05_ultrasound guided regional anesthesia malchow

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Page 1: 05_Ultrasound Guided Regional Anesthesia Malchow
Page 2: 05_Ultrasound Guided Regional Anesthesia Malchow
Page 3: 05_Ultrasound Guided Regional Anesthesia Malchow
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Page 5: 05_Ultrasound Guided Regional Anesthesia Malchow

Endoneurium

Epineurium

Connective tissue/perineurium

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180 Plus -<8lbs -Drop tested -Ease of switching probes -Color Doppler -Memory: flash memory cards -Probes: 3 total

Titan, MicroMaxx, S-Nerve and Turbo

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High Quality Images Difficult to switch betw probes Windows based hard drive

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12 MHz

10 MHz

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Lower Frequency Deep Penetration Wider but distortion Eg. Sciatic

Higher Frequency Superficial Narrower field

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“In-Plane- correct for most blocks” Tip not visualized

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Out of Plane: -Good for vascular access or

catheter placement -Tip of needle challenging. -45deg method:

-measure skin-nerve dist -entry pt same dist. -reach nerve at 45 deg.

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Sliding

Rotating

Tilting

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Ultrasound Simulation Training

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SCB:

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ASM MSM

SCM

UT

MT

LT

Needle

Medial Lateral

IJ CA

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Sub Art

1st rib

Lung

Anterior/Medial Posterior/Lateral

Trap

needle

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Pect Major

Pect Minor

Ax Vein

Ax Art

Anterior/Medial

Post/Lateral

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5-10ml

10-15ml

10-15ml

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-MCN lies in fascial plane betw CB heads.

-oval, round, eliptical, then triangular

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TP

needle

QL

L3

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Iliacus

Fascia Lata

Fascia Iliacus

needle

Pectineus

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CP Tib BF

SM

PA

Posterior

Medial

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Page 48: 05_Ultrasound Guided Regional Anesthesia Malchow

Anterior

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