Lower Blocks

Question 1

spinal nerves that make up the lateral femoral cutaneous nerve

Answer 1

L2-L3

Question 2

spinal nerves that make up the obturator nerve

Answer 2

L2, L3, L4

Question 3

function of the obturator nerve

Answer 3

motor to adductor muscles of thigh

sensory to medial thigh

Question 4

spinal nerves that make up the femoral nerve

Answer 4

L2, L3, L4

Question 5

3 ways to block the femoral nerve and cover the knee

(I think? tried to find where he said this to relisten and I couldn’t)

Answer 5

femoral block

fascia iliaca block

saphenous block

Question 6

analgesia provided by femoral block covers what areas?

Answer 6

anterior thigh and knee

medial aspect of lower leg (via saphenous nerve)

Question 7

analgesia provided by fascia iliaca block covers what areas?

Answer 7

hip, femoral shaft, knee

Question 8

analgesia provided by sciatic block covers what areas?

Answer 8

below knee (sparing medial side of lower leg)

Question 9

analgesia provided by popliteal block covers what areas?

Answer 9

below knee (sparing medial side of lower leg)

Question 10

analgesia provided by ankle block covers what areas?

Answer 10

anesthesia or analgesia to foot and distal ankle

Question 11

approach for needle insertion of ultrasound-guided femoral nerve block

Answer 11

laterally from femoral artery and below inguinal ligament

Question 12

volume of LA used for femoral nerve block

Answer 12

no less than 20 mL

(ideally 20-30)

Question 13

postop disadvantage of femoral block

Answer 13

may affect/prevent early ambulation

Question 14

US placement for femoral block

(M&M)

Answer 14

• placed over and parallel to the inguinal crease
• visualize femoral artery and vein in cross-section
• just lateral to artery and deep to fasica iliaca, femoral nerve appears in cross-section as a spindle-shape “honeycomb”

Question 15

why can fascia iliaca block be used for pain management in hip surgery?

Answer 15

provides femoral block coverage but adds reliable coverate of lateral femoral cutaneous nerve

Question 16

block that occurs by default with fascia iliaca block

why?

Answer 16

femoral nerve block

femoral n. is adjacent to this plane

Question 17

mL LA used for fascial iliaca block

(M&M)

Answer 17

30-40 mL

Question 18

nerves that make up the sciatic nerve

Answer 18

tibial (L4-S3) and common peroneal (L4-S2)

Question 19

functions of the sciatic nerve

Answer 19

• hip extension
• knee flexion
• ankle plantarflexion
• ankle dorsiflexion
• all movements of toes

Question 20

what nerve block covers the opposing portions of the leg not covered by the femoral nerve?

Answer 20

sciatic block

Question 21

nerve blocks required to achieve complete anesthesia below the knee

Answer 21

sciatic block plus saphenous or femoral block

Question 22

sciatic block approach for ankle coverage

Answer 22

at posterior knee (popliteal block)

Question 23

responses expected from sciatic nerve stimulation

Answer 23

tibial response: plantarflexion

peroneal: dorsiflexion

Question 24

what is in the adductor canal?

(M&M)

Answer 24

several nerves that provide sensory innervation to the knee, most notably the saphenous nerve

Question 25

use of adductor canal block | (M&M)

Answer 25

analgesia of knee and medial leg

Question 26

how does an adductor canal block allow for a more focused blockade of the knee?

Answer 26

decreases effect of proximal branches and hip (more dense block of the knee)

Question 27

block used in knee surgery that increases likelihood of early ambulation

Answer 27

adductor canal block (doesn't affect the hip)

Question 28

landmark for adductor canal block

Answer 28

femoral artery

Question 29

use of popliteal block

Answer 29

excellent coverage for foot/ankle surgeries (covers lower leg and ankle)

Question 30

which is lateral and which is medial? tibial nerve common peroneal nerve

Answer 30

lateral - common peroneal medial - tibial

Question 31

which is lateral and which is medial? tibial nerve common peroneal nerve

Answer 31

lateral - common peroneal medial - tibial

Question 32

where are tibial & common peroneal nerves located in relation to popliteal vein & artery

Answer 32

lateral join superiorly above the knee

Question 33

mL LA used for popliteal block

Answer 33

20 mL

Question 34

nerves that have to be blocked for a **complete** ankle block (5)

Answer 34

1. posterior tibial 2. saphenous 3. deep peroneal 4. superficial peroneal 5. sural

Question 35

where is the posterior tibial nerve in relation to the posterior tibial artery?

Answer 35

just posterior (6-9 o clock)

Question 36

location of the saphenous nerve in relation to the medial malleolus

Answer 36

anterior (9-12 o clock)

Question 37

location of the deep peroneal nerve

Answer 37

just above ankle slightly lateral to anterior tibial artery (12 o'clock)

Question 38

location of the superficial peroneal nerve

Answer 38

lateral ankle anterior to malleolus (1-3 o clock)

Question 39

location of sural nerve

Answer 39

lateral ankle posterior to lateral malleolus 3-6 o clock

Question 40

which nerve is blocked in mirror to posterior tibial

Answer 40

sural

Question 41

only innervation of the foot that is not part of the sciatic system (M&M)

Answer 41

saphenous nerve (terminal branch of femoral nerve)

Question 42

where does the sciatic nerve divide into the tibial and common peroneal nerves?

Answer 42

approx 10 cm above the bend of the knee

Question 43

list 3 peripheral blocks that can be used to provide analgesia to the anterior knee (worksheet)

Answer 43

1. femoral nerve block 2. fascia iliaca block 3. adductor canal plz lmk if this is incorrect xoxo BH - u right hunni