Neuraxial Block Test Questions Flashcards by Troy Green

Which nerve blocks the anterior AND posterior of the medial one and a half fingers?

a. Ulnar
b. Median
c. Radial
d. Musculocutaneous
e. Axillary

Ulnar

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Which of the following nerves is not blocked during an axillary block?

a. Median
b. Ulnar
c. Axillary
d. Radial

Axillary

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In order to obtain optimal visualization the most ______ nerve should be anesthetized first in an axillary block.

a. Anterior
b. Posterior
c. Lateral
d. Superficial

Posterior

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Which block is associated with Horner syndrome?

a. Interscalene
b. Axillary Block
c. Stellate Ganglion
d. TAP Block

Stellate Ganglion

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What block would increase blood flow for frost bite of the three and a half lateral fingers?

a. Radial
b. Median
c. Axillary
d. Stellate Ganglion

Stellate Ganglion

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Which one of these nerve blocks provides sensory anesthesia to the medial knee and medial leg?

a. iPACK
b. Sciatic
c. Adductor Canal
d. Femoral

Adductor Canal

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During an adductor canal nerve block, what are 3 muscles you identify on the ultrasound?

a. Sartorious, Adductor Longus, Vastus Medialis
b. Adductor Longus, Rectus Femoris, Sartorius
c. Vastus Medialis, Vastus Lateralis, Adductor Longus
d. Pectineus, Adductor Longus, Vastus Medialis

Sartorious, Adductor Longus, Vastus Medialis

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Which of the following would be an indication for an adductor canal block?

a. Ankle arthroscopy
b. TKA
c. Bunionectomy
d. Tibia/Fibula ORIF

TKA

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Where does an iPACK nerve block provide anesthesia?

a. Lateral knee
b. Anterior knee
c. Posterior knee
d. Medial knee

Posterior knee

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Which of the following nerve blocks is used in conjunction with an iPACK in order to provide analgesia for post-op TKA?

a. Adductor canal
b. Femoral
c. Fascia Iliaca
d. Sciatic

Adductor canal

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During what type of procedure would a sciatic nerve block be indicated?

a. hysteroscopy
b. craniotomy
c. appendectomy
d. corrective foot surgery

corrective foot surgery

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What nerve(s) does the sciatic nerve bifurcate into at the popliteal fossa?

a. saphenous nerve
b. biceps femoris
c. tibial nerve
d. common peroneal nerve
e. Both C & D

Both C & D

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The sciatic nerve innervates what portions of the lower limb?

a. quadriceps femoris
b. entire lower limb below (knee down)
c. lower limb below the knee, except medial aspect
d. gluteus maximus and quadriceps femoris

lower limb below the knee, except medial aspect

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The SPEDI (single penetration dual injection) technique includes what block(s)?

a. saphenous & sciatic nerve blocks
b. sciatic nerve block only
c. saphenous nerve block only
d. lumbar plexus block

saphenous & sciatic nerve blocks

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Regional anesthetic blockade of the sciatic nerve is possible at the following locations EXCEPT:

a. sacral plexus
b. brachial plexus
c. transgluteal
d. subgluteal
e. Popliteal

brachial plexus

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Which of the following is an indication for a celiac plexus block?

A. Pancreatic cancer
B. Brain cancer
C. Lateral leg surgery
D. Abdominal incision pain

Pancreatic cancer

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When doing a TAP block, where do the target nerves lie in relation to abdominal wall muscle layers?

A. Between the transverse abdominus and the peritonium
B. Between the external oblique and the internal oblique
C. Between the internal oblique and the transverse abdominus
D. Between the external oblique and the transverse abdominus

Between the internal oblique and the transverse abdominus

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Which of the following correctly lists the anatomical landmarks that are used when performing a BLIND approach TAP block?

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Which of following is a potential complication of performing the celiac plexus block?

A. Subclavian vein puncture
B. Right common carotid puncture
C. Stomach puncture
D. Aortic puncture

Aortic puncture

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What part of the abdomen is covered by a TAP block?

