Test 2

Question 1

subcostal block blocks which dermatomes

Answer 1

T7-T11

Question 2

TAP blocks block which dermatomes

Answer 2

T10-L1

Question 3

Ilioinguinal iliohypogastric blocks which dermatomes

Answer 3

L1

Question 4

Structures composing Petit’s Triangle

Answer 4

Rib cage
Latissimus dorsi
External oblique
Pelvis

Question 5

TAP blocks provides which type of relief

Answer 5

Somatic but no visceral analgesic relief

Question 6

LA for TAP block

Answer 6

30-40ml per side

0.3-0.6 mg/kg

Dilute concentrations down to at least 0.25% bupivacaine or 0.3% Ropivacaine

Question 7

Indications for TAP block

Answer 7

C section
Appy
Inguinal Hernia Repsir

Question 8

LA only approved for TAP blocks by FDA

Answer 8

Exparel

20ml diluted in NS

Question 9

Consideration with TAP block as possible complication/inadvertent

Answer 9

Femoral nerve block

Question 10

Femoral nerve block with TAP block is due to

Answer 10

Unexpected injection into the transversalis fascia

Transversalis fascia is continuous plane with fascia iliaca

Caution with ambulation

Question 11

Landmarks for mid axillary TAP block

Answer 11

Subcostal margin

Iliac crest

Question 12

Muscles involved in TAP block and order from superficial to deep

Answer 12

External oblique
Internal oblique
Transversus abdominis

Question 13

Where inject LA for TAP block

Answer 13

Between internal oblique and transversus abdominis

Question 14

US and needling for TAP block

Answer 14

In plane medial to lateral needle approach

Question 15

If having difficulty Identifying area for injection for TAP what movement with probe

Answer 15

Heel to Toe

**Rocking

Question 16

To extend TAP block duration

Answer 16

Add epi 1:400,000
Decadron 4 mg per side

Exparel

Question 17

Problem with Exparel for TAP blocks

Answer 17

Very slow onset

Need to do block preop or early in case

Question 18

2 tips for improving success of TAP block

Answer 18

Larger volumes (30-40ml)

Be posterior as possible

Question 19

Subcostal approach for TAP block is beneficial for

Answer 19

Upper abdominal surgeries

Question 20

Subcostal approach provides analgesia of

Answer 20

T7-T12

Question 21

Amount of LA for subcostal TAP

Answer 21

20-30ml per side

Question 22

Muscles identified with subcostal approach

Answer 22

External oblique
Internal oblique
Transversus abdominis
Rectus abdominis

Question 23

Ilioinguinal/Iliohypogastric block indications

Answer 23

Inguinal hernia repair
Testicular or scrotal surgery

Innervates base of penis only

Question 24

Iliohypogastric nerve origin

Answer 24

L1

Question 25

Ilioinguinal nerve origin

Answer 25

L1

Question 26

Genitofemoral nerve origin

Answer 26

L1-2

Question 27

Lateral femoral cutaneous nerve origin

Answer 27

L2-3

Question 28

Subcostal nerve origin

Answer 28

T12

Question 29

Ilioinguinal-iliohypogastric TAP block landmark approach

Answer 29

2cm medial and then 2 cm cephalad from anterior superior iliac spine (ASIS)

Question 30

LA amount needle type ilioinguinal/Iliohypogastric block

Answer 30

10ml of LA each injection

0. 25-0.5% bupivacaine
1. 375-0.5% Ropivacaine

Blunt block needle

Double injection

Question 31

Ilioinguinal-iliohypogastric provides analgesia to

Answer 31

L1 segment

Question 32

Near the ilioinguinal iliohypogastric nerve injection area is this structure to be aware of

Answer 32

Deep circumflex iliac artery

Question 33

For the ilioinguinal-iliohypogastric block should you use doppler? Why?

Answer 33

Yes. Because deep circumflex iliac artery is in the same location

Question 34

For ilioinguinal-iliohypogastric block injection

Answer 34

2 separate injections
Between EOM and IOM
And between EOM and TAM