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Retired NBME 16 Answers

nbme16/Block 2/Question#16 (reveal difficulty score)
A 56-year-old man is scheduled for repair of ...
Ligamentum flavum ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1781)
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This is anesthesia being given via lumbar puncture. [FA2020 p507]

The needle will pass through the supraspinous ligament, intraspinous ligament, and ligamentum flavum before entering the epidural space.

The anterior longitudinal ligament is on the anterior side of the spinal cord. The costotransverse would not be punctured. Image of the anterior longitudinal and costotransverse spinal ligaments here.

The denticulate ligament is what holds the pia mater to the dura mater. Since this is likely epidural anesthesia it would not be punctured.

The posterior longitudinal ligament is on the posterior portion of the vertebral body but is anterior to the spinal cord, and thus would not be punctured.

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nbmeanswersownersucks  also to add to this, the costotransverse ligaments are only present in the thorax because they run between the rib and the transverse process. Epidurals occur in the lumbar region...and if you have ribs in the lumbar region you've got a big problem on your hands +2



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