A. Anterior midline
B. Upper lateral abdomen
C. Sub-umbilical anterolateral abdomen
D. Lateral wall to midline, costal margin to iliac crest

Sub-umbilical anterolateral abdomen

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An interscalene block targets what level of the brachial plexus?

a. Roots
b. Trunks
c. Divisions
d. Cords
e. Branches

Roots

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An interscalene block is effective for anesthetizing

Where is the injection made for an interscalene block?

a. Thyroid Cartilage
b. Cricoid Cartilage
c. Internal Jugular Vein
d. Sternocleidomastoid

Cricoid Cartilage

Which are the following are complications of an interscalene block?

Which of the following are true regarding an anterior suprascapular block? a. It has more complications and side effects than an interscalene block b. It may require supplementation c. It provides inferior pulmonary function compared to an interscalene block d. It is commonly used in patients with pre-existing pulmonary pathology where an interscalene block is contraindicated e. A and B f. B and D g. A, B, D h. All of the above

B and D

Regarding an ultrasound guided femoral nerve block, what is the most correct statement: a. The femoral nerve is deep so a low frequency probe is usually used b. Continuous infusion with an epidural catheter is contraindicated because of close proximity to the femoral artery c. The femoral nerve is a major contributor of sensation to the knee joint and blocking it will provide useful analgesia for knee surgery d. The femoral nerve arises from nerve roots L3-S4

The femoral nerve is a major contributor of sensation to the knee joint and blocking it will provide useful analgesia for knee surgery

The knee joint is innervated by all the following nerves, except: a. Femoral nerve b. Lateral femoral cutaneous c. Obturator nerve d. Sciatic nerve (L4-S3)

Lateral femoral cutaneous

The landmarks for the fascia iliaca block include all of the following, except: a. ASIS (Anterior superior iliac spine) b. Ipsilateral pubic tubercle c. Umbilicus d. Femoral arterial pulse

Umbilicus

An 88-year old woman is scheduled for an elective total hip arthroplasty, which of the following regional techniques would be most appropriate for analgesia? a. Deep peroneal b. Obturator c. Popliteal d. Fascia iliaca

Fascia iliaca

The ___________ nerve is the largest terminal branch of the lumbar plexus, formed by the dorsal divisions of the anterior rami of L2-L4. a. Femoral b. Lateral femoral cutaneous c. Obturator d. Genitofemoral

Femoral

When performing a paravertebral block, the tip of the needle should pass between the a. spinous processes of the vertebrae b. transverse processes of the vertebrae c. ribs d. vertebral foramen

transverse processes of the vertebrae

An intercostal nerve blockade should include a. one dermatome below and one dermatome above the surgical site b. two dermatomes below and one dermatome above the surgical site c. two dermatomes below and two dermatomes above the surgical site d. three dermatomes below and three dermatomes below the surgical site

two dermatomes below and two dermatomes above the surgical site

An intercostal block can be difficult to perform a. above T7 b. above T8 c. above T9 d. above T10

above T7

This block has the highest chance of local anesthetic toxicity a. paravertebral block b. serratus plane block c. PECs block d. intercostal block

intercostal block

An intercostal block is commonly performed a. just medial to the transverse process b. along the angle of the rib c. along the midaxillary line d. along the midclavicular line

along the angle of the rib

he intercostal neurovascular bundle is oriented (from top to bottom) a. vein-artery-nerve b. artery-vein-nerve c. nerve-vein-artery d. vein-nerve-artery

vein-artery-nerve

In a serratus plane block, the local anesthetic is administered between a. the serratus and pectoralis minor muscles b. the serratus and pectoralis major muscles c. the latissimus dorsi and pectoralis minor muscles d. the serratus and latissimus dorsi muscles

the serratus and latissimus dorsi muscles

This digital block involves 4 injections to anesthetize both dorsal and both palmar nerves. A) Webspace B) Ring C) Transthecal D) Wing

