Pocus (Week 6) Flashcards
(38 cards)
What vertebral level is associated with the nipple line?
T4
Nagelhout 7th, Ch. 50, pg. 1150
What vertebral level is associated with the Xiphoid process?
T6
Nagelhout 7th, Ch. 50, pg. 1150
What verterbral level is associated with the umbilicus?
T10
Nagelhout 7th, Ch. 50, pg. 1150
What vertebral level is associated with the Pubis?
T12
Nagelhout 7th, Ch. 50, pg. 1150
Which ventral rami innervate the chest?
T1-T6
Nagelhout 7th ed, Ch. 50, pg. 1150
Which ventral rami innervate the abdomen?
T6-L1
Nagelhout 7th ed, Ch. 50, pg. 1150
What kind of US artifact is this, and why does it happen?
Reverberation
- Sound waves bounce back and forth between the walls of the needle before returning to the transducer
Miller’s, Ch. 46, Fig. 46.2
What advantages does a linear probe have?
- Higher Scan-density line
- Produce best image quality
Miller’s, Ch. 46, Somewhere cause they ain’t got damn page numbers
What advantages does a Curvilinear probe have?
- Provide a broad view
- Used when space is limited
- Easier to rock
Miller’s Ch. 46, Transducer Selection, Manipulation…
Anesthetic indications for Paravertebral block (PVB)?
- Thoracic surgery
- Breast surgery
- Cholecystectomy
- Herniorrhaphy (Hernia repair)
- Appendectomy
- Acute pain management for rib fx
Nagelhout 7th ed., Ch. 50, pg. 1160
Analgesic indications for Paravertebral block (PVB)?
- Rib fx
- Flail Chest
- Blunt abdominal trauma
- Herpes zoster
- Osteoporosis Vertebral Fx
Nagelhout 7th ed., Ch. 50, pg. 1160
Target for PVB?
Unilateral spinal nerves @ the level of the block in the Paravertebral space
Nagelhout 7th ed., Ch. 50, pg. 1160
Block required for the first 5 ribs, Intercostal block or PVB?
PVB
Nagelhout 7th ed., Ch. 50, pg. 1161
What block target is the arrow pointing at?
Paravertebral space for PVB
Which block target is highlighted pointing at?
Erector Spinae Block
Indications for Erector Spinae block (ESB)?
- Lumbar Spine surgery
- VATS (video-assisted thoracic surgery)
- Breast Surgery
- Rib fx
- Bariatric surgery
- various abdominal surgeries
Nagelhout 7th ed., Ch. 50, pg. 1166
Target for ESB?
Fascial plane between ES m. & Transverse process
- Targets Dorsal/Ventral rami
- Can have craniocaudal spread over multiple dermatones
Nagelhout 7th ed., Ch. 50, pg. 1166/ APEX Truncal Block, ESB
Target for Intercostal Nerve Block (ICB)?
Intercostal n. between internal intercostal m. fascia & Pleura
Miller’s 9th ed, Ch. 46, page something
Indications for ICB
Single dermatome level for Sensory/Motor Block from Xiphoid to pubis
- Chest/Thorax Acute/Chronic Pain conditions
- Rib fx
- Herpes Zoster
- Chest tube insertion
- Cholecystectomy
Nagelhout 7th ed, Ch. 50, pg. 1161
Quick! How to do a PECS1 block?
- Transducer between Coracoid process & Clavicle
- Visualize 2nd/3rd rib
- Insert needle between Pec. Major & Minor distal to thoracoacromial a.
- Inject 10-15mL of LA
APEX
Quick! How to do PECS2 block
- Do PECS1 block
- Find facial plane between PMi m. & Serratus Anterior m. (3rd/4th rib)
- Advance needle between PMi m & SA m.
- Hopefully negative Aspirate, injecto 10-15mL of LA
APEX
What kind of Probe type is this?
Sector probe
- Narrow near transducer, widens further as you go
His PPT
What kind of probe is this?
Linear Array
- Parallel sound waves
- Rectangular image
Reed’s PPT
What kind of probe is this?
Curved/Curvilinear Array
- It’s a compromise between sector/linear
- Can visualize them deep thangs
His PPT again
