Lumbar Puncture Flashcards
1
Q
What is the anatomy in which the lumbar puncture is inserted?
A
- Inserted into the subarachnoid space between the arachnoid mater and pia mater
- It contains CSF
- The human body contains approximately 100-150ml of CSF
2
Q
When would you require a Lumbar Puncture?
A
- Cerebrospinal fluid analysis
- Spinal epidural
- Spinal medications (analgesia, chemotherapy, antibiotics)
- Fluid removal (to reduce ICP)
3
Q
What are the contraindications of Lumbar Puncture?
A
- Suspicion of raised intracranial pressure
- Anticoagulant therapy
- Thrombocytopenia/ clotting disorders
- Suspicion of a spinal abscess
- Risk of herniation (Arnold-Chiari Malformation)
- Acute spinal cord trauma
- Congenital spinal abnormalities
4
Q
What level of insertion should the lumbar puncture go through?
A
- L3/L4 or L4/L5
5
Q
What are the layers the needle passes through before it reaches the subarachnoid space?
A
- Skin
- Subcutaneous fat
- Supraspinous ligament
- Interspinous ligament
- Ligamentum flavum
- Dura mater
- Subdural space
- Arachnoid mater
- three pops when going through - after the third pop = ligamentum flavum CSF should flow
6
Q
What are the results for a Viral LP?
A
- Raised/ Normal protein
- Normal Glucose
- Raised WCC
- Lymphocyte cells present
7
Q
What are the results for Bacterial LP?
A
- Raised Protein
- Low glucose
- Raised WCC
- Neutrophil cells present
8
Q
What are the complications of Lumbar Puncture?
A
- Headache
- Infection
- Bleeding
- Cerebral herniation
- Radiculopathy
- Back Pain
