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You are performing a spinal for a cesarean delivery through a midline approach. The needle should pass through all of the following structures prior to CSF EXCEPT

A. Posterior longitudinal ligament
B. Ligamentum fl avum
C. Supraspinous ligament
D. Intraspinous ligament
E. Dura mater

User TiansHUo
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Final answer:

During a spinal anesthesia for a cesarean delivery, using a midline approach, the needle does not pass through the supraspinous ligament, as it is not in the needle's path to reach the CSF.

Step-by-step explanation:

When performing a spinal anesthesia for a cesarean delivery through a midline approach, the needle will pass through several structures before reaching the cerebrospinal fluid (CSF). The structures that the needle passes through include the ligamentum flavum, the dura mater, and the posterior longitudinal ligament. However, the needle will not pass through the supraspinous ligament, which is located on the posterior side of the vertebral column and interconnects the spinous processes of the thoracic and lumbar vertebrae. Nor will it pass through the intraspinous ligament which connects adjoining spinous processes of the vertebrae. Both the supraspinous and intraspinous ligaments serve to support the vertebral column during forward bending motions but are not located within the trajectory of a midline approach for a lumbar puncture.

User Sen
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