The outcome shows the risk of a potentially fatal spontaneous cerebral hemorrhage. a range of 10,000 to 14,500 mm3 platelets (p. 505).
Immune thrombocytopenia (ITP) patients might have a variety of bleeding symptoms, from minor skin bruising to potentially fatal cerebral hemorrhage (ICH). When the hemoglobin concentration is greater than 30 × 109/L, severe bleeding is rare and only really happens when it drops below 10 × 109/L.
Blood loss from the brain parenchyma is known as spontaneous intracerebral hemorrhage (sICH), which is twice as common but just as lethal as subarachnoid hemorrhage.
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a nurse cares for a client with anemia after having a total gastrectomy a year ago. which unique assessment findings will the nurse likely find when assessing this client that may not be present in another client with anemia? select all that apply.
The type of anemia that is associated with gastrectomy that is the problems dealing with the gastric intestinal tract is iron deficiency anemia which deals with the deficiency of vitamin B12.
What is the major cause of anemia ?The major cause of anemia is the diet imbalance along with some serious health issues dealing with the malfunctioning of RBC structures and functions which have an improper mechanism.
The nurse will have to take the assessment for megaloblastic anemia which deals with the deficiency of vitamin B12 that is the concern that when a person undergoes gastrectomy.
In this case the person is prone to face the deficiency of the vitamin B12 leading to anemia thus the assessment for the total blood count (CTC) will help to find the actual patient report and vary from other patients.
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which condition would the nurse advise a patient with raynaud disease to avoid to prevent vasospastic attacks
Cold exposure and emotional stress condition would the nurse advise a patient with raynaud disease to avoid to prevent vasospastic attacks.
Vasospastic illnesses are conditions where blood flow is constrained as a result of spasms in small blood vessels near to the skin's surface. This can be referred to as vasoconstriction by your doctor. Usually, it's only momentary. A classic vasospastic disorder is Raynaud's syndrome, which affects the hands and feet and makes them feel cold.
When it's chilly outside, the body reduces blood flow to the skin. This acts as a thermoregulatory system to keep the body's core temperature stable and prevent further heat loss. When under stress or in cold weather, Raynaud's phenomenon causes restricted blood flow. In Raynaud syndrome, the cutaneous arterioles and digital arteries in particular experience vasoconstriction.
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which immunization protocol would the nurse follow when administering a hepatitis b vaccine to an infant whose mother is diagnosed hbsag postitive during pregnancy
Once they are physiologically stable, ideally within 12 hours of birth, infants born to HBsAg-positive mothers should receive HBIG (0.5 mL) intramuscularly (IM).
How is HBsAg positivity treated during pregnancy?Reducing the rates of vertical transmission is the major objective of antiviral therapy in pregnant patients. In the case of HBsAg-positive mothers, immunoprophylaxis with HBIG and HBV immunisation shortly following birth has been employed, followed by the completion of the vaccination series.
Can a pregnant woman receive the hepatitis B vaccine?There are no known side effects for the growing foetus from the vaccine. For women who are expecting, the hepatitis B vaccine is advised.
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the clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). what are the general contraindications associated with receiving a live virus vaccine? select all that apply.
The general contraindications associated with receiving a live virus vaccine include the child having a previous anaphylactic reaction to the vaccine and the child having a disorder that caused a severely deficient immune system (Options b and e).
What is an anaphylactic reaction to a vaccine?An anaphylactic reaction to a vaccine refers to any adverse reaction as a consequence of some of its components which generally involve the presence of inactivated proteins of the pathogenic microorganism.
Therefore, with this data, we can see that an anaphylactic reaction to a vaccine may be harmful and therefore it should have into account during administration.
Complete question:
The clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). What are the general contraindications associated with receiving a live virus vaccine? Select all that apply.
a) The child has symptoms of a cold.
b) The child had a previous anaphylactic reaction to the vaccine.
c) The mother reports that the child is having intermittent episodes of diarrhea.
d) The mother reports that the child has not had an appetite and has been fussy.
e) The child has a disorder that caused a severely deficient immune system.
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jessica is 16, single, and a mother of a 3-month-old baby girl. she has been provided weekly visits by a nurse who comes to her place of residence. the nurse gives advice to jessica about the care of her child, infant development, and the importance of proper nutrition. what type of delinquency prevention is home visitation within this scenario? group of answer choices secondary prevention primary prevention risk prevention tertiary prevention
In this case, home visits are a primary prevention method of preventing delinquency.
