Case 1
A 25-year-old man is brought into the ER with a high fever, lethargy, and a stiff neck.  After taking a history and performing a physical exam, it is strongly suspect that he has meningitis.  In order to find the causative agent, a lumbar puncture is requested by the physician.  Laboratory analysis confirms bacterial growth in the cerebrospinal fluid (CSF).  Appropriate antibiotic therapy is administered and the patient recovers without any complications.
1. Where along the vertebral column is the needle typically inserted in order to perform a lumbar puncture?  Provide an anatomical explanation for your answer.   [3 marks] (About 100 words)
2. Identify an anatomical landmark you could use to identify this level.  [2 marks] (About 50 words)
3. Explain why the needle is inserted in the median plane.   [2 marks] (50 words)
4. In what anatomical position is the patient placed for this procedure.  Explain why this is the case.   [2 marks] (50 words)
5. Following the procedure, the patient complains of a severe headache.  Explain the possible causes for this complication.  [3 marks] (About 100 words)
6. Identify the structures that the needle traverses before entering the lumbar cistern containing the CSF.   [3 marks] (About 100 words)
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