Truncal Blocks

Question 1

What does a PECS 1 block targets the facial plane b/t what?

Answer 1

Pectoralis major and minor muscles

Question 2

What does a PECS 2 block entail?

Answer 2

Includes a PECS1(pectoralis major and minor) block with an additional injection of local anesthetic b/t the pectoralis minor and serratus anterior muscles

Question 3

What does the thoracic intercostal n innervate?

Answer 3

T1-T6

Innervates the chest and breast
Intercostal muscles

Question 4

What does the lateral pectoral n innervate?

Answer 4

C5-C7
Innervates the pectoralis major

Question 5

What does the medial pectoral n innervate?

Answer 5

C8-T1
Innervates the pectoralis major AND pectoralis minor

Question 6

What does the long thoracic n innervate?

Answer 6

C5-C7
Chest wall superficial to serratus anterior

Question 7

What does the thoracodorsal n innervate?

Answer 7

C6-C8

Latissimus dorsi

Question 8

What are the Indications for a intercostal nerve block?

Answer 8

Rib fractures, herpes zoster, surgical procedures of chest and abd and chest tube placement

Question 9

What are some downsides to a intercostal block?

Answer 9

Must block multiple levels
High risk of LAST

Question 10

What is a paravertebral block referred to as?

Answer 10

Unilateral epidural

Question 11

What is the purpose of a paravertebral block?

Answer 11

To provide segmental anesthesia that targets the spinal nerves (both somatic and sympathetic)

Question 12

What are some indications for a paravertebral block?

Answer 12

Procedures:
Thoracic, breast, chole, hernia, and appendectomy

Pain management: rib fx, flair chest, blunt trauma, osteoporotic fx, herpes zoster

Question 13

What are the risks of paravertebral blocks?

Answer 13

Risk of LAST
Pneumo
Intrathecal injection

Question 14

What are the 3 regional blocks that are best for rib fractures?

Answer 14

Intercostal
Paravertebral
Erector spinae

Question 15

What 3 muscles does the body rector spinae consist of?

Answer 15

I LONG for SPIN class

I: iliocostalis
LONG: longissumus
SPIN: Spinalis

Question 16

What are the indications for an erector spinae class?

Answer 16

Neuropathic pain, rib fx, lumbar spine, thoracic surgery, cardiac surgery, breast surgery, bariatric

Question 17

What are the 4 muscle groups involved in a TAP block?

Answer 17

rectus abdominis
Internal oblique
External oblique
Transverse abdominis

Question 18

What is a key anatomical reference point for a TAP block?

Answer 18

Triangle of Petit

Question 19

Where do you inject anesthetic for a TAP block?

Answer 19

Between the internal oblique and transverse abdominis

Question 20

what are some indications for a TAP block?

Answer 20

Hernia
Appendectomy
Lap abdominal procedures
C section
Gyn procedures

Question 21

What is the Subcostal approach in TAP blocks?

Answer 21

Procedures ABOVE the umbilicus

Question 22

What is the lateral AND posterior approach?

Answer 22

Procedure BELOW the umbilicus

Question 23

What type of procedures is a rectus sheath block indicated for?

Answer 23

Any procedure with a midline abdominal incision

Hernias, c sections, tubal ligations

Question 24

In a quadratus Lumborum (QL)1 block, where is the LA injected?

Answer 24

Lateral to QLM

Question 25

In a quadratus Lumborum (QL)2 block, where is the LA injected?

Answer 25

LA is injected posterior to the QLM

Question 26

In a quadratus Lumborum (QL) 3 block, where is the LA injected?

Answer 26

LA is injected anterior