USRA - Peripheral Nerve Block

Ulnar Nerve Above the Elbow (4-5 cm Above)

Anatomical Correlation

	Arrowhead = ulnar nerve (U) ME = medial epicondyle
	The ulnar nerve at this level is superficial and not restricted by bony structures. Rescue ulnar nerve block is suitable at this level because there is plenty of room for local anesthetic expansion. Box = scanned area H = humerus
	Pre-injection Arrows = needle Arrowhead = ulnar nerve
	Post-injection Arrows = needle Arrowhead = ulnar nerve LA = local anesthetic around the nerve

Ulnar Nerve at the Elbow

Anatomical Correlation

Note: The ulnar nerve (N) at this level is surrounded by bony structures, the olecranon (OF) laterally and the medial epicondyle (ME) medially. This is NOT a suitable location to perform a rescue ulnar nerve block.

Ulnar Nerve in the Forearm

Anatomical Correlation

	U = ulnar nerve UA = ulnary artery
	U = ulnar nerve UA = ulnary artery FCU = flexor carpi ulnaris

Ulnar Nerve in the Wrist

Anatomical Correlation

	U = ulnar nerve UA = ulnary artery
	U = ulnar nerve UA = ulnary artery FCU = flexor carpi ulnaris FDP = flexor digitorum profundus tendon FDS = flexor digitorum superficialis tendon

Video Gallery

Selected References

Foxall GL, Skinner D, Hardman JG, Bedforth NM: Ultrasound anatomy of the radial nerve in the distal upper arm. Reg Anesth.Pain Med. 2007; 32: 217-20.
Liebmann O, Price D, Mills C, Gardner R, Wang R, Wilson S, Gray A: Feasibility of forearm ultrasonography-guided nerve blocks of the radial, ulnar, and median nerves for hand procedures in the emergency department. Ann.Emerg.Med. 2006; 48: 558-62.
Schafhalter-Zoppoth I, Gray AT: Ultrasound-guided ulnar nerve block in the presence of a superficial ulnar artery. Reg Anesth.Pain Med. 2004; 29: 297-8.
Gray AT, Schafhalter-Zoppoth I: Ultrasound guidance for ulnar nerve block in the forearm. Reg Anesth.Pain Med. 2003; 28: 335-9.

Peripheral Nerve Block - Ulnar Region