Name: ACA- Hadzic- Peripheral Nerve Block 3e- Wrist Block Scanning

Description: ACA- Hadzic- Peripheral Nerve Block 3e- Wrist Block Scanning

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Duration: T00H03M00S

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Upload Date: 2022-02-23T00:00:00.0000000

Transcript: Language: EN.
Segment:0 .
DIGITAL INTRO TUNE:
DR. HADZIC: Today, we're going to talk about the anatomy for the forearm blocks, in here we have a model, and typically to scan the median nerve, and the ulnar nerve and the superficial radial nerves, for the median and ulnar nerve at the very least, the best position is between the elbow crease and the palmar crease. So these two creases are very important landmarks for beginning to scan median and ulnar nerves.
DR. HADZIC: It is very important to hold the transducer very lightly, we typically use a couple of fingers, and we use the additional fingers to latch our hand and the palm of the hand on the subject's forearm and arm because that way the transducer remains stable. So in this particular image, what we see here is the ulnar nerve medially is the ulnar nerve medially with the ulnar artery.
DR. HADZIC: And as we slide the transducer more laterally, And as we slide the transducer more laterally, we get to the image of the median nerve. To block the median nerve we can use an in-plane approach from the lateral to medial or from the medial to lateral. Likewise, we can also use an out-of-plane approach as well, where the needle would be inserted in the middle of the transducer and driven about a centimeter depth in order to access the medial nerve which is outlined by the arrow.
DR. HADZIC: With the ulnar nerve, here we have different options. Here we see the ulnar nerve attached to the artery in the neurovascular sheath. And let's add a little bit of gain to this image, the image becomes a lot better with the gain. So again, these small adjustments can really result in substantial improvement in image quality. This is the focus point over here, or focus zone. If we increase the depth of the focus zone here we can see how the fascicular nature of the ulnar nerve improves.
DR. HADZIC: If we now follow the ulnar nerve a bit more proximally, If we now follow the ulnar nerve a bit more proximally, here we can see a point at which the ulnar nerve diverges from the artery and opens a nice space for diverges from the artery and opens a nice space for an out-of-plane insertion of the needle between the artery and the nerve, in the neurovascular sheath.
DIGITAL OUTRO TUNE:

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