this is a patient whose pain doctor referred her for a cervical ultrasound guiding injection she had an injection in the past which gave her a lot of relief of her chronic headache as well as neck and arm pain she had ultrasound guided bracho plexus blocks or rular temporal and occipital nerve blocks as well as cervical facet capsule medial branch injections of local anesthetic with dexamethazone today I'm going to repeat some of the injections she had pre previously as she's markedly improved since her previous injection and she still continues to have some headache some days she's going to receive a an arular temporal nerve block an occipital nerve block as well as par vertebral cervical blocks which include the medial branch as well as the capsule of the facet joint and she's also going to get trigger point injections of the neck so I'm going to look for the oracular temporal nve this one we did a while ago color mode I'm looking for her oric temporal nerve it runs near the temporal artery okay here's the temporal artery and sometimes you can see the nerve passing over the artery I'm just going to infiltrate in that plane because it's little hard to see that okay little pinch on okay pinch so prep her neck go back to her neck going to do the cervical par vertebral nerve blocks now she responded at the levels of c345 in the past so scan downwards here's the highest transverse process would be C2 and going down would be C3 articular pillar right there a little pinch okay trigger points on the way in needle mode right there my knils on the articular pillar and by the joint capsule as well as some probably going anterior into the framing and to move down another pinch level down another pinch okay mhm how we feeling good
