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  Discussion on Nerve blocks
Author Message
Member:
Caymie

Posted on Wednesday, Dec 1, 2004 - 11:24 pm:

Dr. O.,
Could you please clarify the difference between a four point block and a six point block in a hindlimb? Also, would either of these blocks be specific for the front part of the foot? Meaning, if they were used would they completely rule out foot pain in the entire foot, or would you need a more specific foot block for that region? Does the low PDN block an area that neither the four or six point block would?
Thanks,
Mary
Member:
Caymie

Posted on Thursday, Dec 2, 2004 - 8:01 pm:

Dr. O.,
Please disregard my above post. What I am trying to clarify is this: What is the difference between a four point block, and a six point block in the hindlimb? What does a six point block out that a four point doesn't? Do either of those blocks also cover the fetlock/pastern joint? Also-could a problem in the pastern/fetlock joint cause some soreness in the foot? What exactly does a high PDN block cover?
Thank you so much.
Mary
Moderator:
DrO

Posted on Friday, Dec 3, 2004 - 6:53 am:

Mary the blocks are explained in detail in the "Overview" articles associated with each anatomical block. Start with the "Overview of Diseases of the Foot", proceed to the one on the pastern, then the one on the fetlock. Eack explains what the blocks in that area do and the article on the fetlock explains the difference betweek the 4 and 6 point block in the hind limb. A high PDN is probably the same as a abaxial sesamoind explained in the pastern article.
DrO
Member:
Caymie

Posted on Friday, Dec 3, 2004 - 8:22 am:

Dr. O.,
I have read over the aforementioned articles. I am still uncertain as to what the difference is between the four point vs. six point in a hind leg. Could you tell be briefly what the six point blocks that the four point doesn't?
Thanks,
Mary
Moderator:
DrO

Posted on Saturday, Dec 4, 2004 - 11:18 am:

If you just do the 4 point in the back you do not get the whole fetlock and the proximal (upper) portion of the pastern. The extra 2 points insure you do.
DrO
Member:
Caymie

Posted on Saturday, Dec 4, 2004 - 4:04 pm:

Dr. O.,
Thank you so much! That clears up a big mystery for me. One last question-does the four point completely block out the entire foot-especially the front part of the foot?
Thanks,
Mary
Moderator:
DrO

Posted on Sunday, Dec 5, 2004 - 9:01 am:

Hello Mary,
Yes.
DrO
Member:
Caymie

Posted on Sunday, Dec 5, 2004 - 5:24 pm:

Dr. O.,
If the four point in the hindlimb doesn't block out the whole fetlock and the upper portion of the pastern, how does it block out the foot? What block do you ususlly use to determine if there is foot pain? (As it turns out, my horse has a foot abscess, not a stifle strain). Can severe brusing/abcesses cause lameness for a couple weeks before they finally begin to drain?
Thanks,
Mary
Moderator:
DrO

Posted on Monday, Dec 6, 2004 - 8:19 pm:

The branches to the foot come off of the nerve blocked in the 4 point block below the leveol of the block. The branches to the front of the front of the fetlock and upper front pastern come off above the level of the 4 point block. You can rule out the foot with the 4 point block. If this did not block the foot lameness a nerve was missed.

For the answer to your question on abscesses (bruises do not drain) and much more see the article on Abscesess it explains proper diagnosis, treatment, and about drainage.
DrO
Member:
Caymie

Posted on Monday, Dec 6, 2004 - 9:28 pm:

Dr. O.,
Excellent article on Abscesses. It cleared up everything for me all at once, and the past few weeks make sense. For once, Caymann has a normal horse diagnosis! He is doing much better since the abscess has drained and I plan to do some light riding with him tomorrow if he is sound.
Thanks again for a great site-
Mary
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