Tuesday, 18 August 2015

First with the foot


The foot is innervated by 5 nerves which form the major sensory supply
  • Saphenous nerve
  • Post tibial nerve
  • Deep peroneal nerve
  • Sural nerve
  • Superficial nerve
Saphenous nerve
It is the terminal branch of femoral nerve which supplies to the anteromedial side of the foot
It is blocked at a point 1cm anterior to the point where saphenous vein crosses the medial malleolus of the foot with 3 to 5ml of the local anesthetic.
Deep peroneal nerve
It is the terminal branch of the common peroneal nerve and it is blocked  at a point in the groove between the extensor digitorum longus and flexor hallusis longus and deep to the nerve is anterior tibial artery which becomes the dorsalis pedis artery and infiltrate 5 to 8 ml of local anesthetic from skin to periosteum
Superficial peroneal nerve
From the groove of the extensor digitorum longus and flexor hallusis longus a subcutaneous infiltration towards the lateral malleolus with 5 to 8 ml of local anesthetic
Posterior tibial nerve
It travels posterior to the medial malleolus and lies adjacent to the posterior tibial artery and 5 to 8 ml local anesthetic agent is injected in a fan like manner
Sural nerve
It lies subcutaneous to the lateral malleolus and a field block is performed at this level with 5 to 8 ml of local anesthetic agent
Indications
It is done for procedures of the distal foot.




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