Fascia Iliaca Block Anatomy — FRCA Final MCQ

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EasyRegional AnaesthesiaFascia Iliaca Block AnatomyFRCA Final

A 55-year-old woman undergoes a fascia iliaca compartment block for analgesia following a fractured neck of femur. Which option identifies the two nerves that lie within the fascia iliaca compartment and are the principal targets of this block?

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Correct answer: D — Femoral nerve and lateral femoral cutaneous nerve

Explanation lettering: E = shown as A · A = shown as B · D = shown as C · B = shown as D · C = shown as E

The correct answer is B. The fascia iliaca compartment is the plane deep to the fascia iliaca and superficial to iliopsoas; it contains the femoral and lateral femoral cutaneous nerves, which are therefore the principal targets of a fascia iliaca compartment block. The obturator nerve is anatomically separate from this compartment and its blockade is inconsistent, even with proximal or supra-inguinal techniques. It should not be presented as a reliably blocked component of a standard fascia iliaca block or equated uncritically with a complete “three-in-one” block. The sciatic nerve lies in the posterior pelvis and is not covered by this anterior fascial-plane injection. Options A and E each name only one of the two principal nerves, while C and D incorrectly include the sciatic nerve.

Reference: Ten Hoope W, et al. A radiological cadaveric study of obturator nerve involvement and cranial injectate spread after different approaches to the fascia iliaca compartment block. Scientific Reports. 2023;13:12070. https://pubmed.ncbi.nlm.nih.gov/37495606/