Anatomy Flashcards by Andrew Sullivan

superficial cervical plexus

block

c1-c4
ONLY cutaneous blocked
BLOCK: midpoint of posterior border of SCM
often block ACCESSORY nn accidentally with it (cn 11)

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5 nn of superficial cervical plexus

1-Greater auricular
2-LESSER occipital
3-GREATER occipital
4-transverse cervical
5-supraclavicular

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Superior surface of posterior arytenoids

INTERNAL branch of SUPERIOR laryngeal nn

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Superior Laryngeal Nerve

-block thru thyrohyoid membrane

base of epiglottis
superior portion of cords
arytenoids
glottic opening

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cricothyroid membrane injection

VOCAL cords block and below (captures recurrent laryngeal)

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Recurrent Laryngeal territory

up to vocal cords

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Glossopharyngeal territory

upper epiglottis
base of tongue
back of oropharynx

BLOCK: behind tonsillar pillars
(retropharyngeal hematoma, CAROTID receptors afferent pathways…increasing pressure….can get bradycardia!!)

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ALL MUSCLES OF AIRWAY INNERVATED BY RECURRENT LARYNGEAL EXCEPT:

cricothyroid mm (external br of SLN)

DOES: TENSOR of vocal cords

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Stellate ganglion block in relation to carotids

MEDIAL to carotid pulse ANTERIOR to C6 transverse process

–(80% of people) lowest cervical ganglion is fused with the first thoracic ganglion to form the cervicothoracic (stellate) ganglion

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stellate ganglion located:

anterior to pre vertebral fascia
medial to carotid sheath
vertebral artery passes ANTERIOR to ganglion at C7, BUT is posterior to anterior tubercle of C6 (90%)

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palpate this to locate C6 level

cricoid cartilage

CHASSAIGNAC’s tubercle is C6 TP….felt just lateral to the cartilage

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syndrome get with stellate block

HORNER’s

ptosis
miosis
anhydrosis

THIS DOES NOT IMPLY SYMPATHETIC DENERVATION of arm. only that there’s cephalic sympathetic blockade

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MOST common clinical sign of sympathetic blockade with stellate block

INCREASE in skin temp [>50% increase in skin blood flow]

will approximate core temp

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vertebral artery originates from?

from subclavian aa

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stellate block PROOF

-adrenergic activity confirm PLUS sympathetic cholinergic activity

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left SUBCLAVIAN line placement can result in?

chylothorax; thoracic duct compromise

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anterior border of the lumbar epidural space?

posterior longitudinal ligament

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epidural space borders?

ANTER-Post longitud ligament of vertebral body

LATERAL-pedicles and intervertebral foramina

POSTER- flavum

SUPER-foramen mag
INFER-sacral hiatus

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plexus in epidural space?

BATSON venous plexus

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out to in: epidural space

supraspinous lig
interspinous lig
ligament FLAV
epid space
THRU SPINAL CORD
posterior spinous ligament
vertebral body

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C7 marker

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most prom

T3 marker

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scapular spine

T7 marker

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inferior angle of scapula

T12 marker

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lowest rib

L4 marker

iliac crests

S2 marker

PSIS

which nerve usually missed with inter scalene block?

ulnar (C8-T1...lowest pocket) HOW TEST? -finger abduction -

axillary block missed what nn?

Musculocutaneous ACTION:

Brachial plexus nn

C5-C8, T1 | ANTERIOR PRIMARY RAMI

Posterior cord become?

radial | and axial

Lateral cord becomes

MC nn | after part of it splits off to join with medial cord to become median nn

medial cord becomes ultimately

ulnar

how many divisions?

6 three after three poster

where does the MEDIAN nn come from?

lateral and medial cords (coming together after gets branch from medial cord and branch from lateral cord)

nerves in relation to AXILLARY artery?

superior - MEDian infer - ULNar poster/lat - RADial

BRACHIAL artery - at elbow....where median nn?

medial to brachial aa

median nn placement at wrist?

- -flexor carpi radialis | - -palmaris longus

ulnar nn to hand supplies

-ulnar side -ALL mm of hand [except: thenar eminence; 1st and 2nd lumbrical mm]

where ulnar nn at wrist?

btwn: - flexor carpi ulunaris - ulnar aa - pisiform

ANTERIOR roots to lumbar plexus (go to)

-ultimately converge on OBTURATOR nn

POSTERIOR roots of lumbar plexus (go to)

LFC; fem nn

SACRAL plexus gives two nn

- SCIATIC | - poster cut nn thigh

saphenous nn is ONLY component of distal lower extremity that comes from ____nn

femoral | everything else thru sciatic

Obturator

L3-L4 | -medial thigh

anterior br of fem

skin

total anesthesia of knee

obturator, sciatic, AND femoral

BEST test to check sciatic block?

foot inversion | (bc most of sciatic is medial side); although will have plantar flexion too

BORDERS of popliteal fossa?

-MEDIAL: semimembranosus -LATERAL: biceps femoris -POSTER: gastrocnemius

popliteal fossa arrangement (lateral to medial)

- nerve - artery - vein

sural nn vs | poster tib IN RELATION TO ACHILLES

MEDial side - poster tib nn LAT side - sural nn

Anatomy Flashcards

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