Regional Exam 3
A review to material for test 3 on peripheral nerve blocks.
- 1.
The brachial plexus is formed by the nerve roots of which vertebrae in the majority of people?
- A.
C5-C8
- B.
C2-T2
- C.
T1-T2
- D.
C1-C4
Correct Answer
A. C5-C8 -
- 2.
In the cervical region nerve roots exit _____ the vertebrae for which they are named, but starting in the Thoracic region nerve roots exit _____ the vertebrae for which they are names.
- A.
Below, above
- B.
Above, below
- C.
Beside, above
- D.
Below, Beside
Correct Answer
B. Above, below -
- 3.
Which of the following is the proper sequence, from proximal to distal, for the composition of the brachial plexus?
- A.
Trunks, Cords, Roots, Divisions, Branches
- B.
Cords, Roots, Branches, Trunks, Divisions
- C.
Roots, Trunks, Divisions, Cords, Branches
- D.
Branches, Divisions, Trunks, Roots, Cords
Correct Answer
C. Roots, Trunks, Divisions, Cords, Branches -
- 4.
Which nerve passes behind humerus and laterally at the epicondyle?
- A.
Median Nerve
- B.
Ulnar Nerve
- C.
Scalene Nerve
- D.
Radial Nerve
Correct Answer
D. Radial Nerve -
- 5.
Stimulation of the radial nerve at level of elbow would result in which of the following?
- A.
Extension of wrist and fingers
- B.
Pronation of forearm and flexion of wrist
- C.
Flexion of pinky finger and ulnar wrist deviation
- D.
Contraction of deltoid muscle
Correct Answer
A. Extension of wrist and fingers -
- 6.
A patient experiencing numbness of posterior forearm, thumb, and first two digits would most have a block of which nerve?
- A.
Ulnar
- B.
Radial
- C.
Medial
- D.
Obturator
Correct Answer
B. Radial -
- 7.
The Ulnar nerve arises from the inferior roots of which vertebrae?
- A.
C5-C6
- B.
C6-C8
- C.
C2-C4
- D.
C8-T1
Correct Answer
D. C8-T1 -
- 8.
In above picture, what is nerve #2?
- A.
Ulnar
- B.
Median
- C.
Radial
- D.
None of Above
Correct Answer
A. Ulnar -
- 9.
In above picture, what is nerve #1?
- A.
Ulnar
- B.
Median
- C.
Radial
- D.
None of Above
Correct Answer
B. Median -
- 10.
In above picture, what is nerve #3?
- A.
Ulnar
- B.
Median
- C.
Radial
- D.
None of Above
Correct Answer
C. Radial -
- 11.
Which nerve can be located posterior to the medial epicondyle and the elbow?
- A.
Median
- B.
Scalene
- C.
Radial
- D.
Ulnar
Correct Answer
D. Ulnar -
- 12.
Stimulation of the ulnar nerve would result in which of following actions?
- A.
Flexion of pinky finger and ulnar wrist deviation
- B.
Extension of wrist and fingers
- C.
Pronation of forearm and flexion of wrist
- D.
Contraction of deltoid muscle
Correct Answer
A. Flexion of pinky finger and ulnar wrist deviation -
- 13.
Which of the following provides sensory and motor enervation to the deltoid muscle?
- A.
Scalene nerve
- B.
Axillary nerve
- C.
Median nerve
- D.
Musculocutaneous nerve
Correct Answer
B. Axillary nerve -
- 14.
Which of the following properly describes the musculocutaneous nerve?
- A.
It supplies motor enervation to the deltoid muscle it also supplies sensory enervation to the same area both anteriorly and posteriorly
- B.
Sensory it supplies the thumb, index, middle and half of the ring finger on the palmar(bolar) side on the dorsum of the hand it supplies the distal 3rd of the thumb and index fingers.
- C.
Stimulation of the nerve causes extension of the wrist.
- D.
Provides motor enervation to biceps and coracobrachialis, sensory to lateral aspect of forearm.
Correct Answer
D. Provides motor enervation to biceps and coracobrachialis, sensory to lateral aspect of forearm. -
- 15.
A block of the radial nerve at the level of the elbow would generally require what volume of anesthetic?
- A.
40 ml
- B.
10 ml
- C.
25 ml
- D.
2-5 ml
Correct Answer
B. 10 ml -
- 16.
What is the largest nerve in the body?
- A.
Sciatic nerve
- B.
Brachial Plexus nerve
- C.
Femoral nerve
- D.
Spinal cord
Correct Answer
A. Sciatic nerve -
- 17.
Which of the following nerves does not play a role in lower extremity nerve blockade?
- A.
Lateral femoral cutaneous
- B.
Ilioinguinal
- C.
Obturator
- D.
Femoral
Correct Answer
B. Ilioinguinal -
- 18.
Which nerve supplies sensation to the lateral aspect of the thigh down to the knee?
- A.
Femoral
- B.
Sciatic
- C.
Lateral Femoral Cutaneous
- D.
Ilioinguinal
Correct Answer
C. Lateral Femoral Cutaneous -
- 19.
