Cadaver Lab Module 1: Interscalene Block
Anterior deltoid
Pectoralis major
Clavicle
Head
Neck
Reflected pectoralis major
Pectoralis minor
Clavicle
Sternal head of sternocleidomastoid muscle (SCM)
Clavicular head of SCM
Fingers rolling into the interscalene groove (ISG)
Is there a brachial plexus sheath? A picture is worth a thousand words! Mobilized clavicle Anterior scalene muscle Brachial plexus in sheath
Middle scalene muscle
Omohyoid muscle (inferior)
Brachial plexus with sheath removed
Mobilized clavicle Brachial plexus trunks 1. Superior trunk 2. Middle truck 3. Inferior trunk
3 2 1
Omohyoid muscle (inferior)
Ultrasound-guided nerve blocks in fresh frozen cadavers
Interscalene block – scanning IS groove
In-plane needle advancing under superior trunk at level of ISG
Superior trunk Middle trunk
Nerve roots needle
Nerve roots
needle
Interscalene catheter placement