Self-Assessment Questions: Text

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Appendix 1 Self-Assessment Questions: Text

1. Why do peripheral nerves often appear more echogenic after injection of anechoic local anesthetic?

A. The connective tissue content of the nerves has increased.
B. Nonattenuating fluid has been injected into an attenuating sound field.
C. The number of fascicles has increased.
D. Local anesthetic has entered the nerve and increased reflection.

2. Which of the following statements regarding peripheral nerve anatomy is most correct?

A. Polyfascicular nerves have a low connective tissue content compared with monofascicular nerves.
B. The cervical ventral rami have a high connective tissue content.
C. The number of fascicles and the connective tissue content of peripheral nerves are directly related.
D. Nerve fascicles are made exclusively of connective tissue.

3. Which of the following is most accurate?

A. Ultrasound frequencies of 10 MHz or higher are necessary to distinguish peripheral nerves from tendons based on echotexture alone.
B. Peripheral nerves can only be imaged with ultrasound frequencies of 10 MHz or higher.
C. Peripheral nerves can only be imaged with ultrasound frequencies of 20 MHz or higher.
D. Peripheral nerves and tendons cannot be distinguished with ultrasound imaging.

4. Which of the following statements regarding probe compression is most correct?

A. Nerves do not move in response to probe compression.
B. Arteries cannot be compressed by the ultrasound probe.
C. Veins are easier to compress than arteries.
D. Nerves are easily compressed by the ultrasound probe.

5. What term describes the fact that the received echoes from peripheral nerves vary with the angle of insonation?

A. Acoustic emission
B. Anisotropy
C. Power Doppler imaging
D. None of the above

6. Which of the following statements is most accurate?

A. Nerves are more anisotropic than tendons.
B. The anisotropy of peripheral nerves is thought to be related to their myelin content rather than their collagen content.
C. The amplitude of the received echoes from peripheral nerves is usually largest when the sound beam is perpendicular to the nerve.
D. Nerves and tendons do not exhibit anisotropy.

7. Which of the following influences needle tip visibility? (Select all that apply.)

A. The angle of insonation
B. The gauge of the needle
C. The bevel orientation
D. The bevel angle

8. Which of the following is associated with comet-tail artifact?

A. First rib
B. Pneumothorax
C. Normal pleura
D. Brachial plexus

9. Select the best answer.

A. Bone is a strong absorber of sound waves.
B. Pleura is a strong reflector of sound waves.
C. Both of the above statements are true.

10. Which of the following statements regarding interscalene block is true?

A. The phrenic nerve lies medial to the brachial plexus within the middle scalene muscle.
B. The phrenic nerve crosses over the anterior scalene muscle medial to the brachial plexus.
C. The dorsal scapular nerve is often seen within the anterior scalene muscle.
D. The spinal accessory nerve arises from the brachial plexus.

11. Which of the following statements regarding the first rib and pleura is true?

A. Only the first rib produces comet-tail artifact.
B. Comet-tail artifact signifies the presence of pneumothorax.
C. The pleura produces a bright reflection and comet-tail artifact.
D. The first rib does not produce reflection of sound waves.

12. What is the most common anatomic variation in the interscalene region?

A. Cervical rib
B. Cervical ventral rami that pass over or through the anterior scalene muscle
C. Phrenic nerve passing through the middle scalene muscle
D. Phrenic nerve passing through the subclavian artery

13. The phrenic nerve lies on which muscle in the neck?

14. The cords of the brachial plexus are named with respect to what structure?

15. What branches leave the brachial plexus sheath under the pectoralis minor at the coracoid process?

16. At the level of an axillary block, the musculocutaneous nerve typically lies in what muscle?

17. Regarding the anatomy of the axilla, pick one nerve (MCN, RAD, MED, ULN) for each:

The nerve that passes though the coracobrachialis muscle: _______
The nerve that passes between the axillary artery and vein: _______
The nerve that follows the profunda brachii artery into the triceps muscle and spiral groove of the humerus: _______
The nerve that passes from lateral to medial over the surface of the axillary artery and can be displaced to either side of the artery with probe compression: _______

18. True or False? In most subjects, the lateral femoral cutaneous nerve travels over (superficial to) the sartorius muscle near its insertion on the anterior superior iliac spine.

19. Which of the following statements regarding the femoral nerve are true? (Select all that apply.)

A. The femoral nerve is always oval in shape.
B. The femoral nerve is never triangular in shape.
C. The femoral nerve can be triangular in shape, especially when imaged proximal to the inguinal ligament.
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