Truncal blocks 3 Flashcards
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
c. rectus abdominis muscle
d. posterior rectus sheath
What is the objective of a rectus sheath block?
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
What are indications for a rectus sheath block?
procedures with a midline abdominal incision (umbilical hernia repair)
What arteries travel within the rectus sheath that could potentially lead to a LAST event?
inferior epigastric arteries
________- is a thickened region of the anterior rectus sheath that extends vertically from the xiphoid process to the pubic symphysis.
Linea alba
The _________- runs vertically along the lateral edges of the rectus abdominis.
linea semilunaris
___________– runs horizontally across the rectus abdominis
Tendinous intersections
With a rectus sheath block, the posterior rectus sheath is ______________________- below the level of the umbilicus and may ____________
absent (or very thin); and may not be appreciated
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
QL 1- lateral to the quadratus lumborum muscle
QL 2- posterior to the quadratus lumborum muscle
QL 3- anterior to the quadratus lumborum muscle
What is the objective of the QL block?
quadratus lumborum muscle is a key anatomic landmark and the thoracolumbar fascia is the target area for depositing local anesthetic
Indications for the QL block include
analgesia for procedures of the anterolateral abdominal wall
Implications of the QL block include
inadvertent peritoneal puncture & visceral injury (kidney, liver, and spleen)
The thoracolumbar fascia consists of 3 layers:
anterior, middle & posterior
The quadratus lumborum muscle resides between the
anterior to the middle layers of the thoracolumbar fascia
The QL 1 block provides coverage for
abdominal surgery below the umbilicus