Cadaver Lab Module 1: Interscalene Block

Clavicle

Pectoralis major

Neck

Head

Anterior deltoid

Reflected pectoralismajor

Pectoralisminor

Clavicle

Fingers rolling into the interscalene groove (ISG)

Clavicular head of SCM

Sternal head of sternocleidomastoidmuscle (SCM)

Mobilized clavicle

Anterior scalene muscle

Brachial plexus in sheath

Middle scalene muscle

Omohyoid muscle (inferior)

Is there a brachial plexus sheath?A picture is worth a thousand words!

Brachial plexus with sheath removed

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3

Mobilized clavicle

Brachial plexus trunks1. Superior trunk2. Middle truck3. Inferior trunk

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 trunkMiddle trunk

Nerve roots

needle

Nerve roots

needle

Interscalene catheter placement