Ventricular puncture and drainage

Applied Anatomy: The ventricle system includes symmetrical left and right ventricles located in the cerebral hemispheres on both sides, located in the midline of the cerebral ventricle, a third ventricle communicating with both ventricles through the interventricular foramen, aqueducts in the midbrain, and a cerebellar hemisphere in the posterior cranial fossa The fourth ventricle between the pontine and the medulla oblongata. Ventricle puncture refers only to the puncture of both lateral ventricles. The lateral ventricle is a narrow and longitudinal slit in the cerebral hemispheres on both sides, which is divided into the following parts: Anterior horn (frontal angle): In the frontal lobe, its upper wall and anterior wall are anterior to the corpus callosum, and the outer wall is caudate. Nuclear head, the inner wall is transparent. There is an interventricular foramen (Monro foramen) in the lower part, which communicates with the third ventricle. Body: Horizontal crack, in parietal lobe. The upper wall is the corpus callosum, the inner wall is a transparent septum, and the lower wall is the dome, choroid plexus, dorsal thalamus, terminal lines and caudate nucleus from the inside to the outside. Dorsal angle (occipital angle): It is an extension of the body to the occipital lobe, a longitudinal slit. Morphological variation is large, often small, and sometimes absent. The upper and outer walls are corpus callosum, and the inner wall has two bulges. The upper one is the rear corner kick. Inferior angle (temporal angle): It is located in the temporal lobe. It is a fissure that bends downward, anteriorly and inwardly. The inner edge is the tail and caudate nucleus. The end is connected with the amygdala. , Side vice uplift. The body part, the rear corner, and the lower corner are shifted in a triangle. There is a lateral ventricle choroid plexus in the body and inferior corner, which is continuous with the third ventricle choroid tissue at the interventricular foramen. The choroid plexus is in the triangle of the lateral ventricle. Puncture site: The following are commonly used and sometimes used in the clinic: (1) Anterior puncture: the puncture point is 2.5cm each before the coronary suture and the midline, the puncture direction is parallel to the sagittal plane, and the two external ear canals are supposed to Line, the depth does not exceed 5cm. (2) Puncture of the posterior horn: The puncture point is 5-6cm above the trochanter, 3cm beside the midline, and the puncture direction is aligned with the outer end of the same eyebrow arch, and the depth does not exceed 5-6cm. (3) Lateral puncture: 1 cm above the highest point of the ear when puncturing the lower ventricle of the lateral ventricle, and 4 cm above and behind the outer ear hole when puncturing the triangle. Both needles are inserted vertically with a depth of about 4 to 5 cm. (4) Transorbital puncture: at 0.5cm below the midpoint of the upper edge of the orbit, enter the needle upward 45 ° and inward 15 °, with a depth of about 4-5 cm, and enter the bottom of the anterior horn.