11. Digital Block

Question 1

volar

Answer 1

palm side
anterior

Question 2

dorsal

Answer 2

back on hand
posterior

Question 3

median hand (anterior/posterio)

Answer 3

ulnar
C8-T1

Question 4

posterior lateral hand

Answer 4

radial
C5-C6

Question 5

anterior lateral hand
fingertips of first 3.5 digits

Answer 5

median
C6-C8

Question 6

digital block indications

Answer 6

finger or toe surgery

Question 7

ring block insertion

Answer 7

dorsolateral aspect of base of finger

Question 8

ring block needle advance

Answer 8

until it contacts bone (phalanx)

Question 9

ring block volume

Answer 9

< 2 mL on each side
-1 mL as withdrawing first 1-2 mm after bone contact
- 1 mL as withdrawing to skin

Question 10

TOTAL ring block volume

Answer 10

< 4 mL per digit

Question 11

transthecal block needle insertion

Answer 11

45 degree angle
distal to palmart crease

Question 12

where is LA injected into for transthecal block

Answer 12

flexor tendon sheath

Question 13

transthecal block volume

Answer 13

2-3 mL

Question 14

resistance during transthecal block indicates

Answer 14

needle tip contacting tendon

Question 15

transthecal advantage

Answer 15

single injection

Question 16

which is more painful ring block or transthecal block?

Answer 16

transthecal block

Question 17

subQ volar digital block needle injection

Answer 17

pinch skin on volar side of finger
insert perpendicular

Question 18

subQ volar block volume

Answer 18

2 mL

Question 19

easiest digital block

Answer 19

subQ volar

Question 20

least painful digital block

Answer 20

subQ volar

Question 21

which digital block require proximal pressure?

Answer 21

transthecal
subQ volar

Question 22

why is proximal pressure applied?

Answer 22

to ensure more distal spread of local

Question 23

transthecal onset

Answer 23

faster
120 sec

Question 24

transthecal duration

Answer 24

shorter
3 hrs

Question 25

transthecal pain

Answer 25

painful 3.1

Question 26

subQ volar onset

Answer 26

slower 140 sec

Question 27

subQ volar duration

Answer 27

longer 4.3 hrs

Question 28

subQ volar pain

Answer 28

not as bad 2.4

Question 29

which digital block do pts prefer?

Answer 29

subQ volar

Question 30

3 sided big toe block how many injections

Answer 30

3

Question 31

what injections does the big toe block get?

Answer 31

medial dorsal lateral

Question 32

big toe block medial insertion

Answer 32

perpendicular

Question 33

which toes can the 3 sided block be used for?

Answer 33

all of them

Question 34

toe block volume: big toe

Answer 34

4-6 mL

Question 35

toe block volume: small toes

Answer 35

3 mL

Question 36

digital block complications

Answer 36

hematoma compartment syndrome

Question 37

great toe block volume

Answer 37

<6 mL

Question 38

finger and small toe block volume

Answer 38

< 4 mL

Question 39

tranthecal and subQ block volume

Answer 39

< 2 mL

Question 40

digital block CI

Answer 40

epi pts w/compromised digital circulation

Question 41

pts w/compromised digital circulation

Answer 41

diabetes peripheral vascular disease raynauds AV fistula

Question 42

digital block advantages

Answer 42

easier not as painful lower risk of LAST

Question 43

digital block disadvantages

Answer 43

multiple injections shorter duration