ICU Primary PrepCast #Epi 100 - ICU Primary Snippet - Anatomy for lumbar puncture
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Oct 2, 2025 Celebrate a milestone as hosts discuss the intricacies of lumbar puncture anatomy. Discover the key differences between adult and pediatric approaches. Learn the significance of lumbar vertebrae and the safety zones to avoid cord injury. Explore surface landmarks and the considerations for various patient types. Maddy and Swapnil explain needle techniques and the anatomy of essential ligaments. Plus, enjoy a touch of humor with a lumbar-themed joke that lightens the medical talk!
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Hosts Celebrate Episode 100 And Listener Thanks
- Swapnil and Maddy celebrate the podcast's 100th episode and thank listeners for exam success stories.
- Swapnil shares emails from trainees who passed exams and praised Mike Clifford's contributions.
Target: The Lumbar Cistern Below The Cord
- The lumbar puncture targets the lumbar cistern in the subarachnoid space below the conus medullaris where CSF and loose nerve roots float.
- Performing the tap at L3-4 or L4-5 avoids the spinal cord which usually ends at L1-L2 in adults.
Use Midline Approach And Feel For Pops
- Use a midline approach at L3-4 or L4-5 and feel for ligament layers as landmarks while inserting the needle.
- Expect loss-of-resistance at the ligamentum flavum and another 'pop' when penetrating the dura into the subarachnoid space.