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227 (15)
227 .205 (15)
Lecture

Anatomy of nerve blocks printed.docx

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Department
227
Course
227 .205
Professor
Peter Davie
Semester
Fall

Description
Anatomy of nerve blocks Friday 4.10.2013 Kavitha  Topical local nerve blocks 1) Auriculopalpebral block To desentitise the auriculopalpebral nerve that supplies motor fibres to the orbicularis oculi muscle. The nerve runs from the base of the ear along the facial crest , past and ventral of the eye , giving off branches on the way. -indication- for examination of the eyeball(prevents eyelid closure during examination/surgery of eyes) -site- rostral to the base of the ear at the end of the zygomatic arch(at the caudo-dorsal border of the zygomatic arch) 1.cornual nerve 2.temporal line 3)auriculopalpebral nerve 2) Cornual nerve block -caudal to orbit, along the temporal line. - For desentitisation of the horn during dehorning . -opthalmic division of the fifth cranial nerve(trigeminal nerve) - injected on the upper third of the temporal ridge 3) Paravertebral block –regional anaesthesia -abdominal wall: the distribution of lumbar spinal nerves --important nerves to the abdominal wall to desensitize T13,L1,L2- to desensitize for rumenectomy and c-section. general distribution of the spinal nerve -the spinal nerve-emerges from the vertebral canal- Branches are: a) dorsal branch- supplies the epaxial muscle and skin the dorsal part of the abdomen(between the midline (vertebra) to the level of the patella) b) ventral branch- supplies the flank(internal abdominal oblique,transverse abdominal muscle, hypaxial, parietal peritoneum) . c) skin-the lower flank and skin of abdominal floor. abdominal wall: caudoventral flow of sensory innervation - skin area may be a dermatome- a dermatome is an area only supplied by one spinal nerve. - Though there are areas of dermatome there is also an overlap of sites due to the pathway of the nerve - As the spinal nerve leaves the intervertebral foramina- the dorsal and ventral branches pass obliquely and ventrally. 2 techniques can be used for paravertebral nerve block a) Proximal paravertebral nerve block Needle is inserted close to the emergence of the nerve from the spinal cord Both dorsal and ventral nerves will be desensitized. Left side –it is closer to the aorta and on the right side it is closer to the vena cava. Block at the emergence of the ner
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