Neurology / / August 12, 2017
operations on the nervous system
lumbar puncture - the introduction of a needle into the subarachnoid space of the spinal cord in order to extract cerebrospinal fluid (CSF) or infusion of drugs or contrast media.It is produced at various levels of the spine - the lumbar spine, at least - in the breast, in the area of the foramen magnum (suboccipital puncture), but most of it is made in the lumbar spine (lumbar puncture or lumbar puncture).
lumbar puncture provides valuable diagnostic information.The resulting liquor can be transparent or contain an admixture of blood or pus, suggesting subarachnoid hemorrhage or meningitis;cerebrospinal fluid may leak from the needle under normal, increased or reduced pressure that is set by the pressure gauge, ie. e. bent at right angles to the glass tube coated with it centimetric divisions.The liquor should be sent to the laboratory in two sterile tubes: one - for the study of cellular and protein composition of CSF, the other - for the sowing of liquor.
supine position the patient with a lumbar puncture.
lumbar puncture allows you to make specific diagnostic tests - the introduction of contrast media into the subarachnoid space of the spinal cord and the brain, followed by X-ray.X-ray examination of the spinal cord with the introduction of a contrast agent called myelography.When the contrast agent is air or oxygen, this procedure is called airmyelography.If injected by spinal puncture a sufficient amount of air and it rises into the subarachnoid space of the brain, the X-ray examination of the brain at the same time called Pneumoencephalography.
Sitting position of the patient with a lumbar puncture.
With the purpose of treatment produces a spinal tap to extract a certain amount of CSF to be administered sodium salt of penicillin or other drugs.
lumbar puncture is carried out in various areas: in the dressing room - for taking CSF for analysis or for administration of drugs;in the operating room - during brain surgery to rapidly reduce intracranial pressure;in the X-ray room - for myelography or pneumoencephalography.Depending on the patient's condition and research problems lumbar puncture is carried out in the patient supine or sitting.When a puncture in the position of a patient lying medic need help, which covers the patient's neck and popliteal fossa and bends back for the convenience of the needle between the spinous processes and vertebral arches.When a puncture in a sitting position that is normally required for pneumoencephalography, the doctor helps anesthesia or ward sister, who is facing the patient, giving him the right position with bent back.
Training tools and material for lumbar puncture.For lumbar puncture sister prepares: alcohol, iodine, 0.5% novocaine solution, 3 ml syringe with a capacity of 5 needles, scalpel, 2-3 needles for spinal tap, glass tube-gauge, 2 sterile vials, gauze balls and towels, 2sterile sheets, kleol.In addition, the vial is prepared from the sodium salt of penicillin.If the puncture is performed to study the radiopaque sister is also preparing an ampoule with a contrast agent, or a pillow with oxygen to pneumoencephalography.It is necessary to have ready a syringe with a capacity of 5 ml with needles and ampoules with ephedrine, caffeine hypodermic at kollaptoidnye condition that can develop with the introduction of air in the subarachnoid space.