Which of the following nerves provides motor enervation to the quadriceps muscle and sensation to the anterior thigh?
- A.
Ilioinguinal
- B.
Obturator
- C.
Lateral Femoral Cutaneous
- D.
Femoral
Correct Answer
D. Femoral -
- 20.
Blocking the lumbar plexus will block all sensory nerves of the leg and is sufficient for surgery.
- A.
True
- B.
False
Correct Answer
B. False -
- 21.
Lumbar plexus blocks are almost always done with the patient in the _______ position.
- A.
Sitting
- B.
Lateral
- C.
Prone
- D.
Supine
Correct Answer
B. Lateral -
- 22.
Which of the following nerve blocks is most effective for treatment of pain from knee surgery?
- A.
Sciatic
- B.
Lateral Femoral Cutaneous
- C.
Femoral
- D.
Obturator
Correct Answer
C. Femoral -
- 23.
Where is the proper insertion point for a femoral block (after having identified other landmarks, of course)?
- A.
2 cm medial from femoral pulse
- B.
2 cm caudad from femoral pulse
- C.
2 cm distal from femoral pulse
- D.
2 cm lateral from femoral pulse
Correct Answer
D. 2 cm lateral from femoral pulse -
- 24.
When injecting local anesthetic for a femoral block you should stop and re-aspirate every…
- A.
5 ml’s
- B.
2-3 ml’s
- C.
10 ml’s
- D.
You don’t have to after the initial aspiration.
Correct Answer
A. 5 ml’s -
- 25.
Which of the following is not one of anatomical landmarks required to perform a femoral block?
- A.
Anterior Superior Iliac spine
- B.
Sacral Hiatus
- C.
The femoral artery
- D.
Superior lateral corner of pubic tubercle
Correct Answer
B. Sacral Hiatus -
- 26.
Which of the following is not true regarding the Sciatic nerve?
- A.
Provides motor enervation to all muscles distal to knee
- B.
Supplies sensory fibers to posterior hip
- C.
Supplies all sensory enervation to lower extremity(below knee) and foot
- D.
Provides motor enervation to hamstring
Correct Answer
C. Supplies all sensory enervation to lower extremity(below knee) and foot -
- 27.
Which of the following is not a landmark used when performing a Sciatic Block?
- A.
Superior Lateral corner of Pubic Tubercle
- B.
Posterior superior iliac spine
- C.
Greater Trochanter of hip
- D.
Sacral Hiatus
Correct Answer
A. Superior Lateral corner of Pubic Tubercle -
- 28.
When blocking the sciatic nerve at the popilteal fossa, where should you aim to inject the local anesthetic?
- A.
2-5 cm above the posterior crease of knee
- B.
7-10 cm above the posterior crease of knee
- C.
10-12 cm above the patella on anterior portion of thigh
- D.
2-3 cm below the posterior crease of knee
Correct Answer
B. 7-10 cm above the posterior crease of knee -
- 29.
Which of the following nerves produces dorsiflexion of the foot?
- A.
Tibial Nerve
- B.
Saphenous Nerve
- C.
Peroneal nerve
- D.
Radial nerve
Correct Answer
C. Peroneal nerve -
- 30.
Stimulation of the tibial nerve will result in what action?
- A.
Wrist and thumb flexion
- B.
Foot dorsiflexion
- C.
Twitching of lateral thigh
- D.
Plantar flexion
Correct Answer
D. Plantar flexion -
- 31.
Which of the following is not one of the nerves blocked during an ankle block?
- A.
Deep Peroneal nerve
- B.
Dorsal Digital nerve
- C.
Sural Nerve
- D.
Saphenous Nerve
Correct Answer
B. Dorsal Digital nerve -
- 32.
Which of the following nerves cannot be blocked by inserting a needle into the groove formed by the extensor hallicus longus tendon and extensor digitorum longus tendon?
- A.
Deep Peroneal nerve
- B.
Saphenous Nerve
- C.
Sural Nerve
- D.
Superficial peroneal Nerve
Correct Answer
C. Sural Nerve -
- 33.
Regional innervation for the eye, orbit and periorbital structures is supplied by the ______ nerve.
- A.
Trigeminal
- B.
Facial
- C.
Opthalmic
- D.
Oculomotor
Correct Answer
A. Trigeminal -
- 34.
Which of the following describes proper injection technique for a retrobulbar block?
- A.
Site of injection is just below the superior orbital rim, where an angled needle is passed into the intraconal region with the patient gazing supranasally.
- B.
Site of injection is just above the inferior orbital rim, where an angled needle is passed into the intraconal region with the patient gazing supranasally.
- C.
Site of injection is just below the superior orbital rim, where an angled needle is passed into the intraconal region with the patient gazing infranasally.
- D.
Site of injection is just above the inferior orbital rim, where an angled needle is passed into the intraconal region with the patient gazing to the left.
Correct Answer
B. Site of injection is just above the inferior orbital rim, where an angled needle is passed into the intraconal region with the patient gazing supranasally. -
- 35.
What is the most common complication associated with a retrobulbar block?
