the needle goes between the lumbar vertebrae l3/l4, l4/l5 or l5/s1 for a spinal tap in an adult.
the needle goes between the lumbar vertebrae l3/l4, l4/l5 or l5/s1 for a spinal tap in an adult.
where does the needle go for a spinal tap in an adult?
between the lumbar vertebrae l3/l4, l4/l5 or l5/s1
the person is usually placed on their side (left more commonly than right). the patient bends the neck so the chin is close to the chest, hunches the back, and brings knees toward the chest. this approximates a fetal position as much as possible. patients may also sit on a stool and bend their head and shoulders forward. the area around the lower back is prepared using aseptic technique. once the appropriate location is palpated, local anaesthetic is infiltrated under the skin and then injected along the intended path of the spinal needle. a spinal needle is inserted between the lumbar vertebrae l3/l4, l4/l5 or l5/s1 and pushed in until there is a "give" as it enters the lumbar cistern wherein the ligamentum flavum is housed. the needle is again pushed until there is a second 'give' that indicates the needle is now past the dura mater. the arachnoid membrane and the dura mater exist in flush contact with one another in the living person's spine due to fluid pressure from csf in the subarachnoid space pushing the arachnoid membrane out towards the dura. therefore, once the needle has pierced the dura mater it has also traversed the thinner arachnoid membrane. the needle is then in the subarachnoid space. the stylet from the spinal needle is then withdrawn and drops of cerebrospinal fluid are collected. the opening pressure of the cerebrospinal fluid may be taken during this collection by using a simple column manometer. the procedure is ended by withdrawing the needle while placing pressure on the puncture site. the spinal level is so selected to avoid spinal injuries. in the past, the patient would lie on their back for at least six hours and be monitored for signs of neurological problems. there is no scientific evidence that this provides any benefit. the technique described is almost identical to that used in spinal anesthesia, except that spinal anesthesia is more often done with the patient in a seated position.
lumbar puncture
it became a common insult for a pretentious band to be told they were funnier than spinal tap. as george lynch put it, the more seriously a band took themselves, the more they resembled spinal tap. after seeing a 1986 performance by metal band venom, singer henry rollins compared them to spinal tap. in their respective "behind the music" episodes, quiet riot's rudy sarzo and ratt's robbin crosby compared their own bands to spinal tap to some extent. for example, as a parallel to the "shit sandwich" incident, quiet riot's fourth album "condition critical" was given the two-word review of "condition terminal" by j. d. considine in "musician" magazine. his review of the short-lived band gtr's eponymous debut lp in the same magazine was "sht". r.e.m.'s mike mills described the band's early tours as "very spinal tap", citing, among other things, they had played at a united states air force base.
this is spinal tap