BCA Regional Anesthesia Techniques 3

Question 1

Which nerve must be separately blocked to achieve complete anesthesia of the medial forearm when performing an axillary brachial plexus block?

Accepted Answer

Medial cutaneous nerve of the forearm

Answer

The medial cutaneous nerve of the forearm (MCNF) branches proximal to the axilla and must be blocked separately as it is not reliably anesthetized with standard axillary block.

Question 2

What is the mechanism of action of dexmedetomidine when added to local anesthetic for peripheral nerve blocks?

Accepted Answer

Alpha-2 agonist causing hyperpolarization of nerve membranes

Answer

Dexmedetomidine prolongs peripheral nerve block duration via alpha-2 adrenergic receptor-mediated hyperpolarization of peripheral neurons, reducing excitability.

Question 3

A spinal anesthetic with hyperbaric bupivacaine is administered at L3-L4 with the patient in the sitting position. To achieve a sacral block only (saddle block), how long should the patient remain seated?

Accepted Answer

5-10 minutes

Answer

For a saddle block, the patient is kept sitting for 5-10 minutes to allow hyperbaric solution to pool in the dependent sacral and lower lumbar segments before lying down.

Question 4

Which ultrasound view is recommended for visualizing the adductor canal to perform an adductor canal block?

Accepted Answer

Short-axis view of the medial thigh at mid-femur level

Answer

The adductor canal block is performed using a short-axis (transverse) ultrasound view at the mid-thigh level, identifying the saphenous nerve adjacent to the femoral artery in the canal.

Question 5

Inadvertent intravascular injection of local anesthetic during a stellate ganglion block would MOST likely cause which immediate symptom?

Accepted Answer

Seizure due to vertebral artery injection

Answer

The stellate ganglion lies adjacent to the vertebral artery; even 1 mL of intra-arterial local anesthetic injection can cause immediate CNS toxicity and seizure.

(BCA) Board of Certification in Anesthesiology Practice Test

(BCA) Board of Certification in Anesthesiology Practice Test

BCA Regional Anesthesia Techniques 3