Digital nerve block: block the base, one deposit on each side

Question 1Where do the palmar digital nerves run?

1. aThrough the middle of the proximal phalanx
2. bOn each side of the flexor tendon sheath, beside the digital arteries
3. cInside the flexor tendon sheath
4. dOn the back of the finger, over the extensor tendon

Question 2Which area do the palmar digital nerves supply in the index, middle and ring fingers?

1. aOnly the back of the finger at the base
2. bThe whole hand
3. cThe palmar surface and the back of the finger beyond the middle joint, including the nail bed
4. dThe skin over the metacarpals

Question 3What is the current evidence on lidocaine with adrenaline in the fingers?

1. aIt is safe in the fingers of healthy patients, with no finger loss in a large multicentre study
2. bIt is never used in the hand
3. cIt always causes finger necrosis
4. dIt is safe only in the thumb

Question 4After a digital block, the radial side of the finger is numb but the ulnar side is painful. What is the likely reason?

1. aThe patient is allergic to local anaesthetic
2. bThe radial nerve supplies the ulnar side of the finger
3. cThe block was too large
4. dThe nerve on the ulnar side was missed

Question 5Why do you keep the volumes small?

1. aSmall volumes last longer
2. bLarge volumes around the base of the finger raise the pressure in a closed space
3. cSmall volumes avoid the need for consent
4. dLarge volumes block the median nerve