. Pectoralis-
  2. Deltoid
  3. Biceps
  4. median
A
  1. too shallow
  2. axillary (unreliable)
  3. musculocutaneous (unreliable)
  4. median -good
48
Q

INFRACLAVICULAR: PEARLS

complications

A

hematoma- b/c non compressible site

Pneumothorax -0.0-0.7%

49
Q

AXILLARY BLOCK: PEARLS

block what part of arm

A

below elbow

50
Q

AXILLARY BLOCK: PEARLS

is it good for tourniquet coverage?

A

questionable

51
Q

AXILLARY BLOCK: PEARLS

2 different approaches

A

transarterial

stimulator

52
Q

AXILLARY BLOCK: PEARLS

with the block the musculocutaneous n. is hidden in the what?

A

coracobrachialis

53
Q

AXILLARY BLOCK: PEARLS

mneumonic to remember?

A

MMUR

M&Ms Under the Rug

(i just dont know what the fuck it stands for)

54
Q

Ahhhhh i got it!!!

what does MMUR stand for??

or M&Ms Under the Rug?

A

when doinf the axillary block the nerves are in decreasing order

musculocutaneous nerve

median nerve

Ulnar nerve

radial nerve

55
Q

AXILLARY BLOCK: PEARLS

pic for references

A
56
Q

AXILLARY BLOCK: PEARLS

complications (2)

A

IV injection

neural injury

57
Q

BIER BLOCK:

fun fact- first used by whom?

A

august ier in 1908

58
Q

BIER BLOCK:

how to perform?

A

Small IV in operative hand

Exsanguate with esmarch bandage

tourniquet up to 50 mmhg >SBP

40-50 mL’s 0.5% lidocaine

59
Q

BIER BLOCK:

can last how long?

A

1.5 -2 hours

60
Q

BIER BLOCK:

dont deflate until what?

A

< 30 min

61
Q

Gross anatomy of brachial plexus

label

A
  1. roots
  2. 3 trunks
  3. divisions (3 ventral 3 Dorsal)
  4. (3) cords
  5. (terminal) branches

Really Tough Dogs Can Bite

Randy Travis Drinks Cold Beer

62
Q

so how to rememeber the brachial plexus

Randy Travis Drinks Cold Beer

A
63
Q

Brachial Plexus Anatomy and Block Loacation

Interscalene-

Supraclavicular-

Infraclavicular-

Axillary-

A

Interscalene- roots/trunk

Supraclavicular- trunk/divisions

Infraclavicular- cords

Axillary- terminal branches

64
Q

INTERSCALENE: SONOANATOMY

used to visualize what?

A

ROOTS of the brachial plexus

65
Q

INTERSCALENE: SONOANATOMY

look or appear how on the US

A

round oval hypo echoic structures

66
Q

INTERSCALENE: SONOANATOMY

the roots of the plexus lies where?

A

b/t the anterior and middle scalene muscle

67
Q

INTERSCALENE: SONOANATOMY

pic to see all

A
68
Q

INTERSCALENE: SONOANATOMY

again another pic

A
69
Q

INTERSCALENE: SONOANATOMY

yet another pic

A
70
Q

SUPRACLAVICULAR: US

truncks and divisions

3 trunks 6 divisions

just a good pic for you

A
71
Q

INFRACLAVICULAR: US

What level of brachial plexus are we looking at?

A

the cords

72
Q

INFRACLAVICULAR: US

  1. the cords are arranged around what?
  2. the lateral and medial cords are superficial to or at the level of what?
  3. The posterior cord is ___- to the artery?
A
  1. axillary artery
  2. subclavian artery
  3. inferior
73
Q

INFRACLAVICULAR: US

picture to look at

A
74
Q

INFRACLAVICULAR: US

what do you see

A
75
Q

AXILLARY US:

just start with a picture to show you where u are

A
76
Q

AXILLARY US:

another pic

A
77
Q

DISTAL BLOCKS:

advantages (2)

A
  • can block the nerve nearly anywhere you can see it on US
  • Good rescue (esp if you used a long acting LA for a case that starts in 10 min
78
Q

US PEARLS:

Use adequate amount of what?

A

gel

79
Q

US PEARLS:

ergonomics?

A

position supplies so as to keep eyes on screen and needle

80
Q

US PEARLS:

use appropriate _______ for target tissue?

A

Frequency

81
Q

US PEARLS:

adjust the _____ as appropriate?

A

Gain

82
Q

US PEARLS:

_______ changes in pressure or orientation = _____ changes in image quality

A

Subtle

dramatic

83
Q

US PEARLS:

focus on known ________ if you get lost start scanning from known structures

A

Landmarks

84
Q

US PEARLS:

follow target from ______ to ______

A

proximal to distal

85
Q

US PEARLS:

biggest pitfalls

A

Oblique view of needle

moving needle instead of probe for better view

Looking only at the US screen

Left/right probe orientation

Regional (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions