Examining the Sensory System
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Lower Limbs
Subtitles in English for this video can be displayed by clicking on (first button on the bottom right hand corner of the video). Inspection of the Lower Limbs After positioning the patient on the bed and ensuring adequate exposure, the lower limbs should be inspected as follow: The examiner should stand at the end of the bed and…
Complications
Lumbar punctures (LPs) are relatively safe procedures. However, some of the complications include: Post-lumbar puncture headache This is one of the most common complications after LP and occurs in 10-30% of patients receiving a LP. This is due to leakage of cerebrospinal fluid from the dura and traction on pain-sensitive structures. Patients with post-LP headache…
Contraindications of a Lumbar Puncture
A lumbar puncture (LP) is contraindicated in the following scenarios: Patients with bleeding diathesis, e.g. severe coagulopathy (INR >1.4) and thrombocytopenia (platelet <50 x 109/L). If coagulopathy or thrombocytopenia is not corrected prior to the procedure, spinal hematomas resulting in spinal cord compromise may result. Patients with increased intracranial pressure due to an intracranial lesion…
Performing the Lumbar Puncture (Part 2)
By palpating onto the iliac crest and spinal processes of the back, the site of needle puncture for lumbar puncture (LP) is identified. As the spinal cord ends at the level of L2 in adults, the spinal needle can be inserted safely between the L3/4 or L4/5 levels. The highest point of the iliac crest…
