LUMBAR PUNCTURE (Spinal Tap). An invasive procedure to gain access into the sub-arachnoid space. Just as the cisternal
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1. LUMBAR PUNCTURE DR. OGUNDARE E. O
2. LUMBAR PUNCTURE (Spinal Tap) An invasive procedure to gain access into the sub-arachnoid space.
Just as the cisternal & ventricular taps
May be diagnostic &
At times therapeutic.
3. The Normal CSF Pressure: 50 - 180 mmH2O
Appearance: clear, colourless (Xanthochromic in NN)
CSF total protein: 15 - 45 mg/ 100 ml
Gamma globulin: 3 - 12% of the total protein
CSF glucose: 50 - 80 mg/ 100 ml
(or approximately 1/2 - 2/3 of serum glucose level)
CSF cell count:
0 - 5 white blood cells (WBC),
no red blood cells (RBC)
Chloride: 110 - 125 mEq/ L
4. Indications Performed in order to:
Collect CSF samples for biochemical, microbiological and cytological analysis,
Instill intra-thecal drugs e.g. Methotrexate.
or rarely to relieve raised ICP.
5. Indications: Diagnostic Infections:
meningitis (bacterial, viral, TB, fungal e.t.c)
Staging of tumours:
Stage D burkitt’s
Dye injection for myelography
CSF pressure measurement
6. Indications: Therapeutic Drug Instillation: chemotherapeutic agents
Therapeutic relief of:
Benign ICP hypertension (Pseudotumor cerebri)
7. Understanding LP Spinal Anatomy
8. ANATOMY Bones: spinal column has 2 anterior concave curves-in thoracic & lumbar regions.
Foramen : interlaminar foramen
The Meninges & the Spaces
9. Positioning Sitting Good for certain patients: Obese pulmonary disorder Newborn/ infants – prevents hyperflexion