Download Live Demonstration (Luc Mercadal)

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Transcript 
Live demonstration
Adductor Canal
Luc Mercadal
HP Claude Galien
Quincy sous Sénart
France
Adductor Canal: Boundaries
Cephalad boundary:
Apex femoral triangle
Caudal boundary:
Adductor (Magnus) Hiatus
ADDUCTOR CANAL: ANATOMY
Subsartorial
Sartorius croses Adductor longus
Aponeurotic intermuscular tunnel
the middle third of the tight
End at the adductor hiatus in the tendon
of adductor magnus
15 cm
ADDUCTOR CANAL: ANATOMY
Anteriorly: Sartorius m.
Posteriomedially: Adductor Longus m.
Adductor Magnus m.
Laterally: Vaste medialis m.
ADDUCTOR CANAL: CONTENT
The Nerves of the Adductor Canal and the Innervation of the Knee. An
Anatomic Study
David Burckett-St. Laurant
RAPM 2016
20 cadaveric
lower limbs
along the adductor
canal and
all branches
followed to their
termination
Adductor Canal Block
Medial
lateral
Sartorius m
FA
Sn & VMn
FV
Adductor Longus m
Vasta medialis m
Skin
Sartorius m.
Superficial femoral artery
VM n. & S n. close artery (lateral or superfical)
Vaste medialis m. lateral
Adductor longus m. medial
Depth
Superficial block
Positioning: supine
Linear High frequency probe
Depth: ≈ 2 – 4 cm
Needle: 5 cm – 8 cm
OP - IP
Injection: 15 – 20 ml
ADDUCTOR CANAL BLOCK
Medial
lateral
Sartorius m
FA
Sn & VMn
FV
Adductor Longus m
Vasta medialis m
Live demonstration
Obturator nerve
Obturator Nerve
Nerve roots:
L2 – L4
Anatomical Course:
Descends trougth the psoas
Emerges in the obturator foramen
Splits in 2 branches
Anterior division
Posterior division
Obturator Nerves
Lateral
Medial
Femoral n.
Sartorius m
Rectus Femoris m.
Iliopsoas m.
Anterior branch
posterior branch
Obturator Nerves Block
Adductor Longus m.
FA
Oa
Pectineus m.
Adductor Brevis m.
Op
Adductor magnus m.
Skin
Pectineus m.
Fascia plan: Adductor longus & adductor brevis
Obturator anterior branch
Fascia plan: Adductor brevis & adductor magnus
Obturator posterior branch
Depth
Superficial block
Positioning: supine,leg rotated
Linear High frequency probe
Depth: ≈ 2 – 5 cm
Needle: 5 cm – 8 cm
OP - IP
Injection: 5 – 10 ml
Obturator Nerve Block
medial
lateral
Adductor Longus m.
Oa
Pectineus m.
FA
Adductor Brevis m.
Op
Adductor magnus m.
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