Regional

Front 1

Lateral proximal thigh

Back 1

Lateral fem cutaneous L2-3

ASIS

Front 2

Ordr of nerves in spinal

Back 2

Sympathetic, B cold, C pinprick (delta), touch (A beta), Proprioception, motor (A alpha) Comes back in that order.

Front 3

Common Peroneal

Back 3

Foot eversion, so redirect needle medial

biceps femoris laterally, semimembranosus medially, and the two heads of the gastrocnemius inferiorly. This creates a triangle for the posterior approach

tibial nerve results in plantarflexion and inversion of the foot

Front 4

Musculocutaneous

Back 4

Elbow flexion

Gives off the lateral antebrachial cutaneous nerve, lateral forearm sensation.

Branches off prior to radial, ulnar and median. So u inject coracobrachialis

Front 5

Stroke

Back 5

Thalamic pain syndrome is from latent plasticity

Weeks to months after

No temp issues just paresthesias and allodybia

Denerine roussy

Front 6

Substance p

Back 6

First-order neurons secrete substance P in the dorsal horn as a chemical mediator of pain signaling. And then spinothalamic

Dorsal horns also use adenosine

Front 7

Pain pathway

Back 7

Central inhibition occurs via the descending pathways from the periaqueductal gray matter and alpha-2 receptor agonism.

Wind-up" is a phenomenon that describes an exponentially progressive increase in firing of WDR neurons with repeated stimulation.

Front 8

Central sensitization

Back 8

central mechanism is referred to as spinal sensitization, which is defined as a heightened sensitivity of spinal neurons that reduces activation threshold and increases input responsiveness. Spinal sensitization is largely mediated by the N-methyl-D-aspartate (NMDA) receptor.

Front 9

Spinal stenosis

Back 9

Lateral recess stenosis causes radicular pain in the nerve above the spinal level. The lateral recess is very posterior in the spinal canal and impinges on nerves leaving the canal at the level above the corresponding vertebral level. For example, lateral recess stenosis of L3-4 will cause radicular pain of the L2 nerve.

Front 10

Interscalene

Back 10

A diaphragmatic response (e.g., coughing, gasping, hiccupping) during interscalene blockade (ISB) indicates that the needle is stimulating the phrenic nerve. The needle tip is positioned too anteriorly and must be redirected posteriorly (B) toward the cervical nerve roots to achieve the desired blockade.

interscalene groove and directed medially, caudally, and slightly posteriorly in the direction of the C6 transverse process. The caudad tilt of the needle is important to avoid high-spinal anesthesia or a spinal cord injury that could result from entering the neural foramen or injecting into the dural nerve root sheath. When using a nerve stimulator, the desired motor response is twitching of the pectoralis, deltoid, arm, forearm, or hand muscles. Diaphragmatic or trapezius twitches indicate cervical plexus stimulation. A diaphragmatic response occurs due to stimulation of the phrenic nerve. The phrenic nerve runs along the anterior surface of the anterior scalene muscle, whereas the C5-7 nerve roots are located posterior to the posterior border of the anterior scalene

Front 11

Fem block

Back 11

sartorius twitch is encountered, the recommended maneuver to obtain a patellar twitch (the preferred end-point) would be to advance the needle deeper and slightly more lateral

Posterior divisions of l2-4

Front 12

Obturator

Back 12

Bottom Line: The obturator block is performed by injecting local anesthetic between the adductor longus and brevis muscles.TrueLearn Insight : The mnemonic ALABAMa is used to remember the muscles from superficial to deep: Adductor Longus, Adductor Brevis, Adductor Magnus.

L2to4 ANTERIOR division

Front 13

anterior cerebral artery

Back 13

- parietal lobe=motor, sensory, brocas

comes from internal carotid

also supplies frontal lobe

basal ganglia

olfactory

Front 14

basilar stroke

Back 14

locked in syndrome. can still wink and have conciousness

loss of involuntary face

Front 15

PCA stroke

Back 15

macular sparing blindness

Front 16

POsterior cord

Back 16

Radial and Axillary nerve

Front 17

Medial cord

Back 17

median (medial head) and ulnar

Front 18

lateral cord

Back 18

median and musculoskeletal

Front 19

Lateral Femoral Cutaneous

Back 19

L2-3

Sill posterior division

LIKE FEMORAL

Front 20

Lumbosacral Plexus

Back 20

L45, S1-3

Cutaneous Nerve is the other one, and both have branches of anterior rami 4 and 5

Front 21

Tibial v peroneal

Back 21

Tibial is Ventral

Peroneal is dorsal. Both have therefore innervation of L4-S3

Front 22

Anterior Division of FEm nerve

Back 22

Sensory

WHeras POsterior is MOTOR (quads