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Multiple Choice
At which vertebral level is a spinal tap (lumbar puncture) typically performed to avoid injury to the spinal cord?
A
Between L1 and L2 vertebrae
B
Between L3 and L4 vertebrae
C
Between T12 and L1 vertebrae
D
Between C7 and T1 vertebrae
Verified step by step guidance
1
Understand the anatomy of the spinal cord: The spinal cord typically ends at the level of L1-L2 in adults, forming the conus medullaris. Below this level, the cauda equina (a bundle of nerve roots) occupies the vertebral canal, reducing the risk of spinal cord injury during a lumbar puncture.
Identify the purpose of a spinal tap: A lumbar puncture is performed to collect cerebrospinal fluid (CSF) for diagnostic purposes or to administer medications. It is crucial to avoid puncturing the spinal cord, which is why the procedure is done below its termination point.
Determine the safest vertebral level: The procedure is typically performed between the L3 and L4 vertebrae or sometimes between L4 and L5. These levels are below the termination of the spinal cord, ensuring safety.
Locate the anatomical landmarks: The L3-L4 interspace can be identified by palpating the iliac crests (the top of the hip bones) and drawing an imaginary horizontal line between them. This line usually intersects the L4 vertebra, helping to locate the appropriate site for the puncture.
Understand why other options are incorrect: Performing a spinal tap at levels such as T12-L1 or C7-T1 would risk injury to the spinal cord, as these levels are above its termination point. The L1-L2 level is also avoided because the spinal cord ends here, making it less safe than the L3-L4 level.