RT Book, Section
A1 Dilberovic, Faruk
A1 Kapur, Eldan
A1 Wong, Chi
A1 Hadzic, Admir
A2 Hadzic, Admir
SR Print(0)
ID 3498210
T1 Chapter 3. Functional Regional Anesthesia Anatomy
T2 NYSORA Textbook of Regional Anesthesia and Acute Pain Management
YR 2007
FD 2007
PB The McGraw-Hill Companies
PP New York, NY
SN 9780071449069
LK accessanesthesiology.mhmedical.com/content.aspx?aid=3498210
RD 2024/09/15
AB It  is  often  said  that  the  practice  of  regional  anesthesia  is  the  practice  of  applied  anatomy.  Indeed,  the  practice  of  regional  anesthesia  is  inconceivable  without  a  sound  knowledge  of  the  basic  anatomic  facts  that  pertain  to  the  individual  anesthesia  techniques.  However,  just  as  surgeons  rely  on  surgical  anatomy  or  pathologists  rely  on  pathologic  anatomy,  the  anatomic  information  necessary  for  the  practice  of  regional  anesthesia  must  be  specific  to  this  application.  In  the  past,  many  new  nerve  block  techniques  and  “me-too”  approaches  were  devised  by  academicians  merely  relying  on  idealized  anatomic  diagrams  and  schematics,  rather  then  on  functional  anatomy.  Ultimately,  many  of  these  techniques  have  only  introduced  unnecessary  confusion  in  the  field  and  been  of  negligible  relevance  to  clinical  practice.  Indeed,  once  the  anatomic  layers  and  tissues  sheets  are  dissected,  the  fully  exposed  nerve  structures  are  almost  irrelevant  to  the  practice  of  regional  anesthesia.  This  is  because  accurate  placement  of  the  needle  and  the  spread  of  the  local  anesthetic  after  an  injection  depends  on  the  interplay  between  neurologic  structures  and  the  neighboring  tissues  where  local  anesthetic  pools  and  accumulates,  rather  than  on  the  mere  anatomic  organization  of  the  nerves  and  plexuses.  However,  much  research  by  regional  anesthesiologists  has  been  done  in  the  past  10–15  years  on  this  subject,  and  many  myths  of  the  past  have  been  dispelled.  The  reader  should  note  that  specific  anatomic  discussions  pertaining  to  individual  regional  anesthesia  techniques  are  detailed  in  their  respective  chapters.  The  purpose  of  this  chapter  is  to  provide  a  generalized  and  rather  concise  overview  of  anatomy  relevant  to  the  practice  of  regional  anesthesia.  The  reader  is  referred  to  Figure  3–1  for  an  easier  orientation  of  the  body  planes  discussed  throughout  the  book.