ABA ABA Regional Anesthesia and Pain Management 2 — Questions and Answers
Question 1: Which brachial plexus block is often called the 'spinal of the arm' because it reliably anesthetizes the entire arm?
- Interscalene block
- Supraclavicular block (Correct answer)
- Infraclavicular block
- Axillary block
Correct answer: Supraclavicular block
The supraclavicular block targets the brachial plexus trunks where they are most compact, providing reliable coverage for the entire arm.
Question 2: In an erector spinae plane (ESP) block, local anesthetic is deposited between the erector spinae muscle and which bony landmark?
- The transverse process (Correct answer)
- The lamina
- The facet joint
- The spinous process
Correct answer: The transverse process
In the ESP block, local anesthetic is injected between the erector spinae muscle and the tip of the transverse process.
Question 3: What is the primary reason ropivacaine is considered safer than racemic bupivacaine in regional anesthesia?
- Greater analgesic potency
- Less cardiac toxicity due to its pure S-enantiomer configuration (Correct answer)
- Faster onset of neural blockade
- Longer duration of sensory block
Correct answer: Less cardiac toxicity due to its pure S-enantiomer configuration
Ropivacaine is a pure S-enantiomer with reduced cardiac toxicity compared to racemic bupivacaine because of stereospecific sodium channel binding.
Question 4: Which nerve roots form the sciatic nerve, making them the target of a popliteal sciatic nerve block for foot surgery?
- L2-L3
- L4-S3 (Correct answer)
- L4-L5 only
- S1-S3 only
Correct answer: L4-S3
The sciatic nerve is formed from L4-S3 roots; the popliteal sciatic block targets this nerve just above the popliteal fossa for foot and ankle procedures.
Question 5: Which ultrasound safety technique is MOST effective at reducing the risk of intravascular injection during nerve blocks?
- Using color Doppler to identify vessels
- Aspirating before injection
- Using a short-bevel needle
- All of the above combined (Correct answer)
Correct answer: All of the above combined
Combining color Doppler imaging, pre-injection aspiration, and small-bore needles together provides the greatest reduction in intravascular injection risk.
Question 6: What dermatomal level of epidural coverage is typically targeted for thoracic epidural analgesia during open abdominal surgery?
- T4-T10
- T6-L1 (Correct answer)
- T10-S1
- C8-T6
Correct answer: T6-L1
Thoracic epidurals for abdominal surgery target T6-L1 dermatomal coverage to encompass both the abdominal wall and visceral innervation.
ABA ABA Regional Anesthesia and Pain Management 2
Which brachial plexus block is often called the 'spinal of the arm' because it reliably anesthetizes the entire arm?