Can nurses become doctors?Can a nurse practice medicine? Without a doubt, an RN can become a physician. By obtaining a Bachelor's degree and going to medical school like any other student, they can obtain a MD or DO. Or, a registered nurse (RN) could get a doctor in pharmacy (DNP), which is a degree in education and does not provide clinical authority.
Is nursing difficult to study?There is a great deal of material to study, the exams are difficult, the schedules are convoluted, and the projects keep coming in. As a student, all of these things may make life challenging for you. From the minute you start the application form until you get hired, the field of nursing is extremely competitive.
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the nurse is preparing to administer an intramuscular injection of vitamin k to a newborn. the nurse will ensure the amount per injection is within which range?
The nurse is preparing to administer an intramuscular injection of vitamin k to a newborn. the nurse will ensure the amount per injection is within 0.5 mg to 1.0 mg.
Why do newborn get vitamin k shot?
We can get vitamin K from foods such as green leafy vegetables, and lettuce. Vitamin K is essential for wounds to clot and heal, otherwise, bleeding would not stop in an event an individual sustains injury.
A newborn also needs vitamin K as they don't have the required amount of the vitamin. Few hours after being born, newborn should be administered a recommended dose of vitamin K so as to protect and prevent them from developing Vitamin K deficiency bleeding where their bleeding don't clot and might lead to death if bleeding becomes severe.
In summary, the nurse should give an intramuscular injection of vitamin k, within the range of 0.5 mg to 1.0 mg to all new born. This injection can be given on the thigh of the new born
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a client admitted with hypertensive crisis has an intravenous (iv) infusion of 1000 ml of normal saline with 20 meq of potassium chloride added. a prescription is written to administer sodium nitroprusside by continuous iv infusion. the nurse should plan to do which to administer this medication?
Protect the sodium nitroprusside from light with an opaque material.
After beta blocking, a vasodilator like intravenous nitroglycerin or nitroprusside may be used if the blood pressure still remains high. In a hypertensive emergency with acute pulmonary edema, intravenous nitroglycerin, clevidipine, or nitroprusside are the preferred medications (1,2,5).
For patients going through a hypertensive crisis, an IV drip of combined alpha- and beta-blockers is administered. If the patient is at danger for heart failure, they might be prescribed for outpatient high blood pressure use.
Due to the fact that there are two patients involved, preeclampsia is a hypertensive emergency that is extremely unpleasant and challenging to manage. Magnesium sulfate is the first-line treatment, which is given as a 4–6 g loading dose followed by a 1–2 g/hour infusion.
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the nurse is performing a physical assessment of a 3-year-old girl. what finding would be a concern for the nurse?
The 3-year-old female will most certainly have a webbed neck and small stature, according to the nurse.Turner syndrome is a disorder that primarily affects females and is brought on by an X chromosome that is absent or partially deleted.
Turner syndrome can result in a wide range of physical and developmental problems, such as short stature, inability of the ovaries to mature, and heart defects.The prognosis, or outlook, for women with Turner syndrome (TS), is often positive.The life expectancy of women with Turner syndrome may be slightly decreased, despite the fact that they should anticipate leading essentially normal lives provided their abnormalities are identified and addressed.A 3-year-old customer is having a physical examination done by the nurse. The kid starts kicking and crying during the evaluation. This child is behaving out, according to the nurse.In an organised examination known as a physical assessment, the nurse gets a full understanding of the patient. A physical assessment uses the four procedures of inspection, palpation, percussion, and auscultation.Important vital signs including temperature, blood pressure, and heart rate are measured during a physical examination.
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a nurse is requesting to receive the change-of-shift report at the bedside of each client. the nurse giving the report asks about the purpose of giving it at the bedside. which response by the nurse receiving the report is most appropriate?
It will allow for us to see the client and possibly increase client participation in care that response by the nurse receiving the report .
What is report?A report is a document that presents information in an organized form for a specific audience and purpose. Although summaries of reports may be presented orally, full reports are almost always written documents.
Types of External Reports
External Reports. Information reports. long reports. Official reports.Reports are prepared to present and discuss research results. They provide the reader with the rationale for the study, description of the method used, findings, results, logical discussion and conclusions recommendations.
