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This Concept Map, created with IHMC CmapTools, has information related to: Intrasynovial Nerve Blocks, Distal Interphalangeal joint blocks (coffin Joint) Regions Blocked Coffin joint Navicular bursa adjacent soft tissue Distal DDFT Dorsal sole, Digital flexor tendon sheath block Regions blocked Synovial membrane and tendon sheath wall SDFT, DDFT and surrounding soft tissue, Fetlock joint block Procedure There are three approaches to this joint block:Proximal Palmar, Dorsal pouch and CSL Needle size: 20g 1" 6-10mls time to effect: 10 mins, Distal Interphalangeal joint blocks (coffin Joint) Anatomical Landmarks Proximal edge of the cornet 2mm medial or lateral to the midpoint of the cornet The joint capsule can be plapated (seen in the procedure video, Navicular Bursal Injection Anatomical Land Marks Medial plane between the heel bulbs Distal aspect of the pastern Cornary band, Digital flexor tendon sheath block Procedure Needle size: 18/20g 1.5" approx. 10-20mls time: 20 mins, Fetlock joint block Anatomical Landmarks Standing or Elevated limb Proximal Palmar: distal to splint bone, proximal to sesamoid, dorsal to suspensory ligament, Digital flexor tendon sheath block Indications for Block Suspected Tenosynovitis (swelling, pain on palpation) administering medication to site, This injection can be used to administer medication. It can also be used as a diagnostic tool by injecting a positive contrast and performing an x-ray on the joint after. This allows us to see if the joint has a puncture or if its intact. Snyovial fluid samples can also be taken Indications Navicular Bursal Injection, Digital flexor tendon sheath block Anatomical Landmarks Proximal to the proximal sesamoid bones and Annular Ligament, Palmar or Plantar to the Suspensory Ligament Needle directed slightly downward, Distal Interphalangeal joint blocks (coffin Joint) Procedure Needle size: 20g 1.5" needle 5-10mls The dorsal approach to this block is the most common but palmar and lateral approaches can also be The limb can be held or weight bearing, Fetlock joint block Indications for the Block Suspected Joint effusion, Arthritis, swelling, pain on palpation of area or areas distal to the joint, Fetlock joint block Regions blocked Fetlock Joint Digital Flexor Tendon Sheath Proximal Sesamoid Bones Suspensorybranches, Distal Interphalangeal joint blocks (coffin Joint) Indications for block This injection blocks the joint and can diffuses to surrounding soft tissue. It can also be used to release fluid if the joint is swollen or administer medications, Navicular Bursal Injection Procedure A proximal digital nerve block should be performed before this injection. Needle: 20g 3.5" spinal needle (A detailed procedure is seen in the video linked)