Where in the vertebral column is a lumbar puncture done?

Where in the vertebral column is a lumbar puncture done?

A lumbar puncture (LP) or spinal tap may be done to diagnose or treat a condition. For this procedure, your healthcare provider inserts a hollow needle into the space surrounding the spinal column (subarachnoid space) in the lower back to withdraw some cerebrospinal fluid (CSF) or inject medicine.

Why is a lumbar puncture usually performed at the level of L3 or L4?

The insertion of a needle under local anaesthetic requires careful positioning to prevent injury to the spinal cord. Since the spinal cord ends as a solid structure around the level of the second lumbar vertebra (L2) the insertion of a needle must be below this point, usually between L3 and L4 (Fig 2).

At what level is a lumbar puncture performed?

A diagnostic Lumbar Puncture should be performed at the L3/4 interspinal space, marked ‘x’. The approximate distance from the skin to the epidural space is 45-55mm and the dura mater may be up to 7mm beyond that depth.

Where are the lumbar spinal nerves located?

The lumbar nerves are five spinal nerves which arise from either side of the spinal cord below the thoracic spinal cord and above the sacral spinal cord. They arise from the spinal cord between each pair of lumbar spinal vertebrae and travel through the intervertebral foramina.

How long are you sore after a spinal tap?

The headache typically starts several hours up to two days after the procedure and may be accompanied by nausea, vomiting and dizziness. The headaches are usually present when sitting or standing and resolve after lying down. Post-lumbar puncture headaches can last from a few hours to a week or more.

Which is the best way to position a patient for lumbar puncture?

Positioning. There are two positions that a patient can be in for a lumbar puncture – see Figure 1. The preferred position is lying on their side (left lateral) with the patients legs flexed at the knee and pulled in towards their chest, and upper thorax curved forward in an almost foetal position.

Why is a spinal tap usually done between L4 s1?

A lumbar puncture (spinal tap) is the insertion of a needle between the lamina of the vertebrae and into the thecal sac with the purpose of obtaining cerebrospinal fluid. This is done below the L2 level (usually between L3-4 or L4-5) in order not to injure the spinal cord.

What nerves are affected by the lumbar spine?

A limited description of the specific lumbar spinal nerves includes: L1 innervates the abdominal internal obliques via the ilioinguinal nerve; L2-4 innervates iliopsoas, a hip flexor, and other muscles via the femoral nerve; L2-4 innervates adductor longus, a hip adductor, and other muscles via the obturator nerve; L5 …

What does bacteria in spinal fluid mean?

Bacteria or other germs found in the sample may be a sign of meningitis. This is an infection of the membranes covering the brain and spinal cord. The infection can be caused by bacteria, fungi, or viruses.

What does white blood cells in spinal fluid mean?

An increase of white blood cells indicates infection, inflammation, or bleeding into the cerebrospinal fluid. Some causes include: Abscess. Encephalitis. Hemorrhage.

What happens the day after a spinal tap?

Your Recovery You may feel tired, and your back may be sore where the needle went in (the puncture site). You may have a mild headache for a day or two. This can happen when some of the spinal fluid is removed. You may be told to drink extra fluids after the procedure to help prevent a headache or make it less severe.

How long are you on bed rest after a lumbar puncture?

The duty physician advises you that the patient will require four hours bed rest after the lumbar puncture. The duty anaesthetist overhears and says that the patient will be able to go home immediately.

What part of the spine controls the hands?

The C7 dermatome goes down the back of the arm and into the middle finger. C8 helps control the hands, such as finger flexion (handgrip). The C8 dermatome covers the pinky side of the hand and forearm.

What vertebrae controls bowels?

The lowest part of the spinal cord is the sacral spinal cord. Bladder function, bladder and bowel external sphincters, sexual functions (including erections and ejaculation in men and responsiveness in women), and some leg muscles are the domain of the sacral spinal cord.

What part of the body does the lumbar spine control?

These lumbar vertebrae (or lumbar bones) contain spinal cord tissue and nerves which control communication between the brain and the legs. Damage to the lumbar spinal cord subsequently affects the hips and groin area, and may impact the lower abdominal muscles and thigh flexion as well.

What are they looking for in spinal fluid?

A CSF analysis may include tests to diagnose: Infectious diseases of the brain and spinal cord, including meningitis and encephalitis. CSF tests for infections look at white blood cells, bacteria, and other substances in the cerebrospinal fluid.

What causes elevated white blood cells in spinal fluid?

White blood cell (WBC) count—normally very few white blood cells are present. A significant increase in white blood cells in the CSF can be caused by infection or inflammation of the central nervous system.

Should there be white blood cells in spinal fluid?

Normally, there are no RBCs in the cerebrospinal fluid, and there should be no more than five WBCs per cubic millimeter of CSF. If your fluid contains RBCs, this may indicate bleeding.