Test 2 Flashcards

1
Q

subcostal block blocks which dermatomes

A

T7-T11

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2
Q

TAP blocks block which dermatomes

A

T10-L1

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3
Q

Ilioinguinal iliohypogastric blocks which dermatomes

A

L1

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4
Q

Structures composing Petit’s Triangle

A

Rib cage
Latissimus dorsi
External oblique
Pelvis

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5
Q

TAP blocks provides which type of relief

A

Somatic but no visceral analgesic relief

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6
Q

LA for TAP block

A

30-40ml per side

0.3-0.6 mg/kg

Dilute concentrations down to at least 0.25% bupivacaine or 0.3% Ropivacaine

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7
Q

Indications for TAP block

A

C section
Appy
Inguinal Hernia Repsir

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8
Q

LA only approved for TAP blocks by FDA

A

Exparel

20ml diluted in NS

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9
Q

Consideration with TAP block as possible complication/inadvertent

A

Femoral nerve block

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10
Q

Femoral nerve block with TAP block is due to

A

Unexpected injection into the transversalis fascia

Transversalis fascia is continuous plane with fascia iliaca

Caution with ambulation

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11
Q

Landmarks for mid axillary TAP block

A

Subcostal margin

Iliac crest

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12
Q

Muscles involved in TAP block and order from superficial to deep

A

External oblique
Internal oblique
Transversus abdominis

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13
Q

Where inject LA for TAP block

A

Between internal oblique and transversus abdominis

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14
Q

US and needling for TAP block

A

In plane medial to lateral needle approach

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15
Q

If having difficulty Identifying area for injection for TAP what movement with probe

A

Heel to Toe

**Rocking

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16
Q

To extend TAP block duration

A

Add epi 1:400,000
Decadron 4 mg per side

Exparel

17
Q

Problem with Exparel for TAP blocks

A

Very slow onset

Need to do block preop or early in case

18
Q

2 tips for improving success of TAP block

A

Larger volumes (30-40ml)

Be posterior as possible

19
Q

Subcostal approach for TAP block is beneficial for

A

Upper abdominal surgeries

20
Q

Subcostal approach provides analgesia of

21
Q

Amount of LA for subcostal TAP

A

20-30ml per side

22
Q

Muscles identified with subcostal approach

A

External oblique
Internal oblique
Transversus abdominis
Rectus abdominis

23
Q

Ilioinguinal/Iliohypogastric block indications

A

Inguinal hernia repair
Testicular or scrotal surgery

Innervates base of penis only

24
Q

Iliohypogastric nerve origin

25
Ilioinguinal nerve origin
L1
26
Genitofemoral nerve origin
L1-2
27
Lateral femoral cutaneous nerve origin
L2-3
28
Subcostal nerve origin
T12
29
Ilioinguinal-iliohypogastric TAP block landmark approach
2cm medial and then 2 cm cephalad from anterior superior iliac spine (ASIS)
30
LA amount needle type ilioinguinal/Iliohypogastric block
10ml of LA each injection 0. 25-0.5% bupivacaine 0. 375-0.5% Ropivacaine Blunt block needle Double injection
31
Ilioinguinal-iliohypogastric provides analgesia to
L1 segment
32
Near the ilioinguinal iliohypogastric nerve injection area is this structure to be aware of
Deep circumflex iliac artery
33
For the ilioinguinal-iliohypogastric block should you use doppler? Why?
Yes. Because deep circumflex iliac artery is in the same location
34
For ilioinguinal-iliohypogastric block injection
2 separate injections Between EOM and IOM And between EOM and TAM