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Summary of the Day

Inferior Vena Cava Point-of-Care Ultrasound

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Question of the Day

An otherwise healthy 45-year-old woman is seen at an ambulatory surgical center for release of Dupuytren's contracture. A brachial plexus block is performed using the axillary approach. Assuming that no other nerve blocks are performed, and that the axillary block successfully achieves a complete motor and sensory block in its intended distribution, which of the following motor responses in the blocked extremity would MOST likely still be present?

Question of the Day
An otherwise healthy 45-year-old woman is seen at an ambulatory surgical center for release of Dupuytren's contracture. A brachial plexus block is performed using the axillary approach. Assuming that no other nerve blocks are performed, and that the axillary block successfully achieves a complete motor and sensory block in its intended distribution, which of the following motor responses in the blocked extremity would MOST likely still be present?
Your Answer
Correct Answer

Explanation

At the level of the axillary artery, the brachial plexus has divided into three cords (medial, lateral, and posterior), which are named in relationship to the axillary artery. These three cords travel with the axillary artery within the axillary sheath. The musculocutaneous nerve, however, as a terminal branch of the lateral cord, travels separately and is NOT located inside the axillary sheath. Thus, it must be blocked separately from an axillary brachial plexus block. Assuming that a musculocutaneous nerve block has not been performed, we would not expect to see a motor block of the biceps muscle, and elbow flexion and forearm supination, as well as cutaneous sensation to the lateral forearm, would be intact.

References:

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