lumbar puncture layers

[MudPhud20XX]

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Kaplan says that these are the layers that a needle passes through during lumbar puncture

1. Skin
2. Superficial fascia
3. Deep fascia
4. Supraspinous ligament
5. Interspinous ligament
6. Interlaminar space
7. Epidural space
8. Dura
9. Arachnoid
10. Subarachnoid space

So how about ligamentum flavum? Why isn't this not included?

Many thanks in advance.

 

[Ismet]

Ligamentum flavum should be included.

 

[scoKraz4]

The 2 pops you should hear are from ligamentum flavum and dura/arachnoid, right?

 

[Bancrofti]

That description by Kaplan sounds to be the midline approach. More common is to go slightly lateral to the midline so that the only two "pops" you should hear are ligamentum flavum and the dura/arachnoid. LF isn't present over the midline so that's why it isn't included in Kaplan description.

 

[Fatalis]

actually had this on nmbe 16 today, yup liga. flav should be there from the lateral approach

 

[MudPhud20XX]

actually had this on nmbe 16 today, yup liga. flav should be there from the lateral approach

Yo Fatalis, now you know why I asked this question LOL! Man it's hard, but now I think I have a good idea what the board is really asking for us to know for step1. Definitely the detail matters! I better start to put my shxx together man.