الفهرس 
• Sonographic Anatomy of the Peripheral Nervous SystemOnly 14 pages are availabe for public view
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Abstract
Ultrasound guided regional anesthesia (UGRA) for
peripheral nerve blockade is becoming increasingly popular.
The advantage of ultrasound technology is that it affords the
anesthesiologist the real time ability to visualize neural
structures, needle advancement, and local anesthetic spread.
Recent data suggest that UGRA generates improved success
rates and reductions in performance times in comparison to
traditional approaches. Further, the use of ultrasound
technology in peripheral nerve blocks has provided insight into
needle–nerve interactions, revealing distinct limitations of
nerve stimulator techniques (Brian, 2007).
The study of the physical principles and the mechanism
of action of the sound and the ultrasound waves makes the
usage of the ultrasound unit much easier and also helps the user
to choose the proper probe and frequency for the purpose
needed (Willschke et al., 2005).
The nature of ultrasound waves being reflected, refracted
and scattered is the corner stone for the principle of action of
ultrasound which makes it possible to visualize different tissues
with various depth from the probe (Willschke et al., 2005).
The development of recent US. Machines containing
different software options including compound imaging, tissue
harmonic effect, extended field imaging and high resolution
imaging greatly helped us in clear visualization of nerve fibers
and surrounding structures with marked reduction of artifacts
(Baret et al., 2008).
The traditional guidance techniques used in regional
anesthesia have consistently failed to meet this perfectly logical
requirement. ‘Blind’ blocks that rely solely on anatomical
landmarks are known to produce serious complications. Ven the
technique of nerve stimulation which has been recommended as
the gold standard for nerve identification in regional anesthesia
over the past decade fails to ensure an adequate level of nerve
block (e.g., in axillary brachial plexus blocks). In addition, it
carries a risk of inflicting damage to nerve structures by direct
puncture (Marhofer et al., 2005).
Finally we believe that US. Guided nerve block is
considered the gold standard nerve block technique regarding
increasing success rates and minimizing risks of possible
complications.