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23 Cards in this Set

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Indications for axillary blocks?
Surgical procedures distal to elbow

Forearm
Hand and digits
Axillary blocks are performed for surgical procedures of:
a. upper arm distal to acromioclavicular joint
b. forearm
c. hand and digits
d. both b & c
d. both b & c
2. All of the following are axillary block techniques except:
a. subcutaneous median nerve
b. transarterial
c. paresthesia
d. peripheral nerve stimulator
b. subcutaneous median nerve
3. To assess the efficacy of an axillary block of the radial nerve one should check the sensation:
a. over the dorsoradial surface of the distal forearm
b. at the webspace between the thumb and first finger
c. on the palmar surface of the thumb
d. over the dorsal surface of the tip of the small finger
b. at the webspace between the thumb and first finger
4. Complications of an axillary block include:
a. hematoma
b. intravascular injection ( systemic toxicity)
c. post-op neuropathies
d. failure to block musculocutaneous nerve
e. all of the above
e. all of the above
What are the three techniques used for axillary block?
1.Transarterial (transvascular) Technique
2 Paresthesia Technique
3. Peripheral Nerve Stimulator Technique
Complications of axillary block?
Intravascular injection (systemic toxicities)
Hematoma
Post-op neuropathies
Failure to block musculocutaneous nerve
Motor response to Musculotaneous nerve stimulation?
Biceps Flex
Motor response to Median nerve stimulation?
1. Wrist flexion
2. Fingers flexion
3. Thumb opposition
Motor response to Ulnar nerve stimulation?
1. Ulnar deviation of the wrist
2. Metacarpo-pharangeal flexion
3. thumb adduction
Motor response to Radial nerve stimulation?
1. wrist extension
2. Metacarpo-phalangeal extension
3. thumb abduction
Root nerves that make up the brachial plexus?
C4- C5- C6- C7-C8- T1
Describe the Breakdown of the nerve roots to branches?
Roots
Trunks
Divisions
Cords
Branches
(Robert Taylor Drinks Cold Beer)
What does the Axillary nerve innervate?
Deltoid and teres Minor
What does the Musculocutaneous nerve innervate?
sends fibers to the biceps brachii and brachialis
What does the median nerve innervate?
Brances to the flexor muscles of the arm, also travels thru the antecubital.
What does the Ulnar nerve innervate?
supplies the flexor carpi ulnaris and part of the flexor digitorum profundus
What does the Radial nerve innervate?
extensor muscles of the arm.
What is the landmarks for the Interscalene Block?
Groove between anterior and medial scalene muscles at the level of C6 (cricoid cartilage)
(Watch of forearm twitch or deltoid twitch)
What landmark is used for the Infraclavicular block ?
Coracoid Process of the Humerous 2cm medial and 2cm caudad
(less risk of pneumothorax)
When performing an axillary block what nerves are commonly missed and must be blocked separetly?
The axillary and the musculocutaneous nerves.
What landmark is used with the axillary block?
Axillary artery
How are the nerves arranged around the axillary artery?
(face of a clock-approx location)
0200: Median nerve
0400: Ulnar nerve
0800: Radial n.
1000: Musculcutaneous n.