- A.
Globe Perforation
- B.
Neurogenic Apnea
- C.
Optic Nerve Atrophy
- D.
Retrobulbar Hemorrhage
Correct Answer
D. Retrobulbar Hemorrhage -
- 36.
Stimulation of the oculocardiac reflex will result in which of the following?
- A.
Bradycardia
- B.
Hypertension
- C.
PVC’s
- D.
Tachycardia
Correct Answer
A. Bradycardia -
- 37.
Which of the following pts is able to receive a retrobulbar block?
- A.
Pt currently taking daily Coumadin
- B.
Pt with advanced CHF and CAD
- C.
Pt with severe myopia
- D.
Pt with open corneal abrasion
Correct Answer
B. Pt with advanced CHF and CAD -
- 38.
A successful retrobulbar block will result in….
- A.
Loss of ocucephalic reflex
- B.
Loss of oculocardiac reflex
- C.
Patient sedation
- D.
All the above
Correct Answer
A. Loss of ocucephalic reflex -
- 39.
Accidental injection of a retrobulbar dose of LA into the ophthalmic artery will result in which of the following?
- A.
Pt c/o ringing in ears and metallic taste in mouth
- B.
Permanent pt blindness
- C.
Pt unconsciousness and seizures
- D.
Retrobulbar hemorrhage
Correct Answer
C. Pt unconsciousness and seizures -
- 40.
You are delivering regional anesthetic to a patient when they begin to complain of feeling light headed and ringing in their ears. What should you do?
- A.
Slow down your rate of injection, and then administer rest of anesthetic.
- B.
Immediately notify MD and prepare pt for cardiac bypass, your plasma concentration is most likely too high now.
- C.
Immediately stop injection, start lipid infusion, monitor patient, your plasma concentration should still be low enough to reverse this.
- D.
Comfort the patient that this is normal to experience and deliver rest of anesthetic quickly.
Correct Answer
C. Immediately stop injection, start lipid infusion, monitor patient, your plasma concentration should still be low enough to reverse this. -
- 41.
Innervation of the larynx is provided by which nerve?
- A.
Trigeminal
- B.
Glosspharyngeal
- C.
Spinal Accessory
- D.
Vagus
Correct Answer
D. Vagus -
- 42.
A retrobulbar block typically involves use of what gauge of needle?
- A.
25
- B.
22
- C.
20
- D.
18
Correct Answer
A. 25 -
- 43.
Which landmark is used when performing an SLN block?
- A.
Styloid process posterior to angle of jaw
- B.
Greater cornu of Hyoid bone
- C.
Tonsillar pillar
- D.
Cricothyrohyoid membrane
Correct Answer
B. Greater cornu of Hyoid bone -
- 44.
Where would you perform a transtracheal block?
- A.
2 cm caudad to Styloid process posterior to angle of jaw
- B.
Directly above greater cornu of Hyoid bone
- C.
Posterior to Tonsillar pillars
- D.
Through the Cricothyrohyoid membrane
Correct Answer
D. Through the Cricothyrohyoid membrane -
- 45.
What is the largest terminal branch of the brachial plexus?
- A.
Radial Nerve
- B.
Ulnar Nerve
- C.
Medial Nerve
- D.
Musculocutaneous nerve
Correct Answer
A. Radial Nerve -
- 46.
Which nerve may be hardest to anesthetize when performing an interscalene block?
- A.
Radial
- B.
Ulnar
- C.
Axillary
- D.
Medial
Correct Answer
B. Ulnar -
- 47.
What would be the appropriate choice of LA to use for a Bier Block?
- A.
Lidocaine 0.5% with epi
- B.
Bupivacaine 0.75% plain
- C.
Lidocaine 0.5% plain
- D.
Bupivacaine 0.75% with epi
Correct Answer
C. Lidocaine 0.5% plain -
- 48.
Which of the following describes the anatomical landmarks used when doing an interscalene block?
- A.
Axillary artery below the pectoralis major muscle at the insertion of the bicep muscle.
- B.
The brachial pulse and medial epicondyle
- C.
The coracoid process, distal portion of the clavicle
- D.
The interscalene groove, located posterior to the clavicular insertion of the SCM.
Correct Answer
D. The interscalene groove, located posterior to the clavicular insertion of the SCM. -
- 49.
Which of the following describes the landmarks used when performing an axillary block?
- A.
Axillary artery below the pectoralis major muscle at the insertion of the bicep muscle.
- B.
The brachial pulse and medial epicondyle
- C.
The coracoid process, distal portion of the clavicle
- D.
The interscalene groove, located posterior to the clavicular insertion of the SCM.
Correct Answer
A. Axillary artery below the pectoralis major muscle at the insertion of the bicep muscle. -
- 50.
Which of the following would not be a contraindication for a pt to receive an ankle block?
- A.
A diabetic pt with peripheral neuropathy
- B.
A pt with aortic stenosis
- C.
A sickle cell pt
- D.
An awake pediatric patient
Correct Answer
B. A pt with aortic stenosis -
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Dec 31, 2012Quiz Edited by
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