05_ultrasound guided regional anesthesia malchow

Endoneurium

Epineurium

Connective tissue/perineurium

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

Titan, MicroMaxx, S-Nerve and Turbo

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

12 MHz

10 MHz

Lower Frequency Deep Penetration Wider but distortion Eg. Sciatic

Higher Frequency Superficial Narrower field

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

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.

Sliding

Rotating

Tilting

Ultrasound Simulation Training

SCB:

ASM MSM

SCM

UT

MT

LT

Needle

Medial Lateral

IJ CA

Sub Art

1st rib

Lung

Anterior/Medial Posterior/Lateral

Trap

needle

Pect Major

Pect Minor

Ax Vein

Ax Art

Anterior/Medial

Post/Lateral

5-10ml

10-15ml

10-15ml

-MCN lies in fascial plane betw CB heads.

-oval, round, eliptical, then triangular

TP

needle

QL

L3

Iliacus

Fascia Lata

Fascia Iliacus

needle

Pectineus

CP Tib BF

SM

PA

Posterior

Medial

Anterior