**9. "Alternative" cross-cutting approach**

In an alternative approach described by Jack Vander Beek, the ultrasound scan is performed in the caudocraneal sense instead of the medio-lateral sweep of the "classic" technique. This approach is especially useful in patients with previous anatomical changes in the neck (surgery, radiotherapy, lean muscle bellies, etc.). Whichever approach is chosen, it is advisable to make subtle and rapid caudocraneal movements that will help visualize the nerve roots. It is advisable to define the scalene and focus on finding the nerves.
