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What is Lumbar puncture Guide Line?

Lumbar puncture involves inserting a thin needle into the lower back and into the spinal canal to extract some of the fluid that surrounds the spinal cord to the survey.

Central Nervous System
The central nervous system consists of the brain and spinal cord. These two parts are connected. While the brain is protected by the skull, the spinal cord is protected by vertebrae. The spine consists of vertebrae (bones), ligaments and membranes, cerebrospinal fluid and spinal cord with nerves.

Between each of the vertebrae of the spine is an intervertebral disc on the "inside" of the spinal cord. Strong ligaments around and along the spine holding it together. Intervertebral discs act as cushions so that your back is flexible and can "flow" when we are moving.

The spinal cord is a channel in the spine, spinal canal (spinal canal), protected by bone tissue and cerebrospinal fluid (CSF really, cerebral meaning brain) is the aqueous fluid surrounding the spinal cord. From the spinal cord, nerves that make up the nerve supply to the body below the head (see illustration). The nerves are in pairs, one right and one left, corresponding to each level of the spine.

Spinal fluid
Cerebrospinal fluid (CSV) is a clear, colorless liquid that forms inside the brain cavity (see drawing of cerebral below). Daily manufactured approx. 500 ml CSF, but at any given time there are only 120 to 150 ml of fluid in the system by an adult. CSV circulates slowly from the ventricle and into the space around the brain and spinal cord.

The fluid acts as a hydraulic shock absorber so shaken by strikes and blows to the head are muted, and serious damage to the brain and spinal cord avoided. In addition, CSV to control the pressure inside the skull, the supply of nutrients to the nervous tissue and removes waste products.

CSV has a different chemical composition than the blood fluid (plasma). Illness may change the composition of CSV. For example, red and white blood cells come into CSV due respectively bleeding and meningitis.

There is no direct connection between blood and CSV. Blood-brain barrier represents the control and filtration goes with substances in blood plasma before going over to CSV and on to the brain.

What is lumbar puncture?
As part of the study of disorders of the central nervous system has sometimes necessary to drain off some of the cerebrospinal fluid. This is achieved by a lumbar puncture. A needle is inserted then inserted between the vertebrae and into the space around the spinal cord where the spinal fluid is. Spinal fluid can then be drained.

Typically, the insertion site of lumbar, or what in technical terms is called lumbaldelen, hence the name lumbar puncture (puncture means to prick, puncture).

What examined?
At lumbar puncture can measure the pressure in the spinal fluid. Man inspecting appearance - CSV should be crystal clear and colorless. By chemical methods analyze the content, and you can microscope to look for cells.

When done lumbar puncture?
In connection with the diagnosis of conditions such as meningitis , cerebral hemorrhage ( SAH ), cancer of the central nervous system and multiple sclerosis usually performed lumbar puncture. In some cases, lumbar puncture is done to introduce anesthesia ( spinal anesthesia and epidural anesthesia ), drugs or contrast agents in conjunction with X-ray examination of the spinal cord ( myelography ).

Lumbar puncture
Before the doctor stick you in the back, he or she will look into the eye scratch yours. At high pressure in the cerebrospinal fluid could give the typical changes in the eye bottom. Make such findings, your doctor may refrain from performing lumalpunksjon.

The puncture is on the side with his back bent well. The site at washed and cleaned thoroughly to prevent bacteria are introduced into the spinal canal. The doctor will then cause the thin and long needle inserted through the skin between two vertebrae and into the spinal canal. CSV will trickle out of the needle when it is in place in the spinal space. It can relieve the discomfort of breathing deeply associated with stings no.

Sometimes the doctor does not hit right at the insertion of the needle, and that it should be pierced. In connection with this, you can experience lancinating pains down in one leg. Then the doctor stuck a nerve. At the doctor then pull the needle back a little, the needle will be where it should.

When sufficient CSV is taken out, pull the needle out.

After lumbar puncture
After lumbar puncture can be instructed to lie flat on your back or stomach for 4-8 hours. You may want to turn from side to side while the body is held horizontally. The reason you have to lie flat, that you otherwise may have severe headache. Drinking plenty can be helpful, it also prevents headaches. However, new information suggests that it is unnecessary to lie after lumbar puncture.

Side effects of lumbar puncture
After experiencing lumbar puncture every 3 to 4 person headache. It is caused by leakage of cerebrospinal fluid through the hole in the sleeve around the spinal space (dura). The headache usually occurs first a day after the procedure, and it is diffuse and may be accompanied by malaise and dizziness. The headache worsens in portrait and improved in the supine position. The symptoms will return by itself within a few days. If necessary, take painkillers. Exceptionally, doctors must close the hole by inject some of your own blood into the cavity.

Back pain may occur at the injection site. The pain can be treated with anti-inflammatory agent.

Neck & back stiffness can occur with spinal blodtilblanding in the room, but does not require any special treatment.

Other serious complications are very rare.

Printed in CSV can by blockages in CSV system increase.

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