BT_RA 1.7 Describe the midline and paramedian approaches to the sub-arachnoid space and epidural space

BT_RA 1.17

Beyond listing the structures you (hopefully) traverse with a spinal needle, it’s not easy to chase down a few facts about this topic without going to the literature, and even that is sparse.

the paramedian approach avoids the ligamentum flavum    T/F

the paramedian approach avoids the interspinous ligament   T/F

the paramedian approach is made more difficult by calcification in the supraspinous ligament   T/F

the first pass success rate of a median approach is greater than that of a paramedian approach in the elderly     T/F

the first pass success rate of a median approach is greater than that of a paramedian approach in younger patients    T/F

SS_OB 1.7

SS_OB 1.7 Describe the changes in the anatomy of the maternal vertebral column, the spinal cord and meninges relevant to the performance of a central neuraxial block including epidural, spinal and combined spinal-epidural, with appropriate surface markings

 

TRUE/FALSE  The risk of inadvertent venous puncture, with epidural placement in pregnant women, is the same as in the non-pregnant population

TRUE/FALSE  The line joining the iliac crests (Tuffier’s line) may transverse the body of L5 in late pregnancy

TRUE/FALSE  Epidural space pressure may be positive during labour

TRUE/FALSE  Epidural veins are engorged in late pregnancy

TRUE/FALSE   The ligamentum flavum softens during pregancy