© Advanced nerve blocks - Dr Anand Sardesai - Cambridge; United Kingdom
Ankle Block
Following nerves can be blocked at the level of elbow:
•
Median nerve
•
Radial nerve
•
Ulnar nerve
Median Nerve:
Anatomy
The Median nerve lies on the medial side of the brachial artery at the level of elbow crease.
This image is from Gray's anatomy and shows median nerve lying medial to the artery at the
level of elbow.
Locating the nerve:
Use a linear high frequency transducer.
Position it just above the elbow crease so as to obtain a cross sectional view of the brachial
artery.
Do not look for the nerve initially. Find the artery, then look medial to the artery.
The Nerve lies medial to the artery.
You will have to adjust the probe (tilting and clockwise and counterclockwise movement) to get
the best view of the nerve.
Most of the time it is quite closely associated with the artery but sometimes it can be further
away.
The best way to confirm it is the nerve is to scan back towards the axilla. The median nerve
always stays with the artery and if it is further away at the elbow then it will join the artery by
midarm level.
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