Bb Brachial Plexus

Front 1

Rank the set up time for brachial plexus blocks from fastest to slowest?

Back 1

interscalene, supraclavicular, axillary

Front 2

What are contraindications to brachial plexus blocks?

Back 2

local infection and pneumothorax

Front 3

What tissue forms the axillary perivascular sheath?

Back 3

prevertebral fascia

Front 4

When can you use an axillary block for anesthesia for procedures on the arm?

Back 4

distal to the elbow

Front 5

What problem can you encounter when doing an axillary block as the anesthetic for procedures? How can you solve it?

Back 5

musculocutaneous nerve often exits distal to where the axillary block is performed, which provides sensation to the lateral aspect of the forearm; injection of lidocaine 1% 3-5 cc into coracobrachialis will block this nerve

Front 6

What nerves are frequently missed with the axillary block?

Back 6

intercostal brachial nerve, median cutaneous nerve, musculocutaneous nerve

Front 7

How can you block both the intercostobrachial nerve and median cutaneous nerve if missed by an axillary block?

Back 7

cuff of anesthesia: injecting local anesthetic circumferentially and superficially around the arm as the axillary block needle is needle is being removed

Front 8

How does the axillary nerve block progress?

Back 8

proximal to distal; the outside of the nerve innervates the proximal region and the core innervates the distal region

Front 9

If after an axillary block patient is still having pain in his hand what should you do?

Back 9

wait block probably needs more time to set up

Front 10

what are complications of the interscalene block?

Back 10

vertebral artery puncture, pneumothorax, phrenic nerve paralysis, spinal or epidural block, brachial plexus injury, recurrent laryngeal nerve blockade

Front 11

Where do the interscalene and supraclavicular block provide excellent analgesia?

Back 11

proximal to the elbow including the shoulder

Front 12

If you do an interscalene block for analgesia of the arm what block is often necessary to supplement the analgesia to the forearm?

Back 12

ulnar(unless large volumes are used the lower trunk anesthesia may be missed)

Front 13

How is a supraclavicular block performed?

Back 13

skin should be entered 1-2 cm above the midpoint of the clavicle when the first rib is contacted the needle should be moved in a slightly anterior posterior direction until paresthesia is elicited

Front 14

What are complications associated with a supraclavicular block?

Back 14

pneumothorax, phrenic nerve paralysis, horner's syndrome(ptosis, miosis, anhidrosis, sinking in of eyeball, and flushing of the affected side), nerve damage and neuritis

Front 15

How can you tell if there is a median nerve injury?

Back 15

injury of papal benediction(little and ring fingers are flexed, while other fingers are extended)

Front 16

what is the agent of choice, concentration and dose for a bier block?

Back 16

0.5% lidocaine 50mL

Front 17

what is the minimum and maximum tourniquet time for a bier block?

Back 17

minimum-30min, max-2hrs

Front 18

What are the advantages of a bier block?

Back 18

excellant anesthesia to forearm, hand, and foot, technical ease and reliability, duration and extent of anesthesia are reliable and predictable and recovery is rapid

Front 19

what are the disadvantages of a bier block?

Back 19

limitations imposed by tourniquet time, problems with exsanguination in certain cases such as fracture or laceration

Front 20

How should the tourniquet be released for a bier block?

Back 20

alternating inflation and deflation at 5-10 s intervals for a minute or two