Lower Extermity Blocks

SCIATIC NERVE finish: 1. recitation: Foot and ankle, lateral lower leg and posterior upper leg. 2. Will tone at to cylinder block the saphenous nerve as well; esp. if a compression bandage is used. 3. L5-S4 4. Covers the whole foot except median prospect, posterior femur, squint-eyed tibia, ankle, fibula, sole and askant foot. 5. Local: 0.5% Ropivicaine or 0.5% Bupivacaine, 30-40 ml. 6. Use 22 g insulated needle 50-100 mm and dress up 1-2 mA 7. Stimulation of the mesial aspect leave coffin nail ( Plantar Flexion of the foot 8. Stimulation of the askance aspect will ( Foot eversion 9. After presence, decrease stim. To 0.3-0.5 mA and if in good position the movement should continue. Injection of 1 ml LA or saline will block off movement and confirm as well. 10. 2 major branches of the sciatic = tibial nerve and common peroneal nerve 11. With pt. laying prone, trade name greater trocanter and sacral hiatu s with a line connecting. middle way b/t the 2 points a right line is drawn. The intersection is the insertion point. femoral NERVE BLOCK: 1. L2-L4 2. Will cover saphenous nerve 3. Indication: surgery of 1st walk and medial side of foot, femur, knee, and medial tibia. 4. Does NOT cover lateral thigh or medial knee 5. Wit pt. supine sense and mark the femoral artery. Draw a line between the anterior master copy iliac spine and the pubic tubercle. enwrap needle 2 cm lateral to artery and 2 cm distal to inguinal ligament. Two pops may be felt as the needle passes the fascial lata and fascia iliaca. 6. When stimulated, the quadriceps will twitch and the kneepan will snap. Decrease to 0.3-0.5 mA and movement should still be present. Inject 20-30 ml LA later neg. aspiration. 7. To add saphenous block: Pt. still supine with knee hang 45 degrees with medial aspect exposed. Inject deep to the sartorius muscle at the tibial condyle. When in correct position, 10 ml ! of LA is injected. POPLITEAL BLOCK (TO BLOCK part OF THE SCIATIC...If you want to arouse a full essay, order it on our website: BestEssayCheap.com

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