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<br /> Philips ultrasound-guided<br /> peripheral nerve block tutorial<br /> Forearm nerve blocks<br /> Brian Sites, MD<br /> Associate Professor of Anesthesiology<br /> Director of Orthopedic and Regional Anesthesia<br /> Dartmouth-Hitchcock Medical Center<br /> Table of contents<br /> Forearm nerve blocks<br /> 1 Introduction ........................................................ 3<br /> 2 Equipment and positioning .............................. 4<br /> 3 Gross anatomy.................................................... 6<br /> 4 Sonographic anatomy........................................8<br /> 5 Technique ........................................................... 19<br /> 6 Clinical pearls ....................................................32<br /> Additional resources...................................... 33<br /> 2<br /> 1 Introduction<br /> Nerve blocks of the median, ulnar, and radial nerves<br /> in the forearm are attractive options for providing analg<a title="Forearm Nerve Blocks page 1" href="http://viewer.zmags.com/publication/bd03d0b9?page=1"> Philips ultrasound-guided peripheral nerve block </a> <a title="Forearm Nerve Blocks page 2" href="http://viewer.zmags.com/publication/bd03d0b9?page=2"> Table of contents Forearm nerve blocks 1 Introdu</a> <a title="Forearm Nerve Blocks page 3" href="http://viewer.zmags.com/publication/bd03d0b9?page=3"> 1 Introduction Nerve blocks of the median, ulnar</a> <a title="Forearm Nerve Blocks page 4" href="http://viewer.zmags.com/publication/bd03d0b9?page=4"> 2 Equipment and positioning A high frequency lin</a> <a title="Forearm Nerve Blocks page 5" href="http://viewer.zmags.com/publication/bd03d0b9?page=5"> Figure 1 This photo demonstrates an effective pos</a> <a title="Forearm Nerve Blocks page 6" href="http://viewer.zmags.com/publication/bd03d0b9?page=6"> 3 Gross anatomy The median, ulnar, and radial ne</a> <a title="Forearm Nerve Blocks page 7" href="http://viewer.zmags.com/publication/bd03d0b9?page=7"> Radial nerve: The radial nerve emerges from the g</a> <a title="Forearm Nerve Blocks page 8" href="http://viewer.zmags.com/publication/bd03d0b9?page=8"> 4 Sonographic anatomy Median nerve: In short-axi</a> <a title="Forearm Nerve Blocks page 9" href="http://viewer.zmags.com/publication/bd03d0b9?page=9"> Figure 2 Short-axis image of the median nerve in </a> <a title="Forearm Nerve Blocks page 10" href="http://viewer.zmags.com/publication/bd03d0b9?page=10"> 4 Sonographic anatomy Figur</a> <a title="Forearm Nerve Blocks page 11" href="http://viewer.zmags.com/publication/bd03d0b9?page=11"> Video 1 Demonstration of the ultrasound appearanc</a> <a title="Forearm Nerve Blocks page 12" href="http://viewer.zmags.com/publication/bd03d0b9?page=12"> 4 Sonographic anatomy Ulnar nerve: In short-axis</a> <a title="Forearm Nerve Blocks page 13" href="http://viewer.zmags.com/publication/bd03d0b9?page=13"> Figure 4 Short-axis image of the ulnar nerve in t</a> <a title="Forearm Nerve Blocks page 14" href="http://viewer.zmags.com/publication/bd03d0b9?page=14"> 4 Sonographic anatomy Figure 5</a> <a title="Forearm Nerve Blocks page 15" href="http://viewer.zmags.com/publication/bd03d0b9?page=15"> Video 2 Demonstration of the ultrasound appearanc</a> <a title="Forearm Nerve Blocks page 16" href="http://viewer.zmags.com/publication/bd03d0b9?page=16"> 4 Sonographic anatomy Radial nerve: In short-axi</a> <a title="Forearm Nerve Blocks page 17" href="http://viewer.zmags.com/publication/bd03d0b9?page=17"> Figure 6 Short-axis image of the radial nerve (RN</a> <a title="Forearm Nerve Blocks page 18" href="http://viewer.zmags.com/publication/bd03d0b9?page=18"> 4 Sonographic anatomy Vid</a> <a title="Forearm Nerve Blocks page 19" href="http://viewer.zmags.com/publication/bd03d0b9?page=19"> 5 Technique Aseptic technique is recommended, in</a> <a title="Forearm Nerve Blocks page 20" href="http://viewer.zmags.com/publication/bd03d0b9?page=20"> 5 Technique Figure 7 Transducer pos</a> <a title="Forearm Nerve Blocks page 21" href="http://viewer.zmags.com/publication/bd03d0b9?page=21"> Figure 8 Out-of-plane approach for a median nerve</a> <a title="Forearm Nerve Blocks page 22" href="http://viewer.zmags.com/publication/bd03d0b9?page=22"> 5 Technique Ulnar nerve: Begin by imaging the ul</a> <a title="Forearm Nerve Blocks page 23" href="http://viewer.zmags.com/publication/bd03d0b9?page=23"> Figure 9 Transducer position used to identify the</a> <a title="Forearm Nerve Blocks page 24" href="http://viewer.zmags.com/publication/bd03d0b9?page=24"> 5 Technique Figure 10 Out-of-plane </a> <a title="Forearm Nerve Blocks page 25" href="http://viewer.zmags.com/publication/bd03d0b9?page=25"> Figure 11 In-plane approach for an ulnar nerve bl</a> <a title="Forearm Nerve Blocks page 26" href="http://viewer.zmags.com/publication/bd03d0b9?page=26"> 5 Technique Radial nerve: Begin by imaging the s</a> <a title="Forearm Nerve Blocks page 27" href="http://viewer.zmags.com/publication/bd03d0b9?page=27"> Figure 12 Transducer position used to identify th</a> <a title="Forearm Nerve Blocks page 28" href="http://viewer.zmags.com/publication/bd03d0b9?page=28"> 5 Technique Figure 13 The brach</a> <a title="Forearm Nerve Blocks page 29" href="http://viewer.zmags.com/publication/bd03d0b9?page=29"> Figure 14 Out-of-plane approach for a radial nerv</a> <a title="Forearm Nerve Blocks page 30" href="http://viewer.zmags.com/publication/bd03d0b9?page=30"> 5 Technique Video 4 Demon</a> <a title="Forearm Nerve Blocks page 31" href="http://viewer.zmags.com/publication/bd03d0b9?page=31"> With respect to all forearm nerve blocks describe</a> <a title="Forearm Nerve Blocks page 32" href="http://viewer.zmags.com/publication/bd03d0b9?page=32"> 6 Clinical pearls 1. Although an in-plane techni</a> <a title="Forearm Nerve Blocks page 33" href="http://viewer.zmags.com/publication/bd03d0b9?page=33"> Additional resources Additional resources relate</a> <a title="Forearm Nerve Blocks page 34" href="http://viewer.zmags.com/publication/bd03d0b9?page=34"> Philips Healthcare is part of Royal Philips Elect</a>