Truncal blocks 3 Flashcards

1
Q

When performing a rectus sheath block, the needle is inserted into the fascial plane between the (select 2):
a. external oblique muscle
b. anterior rectus sheath
c. rectus abdominis muscle
d. posterior rectus sheath

A

c. rectus abdominis muscle
d. posterior rectus sheath

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2
Q

What is the objective of a rectus sheath block?

A

a fascial plane block that targets the thoracolumbar nerves and the anterior cutaneous branches as they travel in the fascial plane between the rectus abdominis muscle and posterior rectus sheath

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3
Q

What are indications for a rectus sheath block?

A

procedures with a midline abdominal incision (umbilical hernia repair)

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4
Q

What arteries travel within the rectus sheath that could potentially lead to a LAST event?

A

inferior epigastric arteries

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5
Q

________- is a thickened region of the anterior rectus sheath that extends vertically from the xiphoid process to the pubic symphysis.

A

Linea alba

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6
Q

The _________- runs vertically along the lateral edges of the rectus abdominis.

A

linea semilunaris

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7
Q

___________– runs horizontally across the rectus abdominis

A

Tendinous intersections

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8
Q

With a rectus sheath block, the posterior rectus sheath is ______________________- below the level of the umbilicus and may ____________

A

absent (or very thin); and may not be appreciated

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9
Q

Match each quadratus lumborum block with its target area for depositing local anesthetic.
QL 1, QL2, QL 3
lateral to the quadratus lumborum muscle
anterior to the quadratus lumborum muscle
posterior to the quadratus lumborum muscle

A

QL 1- lateral to the quadratus lumborum muscle
QL 2- posterior to the quadratus lumborum muscle
QL 3- anterior to the quadratus lumborum muscle

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10
Q

What is the objective of the QL block?

A

quadratus lumborum muscle is a key anatomic landmark and the thoracolumbar fascia is the target area for depositing local anesthetic

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11
Q

Indications for the QL block include

A

analgesia for procedures of the anterolateral abdominal wall

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12
Q

Implications of the QL block include

A

inadvertent peritoneal puncture & visceral injury (kidney, liver, and spleen)

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13
Q

The thoracolumbar fascia consists of 3 layers:

A

anterior, middle & posterior

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14
Q

The quadratus lumborum muscle resides between the

A

anterior to the middle layers of the thoracolumbar fascia

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15
Q

The QL 1 block provides coverage for

A

abdominal surgery below the umbilicus

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16
Q

The QL 2 & 3 provides coverage for

A

abdominal surgery below or above the umbilicus (up to T6)

17
Q

QL blocks require

A

ultrasound

18
Q

Which QL block looks for the shamrock sign under ultrasound

A

QL 3

19
Q

The shamrock sign is made up of

A

The stem of the shamrock is formed by the L4 transverse process. The three leaves of the clover include the erector spinae muscle group, QL muscle, and psoas muscle