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which intervention would be most important when caring for the client with breech presentation confirmed by ultrasound?
Keeping an eye on the state of the mother and fetus is most important when caring for a client with breech presentation confirmed by ultrasound.
A fetus lying in a longitudinal position with the buttocks or feet closest to the cervix is referred to as breech presentation. Prematurity, uterine malformations or fibroids, polyhydramnios, placenta previa, fetal abnormalities (such as CNS malformations, neck masses, and aneuploidy), and multiple gestations are all risk factors for breech presentation. If the fetal heart is auscultated higher on the mother's abdomen, a breech presentation can be suspected. As a result, it's critical to keep an eye on both the mother and the fetus.
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what is the main benefit of interval training? select one: a. compared to continuous exercise, it allows for higher exercise intensities. b. it requires a lot of specialized equipment. c. it improves speed by stretching muscles immediately prior to a ballistic movement, like jumping. d. it introduces variety into a training program by combining many modes of exercise.
The main benefit of interval training is : compared to continuous exercise, it allows for higher exercise intensities.
A kind of exercise known as interval training comprises a sequence of high-intensity sessions separated by rest or relaxation intervals. While the recovery intervals entail low-intensity activity, the high-intensity phases are often at or near anaerobic exercise.
Exercises that last anything from a few seconds to several minutes are done repeatedly as part of interval training. You engage in a specified amount of time or distance of work (the work interval) and then a low-intensity rest phase during each interval (recovery interval).
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a patient diagnosed with schizophrenia has taken a conventional antipsychotic medication for a year. hallucinations are less intrusive, but the patient continues to have apathy, poverty of thought, and social isolation. the nurse would expect a change to which medication?
Mood stabilisers, including lithium and anticonvulsants such as carbamazepine are a much expected change in medication of schizophrenia.
What is schizophrenia?
Schizophrenia is a severe mental illness in which reality is perceived by sufferers strangely. Schizophrenia may include hallucinations, delusions, and severely irrational thinking and behaviour, which can make it difficult to go about daily activities and be incapacitating.
Schizophrenia patients require ongoing care. Early intervention may help keep symptoms under control before major issues arise and may enhance the prognosis in the long run.
Over time, symptoms might change in nature and degree, with periods when they get worse and times when they go away. Some symptoms could be present at all times.
Schizophrenia symptoms in men often appear between the ages of 20 and 30. The typical onset of symptoms in women is in their late 20s. Schizophrenia is rarely diagnosed in children and even less frequently in people over the age of 45.
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why is a false positive more significant in hiv testing of patients than in screening donated blood for transfusions?
When a person receives HIV positive blood products, such as tissue or organs, HIV can be transmitted. To prevent this from happening, all of these products are tested before usage.The answer is true.
Additionally, since sterile, clean needles are used, it is impossible to contract HIV when giving blood. the response is accurate.Phlebotomists are the medical professionals in charge of drawing blood samples for testing; occasionally, biochemists will also draw blood, but only when necessary. Blood drawing is a skill that doctors and nurses have also been trained in, but the phlebotomist is the specialist in charge of this.It would be more prudent to choose patient B if you had to choose between the two.All viral replication in the HIV case takes place in lymphoid tissue. If a person who has recently received a blood transfusion and is experiencing blood loss is subsequently injected with fresh blood, it will put them at risk for a number of issues.
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the nurse is caring for a client prior to surgery. the surgeon has prescribed a preoperative nasal swab for the client for staphylococcus aureus. in addition to the nasal mucosa, staphylococcus aureus can also be colonized in what other areas of the body? select all that apply.
Other bodily parts, such as the perineum, naval, and hairline, may also harbor Staphylococcus aureus colonies. On human skin, in the nose, armpit, groin, and other places, Staphylococcus aureus, sometimes known as "staph," is a kind of bacteria.
S. aureus has long been acknowledged as one of the most significant bacteria that harm humans. It is the main contributor to cellulitis, abscesses (boils), and other soft tissue diseases. S. aureus can cause serious infections such as bloodstream infections, pneumonia, or infections of the bones and joints, even though the majority of staph infections are not dangerous.
In most cases, an infection can be prevented by the skin and mucous membranes. But if these defenses are broken down, Infection caused by aureus may spread to deeper tissues or the circulation.
