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Spinal Nerves: Plexus I

Spinal Nerves: Plexus I

Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...

Spinal Nerves: Plexus II

Spinal Nerves: Plexus II

The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
The Lumbar Plexus
The lumbar plexus is situated within the lumbar region of the back and is primarily formed by the first four lumbar spinal nerves (L1 to L4). This plexus extends its branches into several nerves, including the...

Depolarizing Blockers: Pharmocokinetics

Depolarizing Blockers: Pharmocokinetics

Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...

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Related Experiment Video

Updated: May 24, 2026

Minimally Invasive Surgical Decompression of Occipital Nerves

Minimally Invasive Surgical Decompression of Occipital Nerves

Published on: September 13, 2024

["Diagnostic" interscalene plexus block].

K Mischler¹, C Müller, A Keller

¹Klinik für Anästhesiologie, Spital Uster, Schweiz.

Der Anaesthesist

|February 23, 2012

Summary

Systematic ultrasound examination before nerve blocks can reveal unexpected findings. In one case, a thyroid cyst found during an interscalene plexus block was a renal cell carcinoma metastasis.

Area of Science:

Radiology
Oncology
Anesthesiology

Background:

Ultrasound-guided nerve blocks require thorough anatomical assessment.
Systematic examination of the target region is crucial to avoid missing pathologies.

Observation:

During an ultrasound-guided interscalene plexus block, a cystic structure was incidentally detected in the thyroid gland.
The patient was a 73-year-old male.

Findings:

Further diagnostic workup revealed the cystic structure to be a metastasis of a previously treated renal cell carcinoma.
The original renal cell carcinoma had been resected 10 years prior.

Implications:

Incidental findings during ultrasound-guided procedures can lead to the early detection of recurrent or metastatic disease.

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Underscores the utility of ultrasound in identifying unexpected oncologic findings in diverse clinical settings.