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Femoral Nerve Block
A femoral nerve block is a Local anesthetic nerve block, nerve block that uses local anesthetic to achieve analgesia in the leg. The block works by affecting the femoral nerve. A femoral nerve block (FNB) results in anesthesia of the skin and muscles of the anterior thigh and most of the femur and knee joint, as well as the skin on the medial aspect of the leg below the knee joint. The block can be performed using anatomical landmarks, Medical ultrasound, ultrasound or a nerve stimulator. For hip surgery, a femoral nerve block and fascia iliac block (FIB) are alternative methods for providing analgesic relief. A meta-analysis concluded that compared to FIB, the FNB decreased visual analog scale at 24 hrs and the incidence of nausea, vomiting and oversedation. For knee surgery, a femoral nerve block may lead to delayed postoperative mobilization of the patient and greater risk of falls as it causes motor blockade of the quadriceps muscles. Due to the sparing of the thigh muscles ...
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Local Anesthetic Nerve Block
Local anesthetic nerve block (local anesthetic regional nerve blockade, or often simply nerve block) is a short-term nerve block involving the injection (medicine), injection of local anesthetic as close to the nerve as possible for analgesia, pain relief. The local anesthetic bathes the nerve and numbs the area of the body that is supplied by that nerve. The goal of the nerve block is to prevent pain by blocking the transmission of pain signals from the affected area. Nerve blocks have a number of uses including treating headache disorders and providing anesthesia during surgery. The analgesia, pain relief provided by the block is present during the surgery and continues to last after the procedure. This can lead to a reduction in the amount of opiates needed for pain control. The advantages of nerve blocks over General anaesthesia, general anesthesia include faster recovery, Anesthesia awareness#Conscious sedation and monitored anesthesia care, monitored anesthesia care vs. Trac ...
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Local Anesthetic
A local anesthetic (LA) is a medication that causes absence of pain sensation. In the context of surgery, a local anesthetic creates an absence of pain in a specific location of the body without a loss of consciousness, as opposed to a general anesthetic. When it is used on specific nerve pathways (local anesthetic nerve block), paralysis (loss of muscle power) also can be achieved. Examples Short Duration & Low Potency Procaine Chloroprocaine Medium Duration & Potency Lidocaine Prilocaine High Duration & Potency Tetracaine Bupivacaine Cinchocaine Ropivacaine Clinical LAs belong to one of two classes: aminoamide and aminoester local anesthetics. Synthetic LAs are structurally related to cocaine. They differ from cocaine mainly in that they have a very low abuse potential and do not produce hypertension or (with few exceptions) vasoconstriction. They are used in various techniques of local anesthesia such as: * Topical anesthesia (surface) * Topical administration ...
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Analgesia
Pain management is an aspect of medicine and health care involving relief of pain (pain relief, analgesia, pain control) in various dimensions, from acute and simple to chronic and challenging. Most physicians and other health professionals provide some pain control in the normal course of their practice, and for the more complex instances of pain, they also call on additional help from a specific medical specialty devoted to pain, which is called pain medicine. Pain management often uses a multidisciplinary approach for easing the suffering and improving the quality of life of anyone experiencing pain, whether acute pain or chronic pain. Relief of pain in general (analgesia) is often an acute affair, whereas managing chronic pain requires additional dimensions. The typical pain management team includes medical practitioners, pharmacists, clinical psychologists, physiotherapists, occupational therapists, recreational therapists, physician assistants, nurses, and dentist ...
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Femoral Nerve
The femoral nerve is a nerve in the thigh that supplies skin on the upper thigh and inner leg, and the muscles that extend the knee. Structure The femoral nerve is the major nerve supplying the anterior compartment of the thigh. It is the largest branch of the lumbar plexus, and arises from the dorsal divisions of the ventral rami of the second, third, and fourth lumbar nerves (L2, L3, and L4). The nerve enters Scarpa's triangle by passing beneath the inguinal ligament, just lateral to the femoral artery. In the thigh, the nerve lies in a groove between iliacus muscle and psoas major muscle, outside the femoral sheath, and lateral to the femoral artery. After a short course of about 4 cm in the thigh, the nerve is divided into anterior and posterior divisions, separated by lateral femoral circumflex artery. The branches are shown below: Muscular branches * The nerve to the pectineus muscle arises immediately above the inguinal ligament from the medial side of the femoral n ...
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Anterior
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position provides a definition of what is at the front ("anterior"), behind ("posterior") and so on. As part of defining and describing terms, the body is described through the use of anatomical planes and anatomical axes. The meaning of terms that are used can change depending on whether an organism is bipedal or quadrupedal. Additionally, for some animals such as invertebrates, some terms may not have any meaning at all; for example, an animal that is radially symmetrical will have no anterior surface, but can still have a description that a part is close to the middle ("proximal") or further from the middle ("distal"). International organisations have determined vocabularies that are often used as standard vocabularies for subdisciplines of anatomy ...
