Lumbar Puncture

Question 1

What are the 10 layers penetrated during lumbar puncture?

Answer 1

-Skin
-Subcutaneous tissue
-Supraspinous ligament
-Interspinous ligament
-Ligamentum flavum
-Epidural space
-Dura matter
-Subdural space
-Arachnoid matter
-Subarachnoid space

Question 2

What are the diagnostic indications for lumbar puncture?

Answer 2

-To diagnose CNS infections such as meningitis and encephalitis
-To check for subarachnoid hemorrhage
-Evaluation of neurological disorders

Question 3

What are the therapeutic indications for lumbar puncture?

Answer 3

-To reduce the raised intracranial pressure
-To administer medications

Question 4

What are the early complications of lumbar puncture?

Answer 4

-Post lumbar puncture headache
-Back pain
-Bleeding

Question 5

What are the intermediate complications of lumbar puncture?

Answer 5

-Infections
-CSF leakage
-Nerve root injury

Question 6

What are the late complications of lumbar puncture?

Answer 6

-Cerebral herniation
-Arachnoiditis
-Chronic pain

Question 7

Uses Of CSF collected in the 4 sample bottles during lumbar puncture?

Answer 7

Tube 1: Culture and sensitivity
Tube 2:Routine studies
Tube 3:Biochemical studies
Tube 4:Histology

Question 8

Type of spinal needles?

Answer 8

Sharp ended or dural cutting needles:
-Quinkie needle
-Pitkin

Blunt ended or dural separating needles
-Sprote
-Whatacre

Question 9

What are the color coding for the different sizes of spinal needles

Answer 9

18G pink
19G Ivory
20G Yellow
22G Black
23G Blue
25G Orange
26G Brown

Question 10

CSF assessment parameters (Normal)

Answer 10

NORMAL CSF
-Appearance : Clear or colorless
-Opening pressure :6-20 mmH20
-Glucose: 60-70% of blood glucose
-Proteins: <45-50mg/dL
-Cell count: < 5 WBCs/UL
- Gram stain /culture : Does not show bacteria.

Question 11

CSF assessment parameters (Bacterial infection)

Answer 11

-Appearance :Cloudy or turbid
-Opening pressure : Increased
-Glucose: Decreased
-Proteins: Elevated
-Cell count : >1000 WBCs/UL, predominantly neutrophils
-Gram stain and culture : Shows presence of bacteria

Question 12

CSF assessment parameters (Viral infection)

Answer 12

-Appearance : Clear
-Opening pressure : Normal or slightly increased
-Glucose: Normal
-Proteins: Normal
-Cell count : Slightly elevated, predominantly lymphocytes
-Gram stain and culture : No bacteria

Question 13

CSF assessment parameters (Fungal infections)

Answer 13

-Appearance : Cloudy or turbid
-Opening pressure :Increased
-Glucose :Decreased
-Proteins: Elevated
-Cell count : Increased, mainly monocytes and lymphocytes
-Gram stain and culture : No bacteria