Ring

Which Digital block technique allows for the least amount of the hand to be anesthetized? A) Wing B) Webspace C) Transthecal D) Wrist

Wing

This nerve is part of the Wrist Block and is anesthetized by injecting between the Flexor Carpi Radialis and the Palmaris Longus. A) Ulnar B) Thenar C)Radial D) Median

Median

Which Nerve of the Wrist block requires the highest volume of anesthetic due to its variances in branch locations from person to person? A) Radial B) Ulnar C) Median D) Dorsal Digital

Radial

This digital block is considered the easiest for beginners as it has the greatest assurance of anesthesia due to high volume and circumferential application, but is inappropriate for a stuck wedding ring. A) Transthecal B) Wing C) Ring D) Palmar

Ring

Ilioinguinal/Iliohypogastric nerve block may be indicated in which of the following surgeries: a) Orchidopexy b) Hydrocoele repair c) Varicocele surgery d) Inguinal hernia repair e) All of above

All of above

Ilioinguinal/Iliohypogastric block correct injectate placement is between: a) Transversus abdominis and Internal oblique muscles b) External oblique muscle and Internal oblique muscle c) Transversus abdominis and Internal oblique muscle d) Subcutaneous tissue and External oblique muscle

Transversus abdominis and Internal oblique muscles

Common complications of a Ilioinguinal/Iliohypogastric block is: a) Transient femoral nerve palsy b) Pneumothorax c) Intraperitoneal injection d) Bowel/viscus perforation

Transient femoral nerve palsy

A 66-year-old male, with a history of severe obstructive sleep apnea, presents for umbilical hernia repair. To reduce the need for postoperative opioid analgesia, the anesthesiologist plans to use a regional anesthetic. Which regional anesthetic procedure would help accomplish this? a. Pectoralis plane block b. Deep cervical plexus block c. Quadratus lumborum block d. Lumbar plexus block

Quadratus lumborum block

Duration of a Quadratus lumborum block is: a)Longer than a TAP block b)Shorter than a TAP block C) About the same as TAP

Longer than a TAP block

Which is NOT a type of Quadratus Lumborum block (QLB)? a) Lateral QLB b) Medial QLB c) Anterior QLB d) Posterior QLB e) Intramuscular QLB

Medial QLB

What structure(s) is/are NOT included in those that make up the shamrock sign for a Quadratus lumborum block? a) Transverse process of T4 b) Erector spinae c) Quadratus lumborum d) Psoas major e) Latissimus Dorsi

Latissimus Dorsi

Which artery is used as a landmark when performing an infraclavicular block? A. subclavian artery B. Axillary artery C.Ulnar artery D.Radial artery

Axillary artery

Which of the following is not an advantage of infraclavicular nerve blocks? A.Decreased risk of pneumothorax B.The preferred site for catheter insertion C.Utilized for shoulder surgery D.Lower incidence of tourniquet pain

Utilized for shoulder surgery

Which upper extremity peripheral nerve block is performed at the level of the cords of the brachial plexus? A.Supraclavicular nerve block B.Interscalene nerve block C.Axillary nerve block D. Infraclavicular nerve block

Infraclavicular nerve block

The recommended concentration of Local Anesthesia for a Supraclavicular block is ? A.Mepivacaine (1.5%) B.Lidocaine (0.75 %) C.Bupivacaine (0.5 % ) D.Lidocaine (1%)

Mepivacaine (1.5%)

A 20 year old male who experienced a recent radius fracture is scheduled to undergo open reduction internal fixation of the radius. He elects to have regional anesthesia performed of the brachial plexus. Under ultrasonographic guidance, the typical supraclavicular view is obtained. If the needle is accidentally advanced medial to the brachial plexus, what would be the most likely structure to be contacted by the needle and what would be the most likely complication from traversing this medial structure? A.External jugular artery; hematoma B.Subclavian artery; hematoma C.Pleura; pneumothorax and dyspnea D.Phrenic nerve; dyspnea

Subclavian artery; hematoma