Truncal Blocks Flashcards
Where do intercostal nerves arise from? What needs to be careful about blocking them?
Ventral rami T1-T11
Close to vasculature
Describe distribution of paravertebral block
Provides coverage for only one dermatome level
Must block each desired level
What are the boundaries of the vertebral space. Anterior, Medial, Posterior
Anterior - Parietal pleura
Medial - Vertebral body and intravertebral foramen
Posterior - Transverse process and superior costotransverse ligament
Indications for paravertebral block?
Thoracic
Breast
Cholecystecmy
Herniorrhaphy
Appendectomy
Rib Fractures
Flail Chest
Blunt abdominal trauma
Osteoporotic vertebral fractures
Herpes where more than one dermatome is needed
What is an errector spinae block?
Big consideration?
Fascial plane technique that targets dorsal and ventral rami
Significant craniocaudal spread
Describe the angle of Petit
Posterior
Anterior
Inferior
Inside triangle
Helpful for TAPS block
Posterior - Latissimus dorsi
Anterior- External O
Inferior - illiac
Inside triangle- IO
Purpose of a TAPS block? What approaches?
Block the fascial plane between IO and transverse abdominis T6-L1
Subcostal - above belly button
Lateral + Posterior - below belly button
Indications for a rectus sheath block?
Midline abdominal incision
C-section
umbilical hernia in Peds
Tubal ligation
What is the thoracolumbar fascia
Complex network of connective tissue in the lumbar paravertebral area and anterolateral abdominal wall
Consists of three layers
What muscle lies between the anterior and middle layers of TLF?
Quadratus lumborum
Where is local deposited during a TLF block?
QL1 - Lateral to QLM
QL2 - Posterior to QLM
QL3- Anterior to QLM
Just like the brachial plexus but medial is replaced with anterior
Ex: of brachial Plexus cords
Lateral
Posterior
Medial
