week 2 Flashcards
What are the 3 Upper extremity plexuses?
Cervical Plexus
Phrenic Nerve
Brachial Plexus
Which nerves are part of the cervical plexus?
C1-C5
What nerves are part of the Phrenic Nerve?
C3-C5 with major contribution coming from C4
What nerves are part of the Brachial Plexus?
C5-C8 and T1
What does the phrenic nerve innervate?
The diaphragm
Is a nerve stimulator used for cervical plexus block?
no
List the steps in doing a cervical plexus block.
- Turn patients head to opposing side
- Draw line from tip of mastoid process of temporal bone to the anterior tubercle of C6
- Using a 22ga needle penetrate the skin over each point contacting transverse process
- No BLOOD or CSF should be aspirated
- inject 4ml/level
What should you find out before doing a cervical plexus block?
Need to find out if patient is a good candidate for this type of block. Patient must not move during this procedure.
List the complications of Cervical Plexus Block.
- Phrenic nerve block (hiccups)
- Horner’s syndrome (ptosis, miosis, anhydrosis, facial flusing, nasal congestion, enophthalmosis scleral hyperemia.)
- Hoarseness (recurrent laryngeal nerve)
- Accidental intrathecal or epidural injection
For a Cervical Plexus Block would you stay superficial or deep?
Stay extremely superficial
What are the 5 parts to brachial plexus?
Roots Trunks Divisions Cords Terminal Branches
Which block will block the roots and the trunk?
interscalene block
Which block will block Dvisions and Trunks?
Supraclavicular Block
Which block will block the Cords?
Infraclavicular Block
Which Block will block the terminal branches?
Axillary Block
How many roots are there?
5 roots C5-C8 and T1
How many Trunks?
3
Superior
Middle
Inferior
How many Cords?
3
Lateral
Posterior
Medial
Which nerve/s comes from the lateral nerve?
Lateral pectoral nerve (C5-C7)
Which Nerve/s comes from the posterior nerve?
Upper subscapular nerve (5,6)
Thoracodorsal (middle subscapular nerve) (6-8)
Lower subscapular nerve (5, 6)
Which nerves come from the Medial nerve?
Medial Pectoral Nerve (C8, T1)
Medial cutaneous nerve of arm (T1)
Medial cutaneous nerve of forearm (C8, T1)
Which Nerves branch from Terminal Branches?
Musculocutaneous nerve (5-7) Axillary nerve (5,6) Radial nerve (C5-8, T1) Median nerve (C5-8, T1) Ulnar nerve (C7, C8, T1)