So, it is possible for other body parts, like the perineum, naval, and hairline, to harbor Staphylococcus aureus colonies.
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the nurse monitoring a client receiving insulin glulisine notices the client has become confused, diaphoretic, and nauseated; and has a blood glucose of 60 mg/dl. which emergent treatment would the nurse most likely give? select all that apply.
Orange juice or other fruit juice, glucose tablets, or hard candy are the emergency treatments for the client who has been confused, diaphoretic, and nauseous and has a blood glucose level of 60 mg/dl.
The best course of action is to provide an instantaneous source of glucose as the blood glucose level becomes less than 70 mg/dl.
When the amount of blood sugar in the blood is too low, hypoglycemia develops. It is also known as an insulin response or an insulin shock.
Low blood sugar is defined as less than 70 mg/dL. Check your blood sugar levels if you suspect a low. Treat it now if you are unable to inspect it first. Low blood sugar should always be addressed right away since leaving it unattended might be harmful.
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a client has difficulty swallowing secondary to multiple sclerosis. the otr manually assists the client in performing a chin tuck prior to the client swallowing a bite of food. what is the primary benefit of facilitating this position?
The primary benefit of facilitating the given position is c)To prevent food and secretions from entering the larynx below the level of the vocal cords. So, the correct option is c.
Swallowing can be difficult if you also have multiple sclerosis (MS). Because the condition affects the muscle strength and motor coordination—both of which are actually involved in swallowing—you may experience discomfort or distress while eating or drinking.
Specific symptoms of dysphagia or Swallowing can vary and may include:
Excessive saliva or droolingDifficulty chewingInability to move food to the back of your mouthHence, the correct option is c.
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a deficiency of thiamin that affects the cardiovascular, muscular, nervous, and gastrointestinal systems is called .
Beriberi is a thiamin deficit that impacts the gastrointestinal, neurological, muscular, and cardiovascular systems.
What is the benefit of thiamin?One of the B vitamins is thiamine, sometimes referred to as micronutrients or vitamin B1. To maintain a healthy neurological system, thiamine aids in the conversion of food into energy. Thiamine cannot be produced by your body. But typically, you can receive what you need from eating.
What results from thiamin deficiency?They include lethargy, irritability, amnesia, decreased appetite, trouble sleeping, abdominal discomfort, and weight loss. Problems with the heart, brains, and nerves may eventually show up as a result of a severe thiamin deficiency (beriberi). Various beriberi strains cause different symptoms.
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the nurse has created a care plan for a client admitted with acute pericarditis and a nursing diagnosis of acute pain related to pericardial inflammation. what is an appropriate nursing intervention for this client?
The appropriate nursing intervention for this client is placing the patient in the high-Fowler's position with an over-the-bed table for the patient to lean on.
What is acute pericarditis and how this cause a acute pain?Pericarditis is an inflammation of the tissues that surround the heart, called the pericardium, this can result in a spillage of the fluid found in the membrane or in a hardening of the membrane, pressing on the heart, restricting its pumping.
Among the symptoms of acute pericarditis we find a sharp pain in the central part of the thorax that can radiate to the back, for this reason it is advisable to put the patient in high-Fowler's position which will help relax the muscles and will allow the patient to breathe more normally.
Therefore, we can confirm that the correct option is 4. Placing the patient in the high-Fowler's position with an over-the-bed table for the patient to lean on.
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The nurse has created a care plan for a client admitted with acute pericarditis and a nursing diagnosis of acute pain related to pericardial inflammation. What is an appropriate nursing intervention for this client?
1- Administering around-the-clock opioids as prescribed
2- Promoting progressive relaxation techniques with the use of slow, deep breathing
3- Positioning the patient on the right side with the head of the bed elevated 15 degrees
4- Placing the patient in the high-Fowler's position with an over-the-bed table for the patient to lean on
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intravenous (iv) fluids have been infusing at 100 ml/hour via a central line catheter in the right internal jugular for approximately 24 hours to increase urine output and maintain the client's blood pressure. upon entering the client's room, the nurse notes that the client is breathing rapidly and coughing. for which additional signs of a complication should the nurse assess based on the previously known data?
The additional signs of complication which the nurse should assess based on the previously known data is crackles in the lungs and is denoted as option 2.