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Thigh
In human anatomy, the thigh is the area between the hip (pelvis) and the knee. Anatomically, it is part of the lower limb. The single bone in the thigh is called the femur. This bone is very thick and strong (due to the high proportion of bone tissue), and forms a ball and socket joint at the hip, and a modified hinge joint at the knee. Structure Bones The femur is the only bone in the thigh and serves as an attachment site for all muscles in the thigh. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates with the tibia and patella forming the knee. By most measures, the femur is the strongest bone in the body. The femur is also the longest bone in the body. The femur is categorised as a long bone and comprises a diaphysis, the shaft (or body) and two epiphysis or extremities that articulate with adjacent bones in the hip and knee. Muscular compartments In cross-section, the thigh is ...
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Femur
The femur (; ), or thigh bone, is the proximal bone of the hindlimb in tetrapod vertebrates. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates with the tibia (shinbone) and patella (kneecap), forming the knee joint. By most measures the two (left and right) femurs are the strongest bones of the body, and in humans, the largest and thickest. Structure The femur is the only bone in the upper leg. The two femurs converge medially toward the knees, where they articulate with the proximal ends of the tibiae. The angle of convergence of the femora is a major factor in determining the femoral-tibial angle. Human females have thicker pelvic bones, causing their femora to converge more than in males. In the condition ''genu valgum'' (knock knee) the femurs converge so much that the knees touch one another. The opposite extreme is ''genu varum'' (bow-leggedness). In the general populatio ...
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Knee Joint
In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia (tibiofemoral joint), and one between the femur and patella (patellofemoral joint). It is the largest joint in the human body. The knee is a modified hinge joint, which permits flexion and extension as well as slight internal and external rotation. The knee is vulnerable to injury and to the development of osteoarthritis. It is often termed a ''compound joint'' having tibiofemoral and patellofemoral components. (The fibular collateral ligament is often considered with tibiofemoral components.) Structure The knee is a modified hinge joint, a type of synovial joint, which is composed of three functional compartments: the patellofemoral articulation, consisting of the patella, or "kneecap", and the patellar groove on the front of the femur through which it slides; and the medial and lateral tibiofemoral articulations linking the femur, or thigh bone, ...
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Anatomical Landmarks
Anatomical terminology is a form of scientific terminology used by anatomists, zoologists, and health professionals such as doctors. Anatomical terminology uses many unique terms, suffixes, and prefixes deriving from Ancient Greek and Latin. These terms can be confusing to those unfamiliar with them, but can be more precise, reducing ambiguity and errors. Also, since these anatomical terms are not used in everyday conversation, their meanings are less likely to change, and less likely to be misinterpreted. To illustrate how inexact day-to-day language can be: a scar "above the wrist" could be located on the forearm two or three inches away from the hand or at the base of the hand; and could be on the palm-side or back-side of the arm. By using precise anatomical terminology such ambiguity is eliminated. An international standard for anatomical terminology, ''Terminologia Anatomica'' has been created. Word formation Anatomical terminology has quite regular morphology: the sa ...
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Medical Ultrasound
Medical ultrasound includes diagnostic techniques (mainly imaging techniques) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, muscles, joints, blood vessels, and internal organs, to measure some characteristics (e.g. distances and velocities) or to generate an informative audible sound. Its aim is usually to find a source of disease or to exclude pathology. The usage of ultrasound to produce visual images for medicine is called medical ultrasonography or simply sonography. The practice of examining pregnant women using ultrasound is called obstetric ultrasonography, and was an early development of clinical ultrasonography. Ultrasound is composed of sound waves with frequencies which are significantly higher than the range of human hearing (>20,000 Hz). Ultrasonic images, also known as sonograms, are created by sending pulses of ultrasound into tissue using a pr ...
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Nerve Stimulator
Neuromodulation is "the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body". It is carried out to normalize – or modulate – nervous tissue function. Neuromodulation is an evolving therapy that can involve a range of electromagnetic stimuli such as a magnetic field (rTMS), an electric current, or a drug instilled directly in the subdural space (intrathecal drug delivery). Emerging applications involve targeted introduction of genes or gene regulators and light (optogenetics), and by 2014, these had been at minimum demonstrated in mammalian models, or first-in-human data had been acquired. The most clinical experience has been with electrical stimulation. Neuromodulation, whether electrical or magnetic, employs the body's natural biological response by stimulating nerve cell activity that can influence populations of nerves by releasing transmitters, such as dopamin ...
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Fascia Iliac Block
Fascia iliaca blocks (FIC, FICB) is a local anesthetic nerve block, a type of regional anesthesia technique, used to provide analgesia or anaesthesia to the hip and thigh. FICB can performed by using ultrasound or with a loss of resistance technique, the latter sometimes referred to as the "''two-pop-method''". FICB works by affecting the femoral, obturator and the lateral cutaneous nerves with a local anesthetic. Technique When FICB is performed with the loss of resistance technique, the injection site for FICB is found by drawing an imaginary line between the pubic tubercle to the anterior superior iliac spine. The injection site is 1 cm. below the lateral one third and the medial two thirds of this line. Two losses of resistances are felt as the fascia lata and the fascia iliaca is penetrated by a semi-blunt cannula. Aspiration (drawing back the cannula) is performed, after which a local anaesthetic is injected while compressing on the skin distally to increase cra ...
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