PENG block: find the ramus, then lift the tendon

Question 1Which nerves does the PENG block target?

1. aThe lumbar nerve roots
2. bThe sciatic nerve
3. cArticular branches of the femoral, obturator and accessory obturator nerves to the front of the hip
4. dThe lateral femoral cutaneous nerve only

Question 2Where does the needle tip sit?

1. aInside the psoas tendon
2. bBeside the femoral artery
3. cUnder fascia iliaca, lateral to sartorius
4. dBetween the psoas tendon and the superior pubic ramus

Question 3What is the main advantage of the PENG block over a femoral nerve block?

1. aIt needs no dose calculation
2. bIt also blocks the sciatic nerve
3. cIt blocks the whole leg
4. dIt tends to spare the quadriceps

Question 4Where do you start the scan?

1. aSagittal over the femoral shaft
2. bOver the posterior superior iliac spine
3. cTransverse over the anterior inferior iliac spine, then rotate to lie along the pubic ramus
4. dOver the greater trochanter

Question 5What happens if the injection is too lateral and superficial?

1. aThe block covers the back of the hip
2. bThe femoral nerve is blocked, causing quadriceps weakness
3. cThe block lasts longer with no other effect
4. dThe bladder fills with fluid