What is Lungs?This is referred to as a pair of organs which are present in the chest region and function in terms of respiratory activities in the body system.
In this scenario, we were told that the nurse notes that the client is breathing rapidly and coughing which means that respiration isn't at an optimal rate. This may be most likely caused by a problem with the lungs which may be presence of crackles.
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The options are;
1. Excessive bleeding
2. Crackles in the lungs
3. Incompatibility of the infusion
4. Chest pain radiating to the left arm
an angry client has just thrown a chair across the room and is racing to pick up another chair to throw. the most appropriate action by the nurse would be what?
Anger can be managed in a healthy and appropriate way by verbally expressing one's sentiments. Isolation and catharsis might make people feel more enraged and resentful.
Which of the following concerns nurses should be mindful of while dealing with angry, hostile, or violent clients?The practise of assertive communication and conflict resolution by nurses requires them to be conscious of their own thoughts regarding anger.
What should you do if a patient is ranting and upset with you?Keep your composure and act professionally if a patient becomes so enraged as to verbally abuse you. Keep your distance from the patient and hold off responding until the verbal assault is ended. When it does, call and speak softly.
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a nurse sees a pregnant client at the clinic. the client is close to her due date. during the visit the nurse would emphasize that the client get evaluated quickly should her membranes rupture spontaneously based on the understanding of which possibility?
During the visit the nurse would emphasize that the client get evaluated quickly should her membranes rupture spontaneously based on the understanding of the possibility of contractions.
Who is a Nurse?This is referred to as a healthcare professional who is specially trained in the care of sick and infirmed individuals and also ensures that adequate recovery is achieved to prevent various types of complications.
A pregnant woman has to be evaluated quickly when her membranes rupture spontaneously and it is based on the understanding of the possibility of contractions which is an important occurrence during the birth of a child.
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trained professionals that can help you set reasonable physical activity goals based upon your current level of fitness are called multiple choice gym trainers. sports dietitians. health coaches. life coaches.
a client is unhappy with the health care provided and informs the nurse that the client is leaving the facility. the client has not been discharged by the health care provider. the nurse finds that the client has dressed and is ready to go. what should the nurse's action be in this situation?
The nurse should call the nursing supervisor and inform her about the situation.
With their oversight of patient-care operations, assignment and supervision of staff nurses, and identification and implementation of quality improvements, nursing supervisors serve as a vital connection between hospital management and clinical care.
The most significant duties and responsibilities of a Nursing Supervisor are listed in this sample job description. This job description template for a nursing supervisor is editable and prepared for job boards. Use this sample job description for a nursing supervisor to save time, find eligible applicants, and select the top prospects.
A nursing supervisor is a healthcare professional with expertise in leading and managing a nursing team to establish and uphold a high standard of patient care.
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clsi (clinical and laboratory standards institute) standards are often used to monitor processes during activities for:
CLSI(clinical and laboratory standards institute) standards are often used to monitor processes during activities for clinically and laboratory testing used within the healthcare community.
CLSI ensures assure accuracy, adopt efficient protocols and minimise risk of contamination. CLSI is a procedure for collection of blood specimen. A document remarkably improve quality althrough various steps for collecting blood specimens. tourniquet application time should be verified by all quality laboratory manages. The procedure for collecting blood specimen should be revised to eliminate the source of laboratory variability and quality. Thirty skilled phlebotomist were trained with the CLSI. In the quality improvement and safety of the patients has been the focus of the national and international initiatives.
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a nurse is assessing a client admitted with deep partial-thickness and full-thickness burns on the face, arms, and chest. which finding indicates a potential problem?
The potential problem from which the patient might be suffering from due to full thickness burns could be that urine output of less than 20 ml/hour in a client with burns indicates a deficient fluid volume.
Deep partial thickness burns are the second degree burns in a patient which are mainly in the topmost layer that is the epidermis and the lower layer which is the dermal layer. Full thickness burns are more painful as it damages all the underlying layer extending from the topmost layer. It also damages the nerves present beneath the skin. A patient who is suffering from such burns might be unable to get proper rectal temperature and may suffer from fluid deficiency because the related internal organ system could be damaged which would make it difficult for the body to retain proper fluid quantity.
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Refer to complete question for reference below:
A nurse is assessing a client admitted with deep partial-thickness and full-thickness burns on the face, arms, and chest. Which finding indicates a potential problem?
