upper extremity blocks

Question 1

what what is superficial cervical block indicated for

Answer 1

superficial surgery of the neck and shoulder, thyroid, CEA

Question 2

how should you position someone for a superficial cervical block

Answer 2

head relaxed, turned to opposite side

Question 3

what are the landmarks for superficial cervical block

Answer 3

mastoid process, transverse process of C6, posterior border SCM.

-transverse process of C6 should be easily palpable behind clavicular head of SCM just below level of cricoid.

Question 4

superficial cervical block: draw line from mastoid to C6, ___ is point of needle insertion

Answer 4

midpoint

Question 5

superficial cervical block: draw line from mastoid to C6, ___ is point of needle insertion

Answer 5

midpoint

Question 6

what is the technique for a cervical block

Answer 6

field block - 10-15ml - superior and inferior redirections along posterior border of SCM. subq posterior and behind SCM no more than 1 cm deep`

Question 7

superficial cervical block - complications

Answer 7

infection, hematoma, LA toxicity, nerve injury

phrenic nerve block, inadvertent subarachnoid or epidural, TIA, RLN block

Question 8

Interscalene block indications

Answer 8

shoulder, lateral 2/3 of clavicle, proximal humorous, shoulder joint

Question 9

an interscalene block covers the arm and forearm, likely to miss ____ distribution from inferior trunk

Answer 9

ulnar

Question 10

what are the landmarks for interscalene

Answer 10

sternal head of SCM, clavicular head of SCM, upper border of cricoid cartilage, clavical

Question 11

interscalene - needle is inserted at level of __

Answer 11

C6

Question 12

interscalene - stimulation at shoulder could be ___ nerve

Answer 12

suprascapular

Question 13

complications of interscalene

Answer 13

spinal or epidural, intervertebral injection, neuropathy, mechanical plexus injury, infection, pneumo, LA toxicity, phrenic nerve block, horners

Question 14

supraclavicular block indications

Answer 14

any surgery of upper extremity not involving shoulder

Question 15

supraclavicular block is excellent for the ___ and ___

Answer 15

elbow and hand

Question 16

why shouldn’t you do bilateral supraclavicular?

Answer 16

possible resp emergency - bilateral phrenic nerve blocks

Question 17

which brachial plexus block has the highest risk of pneumo

Answer 17

supraclavicular

Question 18

what are complications of supraclavicular block

Answer 18

phrenic nerve block, horners, pneumo, LA toxicity, nerve damage

Question 19

when is an infraclavicular block indicated?

Answer 19

any surgery up to but not including the shoulder

Question 20

T/F infraclavicular block has a low risk of pneumo

Answer 20

true, if not directed medially

Question 21

what is indication for axillary block?

Answer 21

surgeries of forearm, wrist, hand