A lateral insertion (eg, 1 cm both lateral and caudad to the midline skin insertion point) bypasses the midline ligaments and may facilitate lumbar puncture in older patients whose ligaments are calcified and sclerotic. The ligamentum flavum is thick connective tissue, and a distinct pop may (or may not) be palpable when the needle traverses it.

2018年7月2日 · A step-by-step guide to performing a lumbar puncture in an OSCE setting. Including relevant anatomy, indications, complications and CSF interpretation.

2023年7月24日 · Lumbar puncture is one of the most commonly performed procedures in the emergency department. It is used in the diagnosis of potentially life-threatening diseases such as meningitis and subarachnoid hemorrhage. A thorough understanding of anatomy, potential complications, and various techniques helps to ensure a successful and safe lumbar puncture.

Review brain imaging for herniation risk. Check labs for PTT, INR < 1.5, plts > 50. Obtain informed consent, place in chart. A low-dose benzodiazepine can be used for anxious patients. plenty of extra 4 x 4 gauze. Place the yellow sticker from the LP kit on the card inside the red binder at the nurses station.

Surface markings for lumbar puncture. Blue dots = Iliac crests; line connecting them = intercristal (Tuffier's) line; intersection of the Tuffier's line and lumbar spine midline = L4 spinous process. Proper needle trajectory: skin, subcutaneous tissue, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space (containing ...

We review the technique of diagnostic Lumbar Puncture including anatomy, needle selection, needle insertion, measurement of opening pressure, Cerebrospinal Fluid (CSF) specimen handling and after care. We also make some quality improvement suggestions for those designing services incorporating diagnostic Lumbar Puncture.

2017年6月13日 · Prepare your lumbar puncture kit. You will use the same equipment, positioning, local anesthesia, and sterile technique as you would for the midline approach. A longer spinal needle may be required since you are approaching the subarachnoid space at an angle. The patient can be positioned in the lateral recumbent or sitting position.

Positioning for lumbar puncture (LP) A lumbar puncture can be performed in two positions: Lateral recumbent. Patient on his or her side with head propped up on a single pillow to keep spine straight; Knees & torso flexed to optimise interlaminar foramen of vertebrae; Ask or use assistant to draw patient’s legs up to their chest

It includes special reference to three dimensional relationships, functional anatomy, imaging anatomy, normal variation and living anatomy. A lumbar puncture is a commonly performed procedure for diagnostic and therapeutic purposes.

2019年5月20日 · Key Points • Ultrasound increases the success rate of lumbar puncture by improving landmark identification of the lumbar spine's midline and interspaces. • Identification of spinal landmarks with ultrasound relies on visualization of bony processes in both longitudinal and transverse planes.