A. Partial pressure of arterial oxygen (PaO2) value of 80 mm Hg
B. Urine output of 20 ml/hour
C. White pulmonary secretions
D. Rectal temperature of 100.6° F (38° C)
brent is obese and has tried multiple times to implement lifestyle changes to lose weight. he has had some success, but the behaviors never last for very long and he returns to his original weight, which is a serious health risk. he is a good candidate for
Brent is obese and has tried multiple times to implement lifestyle changes to lose weight but the behaviors never last for very long and he returns to his original weight, which is a serious health risk so he is a good candidate for obesity.
Obesity is a advanced illness involving associate excessive quantity of body fat. fatness is not only a cosmetic concern. It is a serious health risk that will increase the chance of alternative diseases and health issues, like cardiovascular disease, diabetes, high vital sign and bound cancers.
The best way treat obesity is to eat a healthy, reduced-calorie diet and exercise often. to try to to this you should: eat a balanced, calorie-controlled diet as counseled by your physician or weight loss management professional person (such as a dietitian) be part of a weight loss cluster.
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the nurse is caring for a patient in a shock state. after reviewing the daily orders for the patient, the nurse notes that electrolyte levels have not been ordered. for which critical electrolyte imbalance should the nurse closely monitor this patient?
Hypokalemia is a critical electrolyte imbalance should the nurse closely monitor this patient.
A state of cellular and tissue hypoxia known as a shock is caused by either inadequate oxygen utilization, decreased oxygen delivery, increased oxygen consumption, or a combination of these processes.
Hypokalemia is a result of the body compensating for renal hypoperfusion by initiating the release of aldosterone. it is likely to result from the body compensating for renal hypoperfusion and initiating the renin-angiotensin-aldosterone system. This results in water retention in exchange for potassium loss, which causes hypokalemia. Hypokalemia can cause a variety of other problems in the body, so the nurse should monitor this condition closely so that early intervention can take place.
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a nurse is preparing a presentation for a local community group of older adults about colon cancer. what would the nurse include as the primary characteristic associated with this disorder?
A nurse is preparing a presentation for a local community group of older adults about colon cancer. Abdominal pain.
Cancer of the colon is a fairly treatable and often curable disorder whilst localized to the bowel. surgical treatment is the number one shape of remedy and effects in remedy in approximately 50% of the sufferers. Recurrence following surgical treatment is a chief trouble and is often the last motive of demise.
Colon most cancers is considered a silent disease. maximum of the time there aren't any signs. The signs and symptoms that people may also experience encompass a exchange in bowel conduct, stomach pain, blood inside the stool, and weight loss. If individuals have those signs, the disease may already have advanced.
Colorectal most cancers can occur in teenagers and teens, but the majority of colorectal cancers occur in humans older than 50. For colon cancer, the average age on the time of prognosis for men is 68 and for women is 72. For rectal cancer, it is age 63 for each men and women.
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when reviewing a newly admitted client's previous medication record, the nurse notes that the client has previously been treated with aprepitant. the nurse is justified in suspecting that this client's medical history includes which therapy/treatment?
When used with other medications, aprepitant capsules and oral suspension work to reduce the possibility of nausea and vomiting during cancer treatment (chemotherapy). Additionally, aprepitant capsules are used to stop post-operative nausea and vomiting.
What is treated with aprepitant in medication?Only preventing nausea and vomiting is how aprepitant functions. If you already experience these symptoms, don't start taking aprepitant; instead, call your doctor.
Therefore, Aprepitant is typically only taken for the first three days of the chemotherapy treatment cycles when used to reduce nausea and vomiting brought on by cancer chemotherapy.
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the ____ is composed of the external shaft and glans and the internal crura.
The cli-toris is composed of the external shaft and glans and the internal crura.
The cli-toris is a feminine reproductive organ gift in mammals, ostriches and a restricted range of different animals. In humans, the visible portion – the glans – is at the front junction of the labium (inner lips), on top of the gap of the channel.
Crura are huge crossed fibres, known as limb cerebri, kind the center neural structure peduncle and function the bridge that connects every neural structure with the alternative half the neural structure. The crura arise from the anterior surface of the body part bone bodies and therefore the anterior longitudinal ligament from L1 through L3 and insert on the central connective tissue. It's longer on the proper facet.
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