Special Operations Forces Medical Handbook

5-168

Dorsal hand innervation

varies between the ulnar

and radial nerve, often

aligning with the 3rd digit

instead of the 4th digit

as shown

Dermatomes of Cutaneous Innervation of the Hand

Palmar (anterior) view Dorsal (posterior) view

Median nerve

Radial nerve

Ulnar nerve

What Not To Do: See IIIb & IIIc

V. Nerve Blockade of the Foot and Ankle:

When: Surgery of the toes and distal foot. The term “ankle block” denotes the location at which the local
anesthetic solution is applied. This block is not suitable for surgery of the ankle. Rarely will all five nerves
require blockade. Surgery of the medial foot requires blockade of the superficial, deep peroneal, saphenous,
and tibial nerves, but not the sural nerve. Surgery of the lateral aspect of the foot requires blockade of all
but the saphenous nerve.

What You Need: Standard Equipment: Complete ankle blockade is accomplished by injecting and blocking
all five nerves that supply the foot. The nervous supply to the foot is made of five terminals: superficial n.,
deep peroneal n., saphenous n., sural n., and tibial n.
NOTE: Additional techniques are discussed on the CD-ROM.

What Not To Do: See IIIb & IIIc

a. Superficial and Saphenous Nerve Block (Figure 5-38)

What To Do:

1. Assemble equipment.


2. Prep area.

Figure 5-37